Pituitary volume in individuals at elevated risk for psychosis: A systematic review and meta-analysis
Abstract
Background Pituitary volume (PV) abnormalities, representing one of several markers of hypothalamic-pituitary-adrenal (HPA) axis dysregulation, have been observed in psychosis, with variable patterns across illness stages. Typically, enlargements characterise first-episode patients, with reductions observed in those with chronic illness relative to healthy controls. Findings in high-risk populations have been inconsistent, highlighting the need for an updated review of the evidence. Methods We searched PubMed, PsycINFO, and EMBASE for studies examining PV in high-risk [clinical high-risk (CHR), family history of psychosis (FHx), schizotypal personality disorder (SPD), and psychotic-experiences (PEs)] and healthy individuals. Random effects models were used to examine group differences in PV (Hedges g) with stratified analyses and meta-regression employed to investigate the effect of high-risk category, transition status, age, sex, and antipsychotic medication. Results Ten studies, yielding 11 effect sizes, were eligible for inclusion. Overall, high-risk individuals had significantly larger PV relative to healthy controls (g = 0.16 [95% CI: 0.01 to 0.32] p = 0.04), despite showing a reduction in whole brain volume (g = -0.17, [95% CI. -0.30 to -0.03] p = 0.020). Individual sub-group analyses for CHR and FHx groups showed no significant differences relative to controls; however, larger PV increases characterised those who later transitioned to psychosis (g = 0.55, [95% CI. 0.06…
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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 [56]
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Self-citationCortisol awakening response in patients with psychosis: systematic review and meta-analysis
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Pituitary volume in psychosis: the first review of the evidence
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Prevention of Psychosis: Advances in Detection, Prognosis, and Intervention
Fusar-Poli, P., Salazar de Pablo, G., Correll, C. U., Meyer-Lindenberg, A., Millan, M. J., Borgwardt, S., Galderisi, S., Bechdolf, A., Pfennig, A., Kessing, L. V., et al. (2020) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2019.4779 · Cited by 476 · see citing works
The HPA axis dysregulation in severe mental illness: Can we shift the blame to gut microbiota?
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Childhood Trauma, the HPA Axis and Psychiatric Illnesses: A Targeted Literature Synthesis
Murphy, F., Nasa, A., Cullinane, D., Raajakesary, K., Gazzaz, A., Sooknarine, V., Haines, M., Roman, E., Kelly, L., O'Neill, A., et al. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.748372 · Cited by 181 · see citing works
“Larger volumes in the at risk groups were found in those who later transition to psychosis (53, 56).”
BackgroundCullen, A. E., Addington, J., Bearden, C. E., Stone, W. S., Seidman, L. J., Cadenhead, K. S., Cannon, T. D., Cornblatt, B. A., Mathalon, D. H., McGlashan, T. H., et al. (2020) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2020.104649 · Cited by 34 · see citing works
Self-citationCullen, A. E., Fisher, H. L., Gullet, N., Fraser, E. R., Roberts, R. E., Zahid, U., To, M., Yap, N. H., Zunszain, P. A., Pariante, C. M., et al. (2022) · Biological Psychiatry · doi:10.1016/j.biopsych.2021.08.009 · Cited by 27 · see citing works
- Authors
- Saunders, T. S., Mondelli, V., & Cullen, A. E.
- Affiliations
- King's College London (GB)
- Corresponding author
- Cullen, Alexis E.
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2019-11
- Volume
- 213
- Pages
- 23-31
- ISSN
- 0920-9964 (ISSN-L)
- OpenAlex
- W2908300620
- Cited by
- 24
- References
- 6
- Citations by year
- 2026: 1 · 2024: 3 · 2023: 4 · 2022: 3 · 2021: 1 · 2020: 10 · 2019: 2
- FWCI
- 0.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust (107395/Z/15/Z)
- National Institute for Health and Care Research (CL-2008-17-005)
- Academy of Medical Sciences (AMS-SGCL5-Mondelli)
- 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 volume, psychosis risk
- MeSH terms
- Disease Susceptibility, Humans, Pituitary Gland, Psychotic Disorders, Schizophrenia, Schizotypal Personality Disorder
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