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Stress hormone may predict psychosis

Posted on 07-05-16 in Stress

Stress hormone may predict psychosis

If the body had popularity contests, cortisol, a steroid hormone many call the “stress hormone,” would probably come in dead last. Why? High cortisol levels are associated with many diseases, including depressive disorders. Also, long-term cortisol exposure can create many additional health problems.

However, cortisol might play another role: A new study conducted at James Cook University (JCU) in Australia shows cortisol may also provide a window into psychosis.

The low-cortisol link

The researchers from JCU’s Australian Institute of Tropical Health and Medicine combined information from 11 different studies that studied the cortisol awakening response (CAR) in nearly 900 patients who were had first-episode psychosis, schizophrenia, or were at risk for developing psychosis. When compared to healthy control subjects, the patients with psychotic disorders had lower levels of cortisol when they woke up. “We were able to show that patients with psychosis fail to produce cortisol after they wake up in the morning,” said study co-author Maximus Berger, Ph.D., in a JCU press release. “We found this even in patients with recent onset of the illness.”

JCU Associate Professor Zoltan Sarnyai, Ph.D., said in a press release that the study may show cortisol can act as a biomarker for psychosis. “Only some 20 to 30 percent of individuals who are at high risk of developing psychosis due to their clinical presentation or family history actually do so. Identifying those people early is where the cortisol measurement comes in. Biomarkers are very few and far between in psychiatry, so even though a huge amount of work is still needed, this could become a valuable technique.”

Sarnyai also said low CAR levels are an indicator of other chronic diseases and may be a possible predictor of those conditions as well.

It’s not the first study that ties abnormal CAR with psychosis. A study published in Psychological Medicine in 2011 found patients with first-episode psychosis who also had a weaker CAR performed poorly on tests measuring verbal memory and processing speed. Additional studies have shown CAR abnormalities may also predict depression.

What does cortisol do?

When people encounter stressful situations – a shadowy figure in a dark corner, an aggressive dog – their bodies enter an alert state. According to Mayo Clinic, in times of stress the adrenal glands produce a large amount of hormones, including cortisol and adrenaline. While adrenaline increases the heart rate and raises the blood pressure, cortisol increases the amount of glucose in the bloodstream and also helps produce substances that help the body repair itself.

Ordinarily, hormone levels return to normal after the stressful event is over. But if the stress response system stays on for an extended period of time, it can create numerous health issues. According to Mayo Clinic, these issues include:

  • Anxiety and depressive disorders
  • Cognitive impairment
  • Digestive problems
  • Headaches
  • Heart disease
  • Sleep difficulties
  • Weight gain

Although constant exposure to cortisol is bad for the health, low cortisol levels are also harmful to the health.

Adrenal insufficiency

Low cortisol levels can cause a variety of problems. According to the National Institute of Diabetes and Digestive and Kidney Diseases, Addison’s disease, or adrenal insufficiency, results when the adrenal glands do not produce enough cortisol. Symptoms of Addison’s disease include chronic fatigue, weakness, weight loss, nausea and vomiting.

Patients with Addison’s disease can experience acute adrenal crisis. This is a dangerous condition that can result in coma or death and requires immediate treatment.

Ongoing research

Sovereign Health’s Alumni Services acts as a resource for patients who graduate from our programs. We support our graduates by providing support group meetings, life skills courses and keeping our patients informed on the latest developments in the mental health and treatment fields. For more information, contact our 24/7 helpline.

About the author

Brian Moore is a staff writer and graphic designer for the Sovereign Health Group. A 20-year veteran of the newspaper industry, he writes articles and creates graphics across Sovereign’s portfolio of marketing and content products. Brian enjoys music, bicycling and playing the tuba, which’s he’s done with varying degrees of success for over 25 years. For more information and other inquiries about this media, contact the author and designer at