Associations between diurnal cortisol patterns and lifestyle factors, psychotic symptoms, and neurological deficits: A longitudinal study on patients with chronic schizophrenia
Abstract
The present study examined the relationships between diurnal cortisol patterns and perceived stress, lifestyle factors, psychotic symptoms, neurological deficits, and daily functioning in patients with chronic schizophrenia. The participants were 149 Chinese patients with chronic schizophrenia, who provided salivary cortisol measures upon waking, before lunchtime, and before bedtime at baseline (Time 1). Self-report measures on perceived stress and lifestyle factors such as body-mass index and daily exercise span were recorded at Time 1. Diagnostic assessments on psychotic symptoms, neurological deficits, and daily functioning were made at Time 1 and Time 2 (3 months later). Latent growth modeling and path modeling analysis were performed to investigate the diurnal cortisol patterns and the relationships with the study variables, respectively. Greater perceived stress and body-mass index and less physical activity were significantly linked to reduced cortisol decline. Reduced cortisol decline at Time 1 significantly predicted greater psychotic (positive and negative) symptoms and more severe neurological deficits in motor coordination and sequencing of complex motor acts at Time 2. The present results contribute to a better understanding of the diurnal cortisol patterns among chronic schizophrenia patients and the associations with lifestyle factors, psychotic symptoms, and neurological deficits. The findings lend support to the neural diathesis-stress model and suggest that hypothalamic-pituitary-adrenal axis may potentially mediate the effects of lifestyle factors on psychotic symptoms and neurological deficits.
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Altered regulation of the HPA axis in schizophrenia is predictive of more severe psychotic and motor symptoms.
“Furthermore, altered regulation of the HPA axis in SZ is predictive of more severe psychotic and motor symptoms159,160.”
From Circadian rhythm disruption and mental health (2020) · cites this paper as [159]
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Circadian rhythm disruption and mental health
Walker, W. H., Walton, J. C., DeVries, A. C., & Nelson, R. J. (2020) · Translational Psychiatry · doi:10.1038/s41398-020-0694-0 · Cited by 1,030 · see citing works
- Authors
- Ho, R. T. H., Fong, T. C. T., Wan, A. H. Y., Au-Yeung, F. S. W., Chen, E. Y. H., & Spiegel, D.
- Affiliations
- University of Hong Kong (HK)
- Hong Kong Sheng Kung Hui Welfare Council Limited (HK)
- Stanford Medicine (US)
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2016-10
- Volume
- 81
- Pages
- 16-22
- ISSN
- 0022-3956 (ISSN-L)
- OpenAlex
- W2437127101
- Cited by
- 19
- References
- 46
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 4 · 2018: 2
- FWCI
- 0.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- Funders
- General Research Fund of Shanghai Normal University (GRF/HKU 744912)
- Research Grants Council, University Grants Committee (GRF/HKU 744912)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- chronic schizophrenia, perceived stress, lifestyle factors, body mass index, physical activity, psychotic symptoms, neurological deficit, motor coordination, daily functioning, hypothalamic-pituitary-adrenal axis, salivary cortisol
- MeSH terms
- Adult, Chronic Disease, Circadian Rhythm, Female, Hong Kong, Humans, Hydrocortisone, Life Style, Longitudinal Studies, Male, Middle Aged, Nervous System Diseases, Predictive Value of Tests, Saliva, Schizophrenia, Schizophrenic Psychology, Area Under Curve, Self Report
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