Pituitary gland volume in patients with schizophrenia, subjects at ultra high-risk of developing psychosis and healthy controls: A systematic review and meta-analysis
Abstract
Background A larger pituitary size is thought to reflect a greater activation of the hypothalamic-pituitary-adrenal (HPA) axis, which may be related to an increase in the number and size of corticotroph cells. Some studies, but not all, indicate that pituitary volume increases before or at the onset of psychosis. There is a need for at critical appraisal of the literature on this topic accompanied by a meta-analytical evaluation of the data. Methods We included studies comparing the volume of the pituitary gland in healthy controls and patients with schizophrenia, first episode of psychosis (FEP), schizotypal disorder or ultra high-risk (UHR) subjects. We defined three groups of subjects for the analyses: healthy controls; UHR and schizotypal patients; and patients diagnosed with first episode of psychosis, schizophrenia or schizoaffective disorder. Results Ten studies were included in the meta-analysis. We found a trend of a larger pituitary volume in both UHR subject who had transition to psychosis (p=0.05) and in FEP subjects (p=0.09) compared to healthy controls. There was no difference in pituitary volume between patients with schizophrenia combined with FEP versus healthy controls (p=0.52) or between UHR (with and without transition) and healthy controls (p=0.24). In a regression analysis, we demonstrated that the number of subjects receiving antipsychotics and pituitary volume were positively correlated. As previously reported in other samples, gender also had an impac…
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Larger pituitary volumes were found in first episode psychosis, clinical high risk individuals and those with a family history of psychosis.
“Similarly, larger pituitary volumes were found in first episode psychosis (53, 54), clinical high risk individuals and those with a family history of psychosis (55).”
From Childhood Trauma, the HPA Axis and Psychiatric Illnesses: A Targeted Literature Synthesis (2022) · cites this paper as [53]
Larger pituitary volumes in at-risk groups were found in those who later transition to psychosis.
“Larger volumes in the at risk groups were found in those who later transition to psychosis (53, 56).”
From Childhood Trauma, the HPA Axis and Psychiatric Illnesses: A Targeted Literature Synthesis (2022) · cites this paper as [53]
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“Similarly, larger pituitary volumes were found in first episode psychosis (53, 54), clinical high risk individuals and those with a family history of psychosis (55).”
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- Authors
- Nordholm, D., Krogh, J., Mondelli, V., Dazzan, P., Pariante, C., & Nordentoft, M.
- Affiliations
- University of Copenhagen (DK)
- King's College London (GB)
- Corresponding author
- Nordholm, Dorte
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2013-11
- Volume
- 38
- Issue
- 11
- Pages
- 2394-2404
- ISSN
- 0306-4530 (ISSN-L)
- OpenAlex
- W2086958158
- Cited by
- 67
- References
- 5
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 5 · 2022: 1 · 2021: 2 · 2020: 9 · 2019: 9 · 2018: 10 · 2017: 3 · 2016: 7 · 2015: 11 · 2014: 4
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Lundbeck Foundation
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Keywords
- pituitary gland volume, schizophrenia, clinical high risk for psychosis, first-episode psychosis, schizotypal personality disorder, schizoaffective disorder, hypothalamic-pituitary-adrenal axis, corticotrophs, antipsychotic effects, sex differences, transition to psychosis
- MeSH terms
- Humans, Hypertrophy, Pituitary Gland, Psychotic Disorders, Schizophrenia, Schizotypal Personality Disorder, Sex Characteristics, Antipsychotic Agents, Case-Control Studies
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