ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 P842 | DOI: 10.1530/endoabs.63.P842

Hypothalamic-pituitary-adrenal axis dysfunction in drug-naive schizophrenic patients

Manel Naifar1, Manel Maalej2, Ahmed Slim Ellouze2, Wassim Guidara1, Khalil Jmal1, Mohamed Maâlej2, Nada Charfi2, Faten Hajkacem3, Mohamed Abid3, Jihen Ben Thabet2 & Fatma Ayadi1


1Biochemistry Laboratory, UR 12ES17, Sfax Medical School, Sfax, Tunisia; 2Psychiatry ‘C’ Department – Hedi Chaker Hospital, Sfax, Tunisia; 3Endocrinology Department, Sfax, Tunisia.


Introduction: Hypothalamic-pituitary-adrenal axis dysfunction (HPA) has been reported in patients with schizophrenia and bipolar disorders but findings are inconsistent and few studies have conducted direct comparaisons of HPA biomarkers in drug native patients. We aimed to assess serum and salivary cortisol in the morning in drug-naive schizophrenic patients compared to controls.

Methods: This was a cross-sectional case-control study conducted between June 2016 and July 2018 on antipsychotic-free schizophrenia patients compared to healthy controls. Patients were hospitalized at the psychiatric C department in Hedi Chaker University Hospital (UH) in Sfax. The diagnosis of schizophrenia was established according to DSM-5 criteria. The symptoms’ severity was evaluated according to the positive and negative syndrome scale. Cognitive functions were evaluated according to the Montreal Cognitive Assessment scale. The analysis of cortisol levels was performed in the laboratory of Biochemistry in Habib Bourguiba UH in Sfax.

Results: This study included 45 patients and 100 male controls. Morning serum cortisol level was significantly higher in schizophrenic patients compared to controls. (140.12±49.79 ng/ml vs 122.70±40.77 ng/ml; P=0.029). There was no significant difference between the two groups regarding salivary cortisol levels. There was a significant and negative correlation between salivary cortisol levels and the severity of negative symptoms. Positive and significant correlations were found between salivary cortisol levels and cognitive functions.

Conclusion: This study allowed better understanding the role of basal cortisol assay in the acute phase of schizophrenia. Further research is needed to improve our knowledge about its role in the different phases of this disorder.