정신분열병환자의 우울증상과 불안증상이 Dexamethasone /Corticotropin Releasing Hormone 병합검사 결과에 미치는 영향
The Effect of Depression and Anxiety Symptoms on The Results of Combined Dexamethasone / Corti cotropin-Releasing Hormone Test in Patient s with Schizophrenia
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Purpose: The aim of this research is to determine the effects of depression and anxiety symptoms of schizophrenic psychopathology on the HPA axis. Subject and method: Twenty patients with schizophrenia were included and divided into the medication non-exposed group (n=10) and the medication exposed group (n=10). Evaluated scales were the Positive and Negative Syndrome Scale (PANSS), Scale for the Assessment of Negative Symptoms (SANS), Scale for the Assessment of Positive Symptoms (SAPS), Hamilton Depression Inventory (HAM-D) and Hamilton Anxiety Inventory (HAM-A), and then the combined Dexamethasone/Corticotropin-Releasing Hormone (DEX/CRH) test was conducted to determine the basal level, the peak level and the area under the curve (AUC) of cortisol and adrenocorticotropic hormone (ACTH). Results: When the correlations between each psychopathology and cortisol level or ACTH AUC value were analyzed, HAM-D showed a negative correlation, whereas HAM-A showed a positive correlation. Also, the non-depression group (HAM-D≤18) showed higher cortisol and ACTH concentrations than the depression group (HAM-D>18), and the anxiety group (HAM-A≥14) showed significantly higher concentrations than the non-anxiety group (HAM-D<14) (P<.05). Also, as for the comparison between the medication non-exposed group and the medication exposed group, the non-exposed group showed significantly higher cortisol and ACTH concentration than exposed group (P<.05). Conclusion: This study suggest that anxiety symptoms rather than depression symptoms are related to the increased activity of the HPA axis of schizophrenics.
Abstract
Purpose: The aim of this research is to determine the effects of depression and anxiety symptoms of schizophrenic psychopathology on the HPA axis. Subject and method: Twenty patients with schizophrenia were included and divided into the medication non-exposed group (n=10) and the medication exposed group (n=10). Evaluated scales were the Positive and Negative Syndrome Scale (PANSS), Scale for the Assessment of Negative Symptoms (SANS), Scale for the Assessment of Positive Symptoms (SAPS), Hamilton Depression Inventory (HAM-D) and Hamilton Anxiety Inventory (HAM-A), and then the combined Dexamethasone/Corticotropin-Releasing Hormone (DEX/CRH) test was conducted to determine the basal level, the peak level and the area under the curve (AUC) of cortisol and adrenocorticotropic hormone (ACTH). Results: When the correlations between each psychopathology and cortisol level or ACTH AUC value were analyzed, HAM-D showed a negative correlation, whereas HAM-A showed a positive correlation. Also, the non-depression group (HAM-D≤18) showed higher cortisol and ACTH concentrations than the depression group (HAM-D>18), and the anxiety group (HAM-A≥14) showed significantly higher concentrations than the non-anxiety group (HAM-D<14) (P<.05). Also, as for the comparison between the medication non-exposed group and the medication exposed group, the non-exposed group showed significantly higher cortisol and ACTH concentration than exposed group (P<.05). Conclusion: This study suggest that anxiety symptoms rather than depression symptoms are related to the increased activity of the HPA axis of schizophrenics.
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