一項來自于《精神病學(xué)研究雜志》(Journal of Psychiatric Research)的研究發(fā)現(xiàn)：未經(jīng)治療的精神疾病臨床高危青少年唾液分泌皮質(zhì)醇濃度明顯高于接受治療者與正常人群,。G Sugranyes 和他的研究團(tuán)隊指出，“這一結(jié)果支持精神疾病高風(fēng)險狀態(tài)患者的下丘腦-垂體-腎上腺軸（HPA）過度激活或（和）神經(jīng)內(nèi)分泌異常這一假說，至少在一部分患者中是這樣的,。”
本研究共納入46位受試者,，其中病例組33例,，均為精神疾病臨床高?；颊撸–HR）,，依據(jù)前驅(qū)癥狀結(jié)構(gòu)式訪談（SIPS）和前驅(qū)癥狀量表（SOPS）評估其精神癥狀（陽性癥狀,、陰性癥狀、情緒和壓力敏感性）,，年齡12~25歲,。對照組13例，為與病例組年齡接匹配的健康志愿者,。
CHR組中,，12例接受5-羥色胺再攝取抑制劑或（和）抗精神病藥物治療，21例未予治療,。所有受試于中午靜坐約30分鐘后,，取唾液標(biāo)本，檢測其皮質(zhì)醇水平,。病例組檢測基線唾液皮質(zhì)醇濃度與精神癥狀之間的關(guān)系及臨床轉(zhuǎn)歸,。
結(jié)果發(fā)現(xiàn)：CHR組患者唾液皮質(zhì)醇水平明顯高于正常對照組（2.05ng/mL v1.44 ng/mL），且未予治療者高于接受精神藥物治療患者（2.31ng/mLv1.59ng/mL）,；CHR組中,，唾液皮質(zhì)醇水平與壓力敏感性有一定相關(guān)趨勢，與陽性癥狀,、陰性癥狀及情緒無明顯相關(guān)性,。
CHR組接受治療、CHR組未予治療及對照組三組的唾液皮質(zhì)醇濃度（ng/mL）比較
G Sugranyes等總結(jié)：“精神疾病藥物治療可以促使CHR患者的HPA軸活性趨于正常,，可以為前驅(qū)癥狀的治療提供干預(yù)方案”,。（生物谷Bioon.com)
doi:10.1016/j.jpsychires.2012.07.011
PMC:
PMID:
HPA-axis function,， symptoms,， and medication exposure in youths at clinical high risk for psychosis
G. Sugranyes, J.L. Thompson
Abstract
Aim
Increased basal cortisol secretion has been associated with heightened clinical risk for psychosis， and among at-risk individuals,， has been variably related to positive and mood symptoms,， as well as clinical outcome.
Methods
Basal salivary cortisol secretion was assessed in 33 patients at clinical high risk (CHR) for psychosis (21 medication-free and 12 taking a serotonin reuptake inhibitor and/or atypical antipsychotic)， and 13 healthy controls. Among the CHR patients,， we also examined associations of basal salivary cortisol with symptoms (positive,， negative， mood,， stress sensitivity) and clinical outcome.
Results
Basal salivary cortisol secretion was significantly higher in CHR patients who were medication-free compared to CHR patients taking medications and to healthy controls. In this small cohort,， basal salivary cortisol secretion was associated at trend level with stress sensitivity， and was not significantly related to other symptoms.
Conclusions
Our finding of elevated basal cortisol secretion in CHR patients supports the premise that excess activation of the HPA axis and/or neuroendocrine abnormalities characterize the psychosis risk state for at least a subset of patients. Our findings further suggest that psychotropic medications may have a normalizing effect on HPA-axis dysfunction in CHR patients,， which could potentially inform intervention strategies for the prodrome.
