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Open AccessJournal ArticleDOI

Pituitary volume in psychosis.

TLDR
The first episode of a psychosis is associated with a larger pituitary volume, which the authors suggest is due to activation of the HPA axis, and the smaller pituitsary volume in the group with established schizophrenia could be the consequence of repeated episodes of HPAaxis hyperactivity.
Abstract
Background Patients with psychosis have activation of the hypothalamic–pituitary–adrenal (HPA) axis during the acute phase of the psychosis. Whether this has any morphological consequences for the pituitary gland is currently unknown. Aims To examine pituitary volume variation in people at different stages of psychotic disorder. Method Pituitary volume was measured using 1.5 mm, coronal magnetic resonance images in 24 people with first-episode psychosis, 51 with established schizophrenia and 59 healthy controls. Results Compared with the control group, the people with first-episode psychosis had pituitary volumes that were 10% larger, whereas those with established schizophrenia had pituitary volumes that were 17% smaller. In both of the groups with psychosis, there was no difference in pituitary volume between those receiving typical antipsychotic drugs and those receiving atypical antipsychotics. Conclusions The first episode of a psychosis is associated with a larger pituitary volume, which we suggest is due to activation of the HPA axis. The smaller pituitary volume in the group with established schizophrenia could be the consequence of repeated episodes of HPA axis hyperactivity.

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Stress-reactivity in psychosis: evidence for an affective pathway to psychosis

TL;DR: This paper will review a series of studies using the Experience Sampling Method that suggest that altered sensitivity to stress is an endophenotype for psychosis, and suggests that women were more likely to display elevated stress-reactivity.
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When Not Enough Is Too Much: The Role of Insufficient Glucocorticoid Signaling in the Pathophysiology of Stress-Related Disorders

TL;DR: Neuroendocrine data provide evidence of insufficient glucocorticoid signaling in stress-related neuropsychiatric disorders, including posttraumatic stress disorder and major depression, which are associated with immune system activation/inflammation, high SNS tone, and CRH hypersecretion.
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Structural Brain Imaging Evidence for Multiple Pathological Processes at Different Stages of Brain Development in Schizophrenia

TL;DR: It is suggested that the onset of psychosis is a time of active brain changes, wherein, for a proportion of individuals, an early (pre- and perinatal) neuro developmental lesion renders the brain vulnerable to anomalous late (particularly postpubertal) neurodevelopmental processes.
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Environment and Schizophrenia: Environmental Factors in Schizophrenia: Childhood Trauma—A Critical Review

TL;DR: Much more research is needed before firm conclusions can be drawn about whether childhood trauma is a cause of psychosis, and a small number of recent population-based studies provide more robust evidence of an association.
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Glucocorticoids, cytokines and brain abnormalities in depression.

TL;DR: Chronic inflammatory changes in the presence of glucocorticoid resistance may represent a common feature that could be responsible for the enhanced vulnerability of depressed patients to develop neurodegenerative changes later in life, but further studies are needed to clarify the relative contribution of glucOCorticoids and inflammatory signals to MD.
References
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Book

Structured Clinical Interview for DSM-IV Axis I Disorders

Abstract: The reusable Administration Booklet contains interview questions and DSM-IV diagnostic criteria. It is designed to be used with the Scoresheet during a 45- to 90-minute session and is tabbed to help the clinician move from one section to another.
Book

Structured clinical interview for DSM-IV axis I disorders : SCID-I: clinical version : administration booklet

TL;DR: The reusable Administration Booklet contains interview questions and DSM-IV diagnostic criteria as discussed by the authors, which is designed to be used with the Scoresheet during a 45- to 90-minute session and is tabbed to help the clinician move from one section to another.
Journal ArticleDOI

Glucocorticoid receptors in major depression: relevance to pathophysiology and treatment.

TL;DR: The data support the hypothesis that the function of the GR is reduced in major depression in the absence of clear evidence of decreased GR expression and indicate that some antidepressants have direct effects on the GR, leading to enhanced GR function and increased GR expression.
Journal ArticleDOI

When not enough is too much: the role of insufficient glucocorticoid signaling in the pathophysiology of stress-related disorders

TL;DR: Neuroendocrine data provide evidence of insufficient glucocorticoid signaling in stress-related neuropsychiatric disorders, including alterations in behavior, insulin sensitivity, bone metabolism, and acquired immune responses.
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