Cortisol response  to psychological stress in patients with schizophrenia in the Chinese population

Accumulating evidence suggests that hypothalamic-pituitary-adrenal (HPA) axis dysfunction might play an important role in the pathophysiology of schizophrenia. This study aimed to explore the cortisol response to psychological stress in patients with schizophrenia. In this study, patients with schizophrenia (n = 104) and healthy volunteers (n = 59) were asked to complete psychological stress challenge tasks, which included the Paced Auditory Serial Addition Task and Mirror-Tracing Persistence Task, and then, saliva was collected to measure cortisol levels. Emotions and psychopathology were assessed by the Positive and Negative Affect Schedule (PANAS) and Positive and Negative Syndrome Scale (PANSS). The results showed (1) that the cortisol stress response and negative emotions in patients with schizophrenia differed significantly from those in healthy controls; (2) there were significant interactions between sampling time and diagnosis for saliva cortisol levels; (3) there were significant interactions between scoring time and diagnosis for the negative affect score of the PANAS; and (4) the changes in salivary cortisol levels and negative affect scores before and after the psychological stress challenge tasks were not correlated with clinical symptoms in patients with schizophrenia. These findings indicated that an abnormal cortisol stress response might be a stable biological characteristic of schizophrenia.