Last update:
01-Aug-2022

OBJECTIVE To compare the serum levels of cortisol, and the sulfated form of dehydroepiandrosterone (DHEA-S) and their ratio in patients with schizophrenia and healthy control subjects, and to evaluate their association with the response to antipsychotic treatment.

METHOD In this clinical prospective study, 60 patients with schizophrenia and 40 healthy age- and sex-matched control subjects participated. Clinical evaluation of patients was conducted using the Positive and Negative Symptom Scale (PANSS), and a questionnaire on socio-demographic and clinical data was used. All the patients had experienced an acute exacerbation of the illness (PANSS: P1 and P3 ≥4). Serum levels of cortisol, DHEA-S, and their ratio, were measured at baseline in all participants and after 3 and 6 weeks of antipsychotic treatment in the patients with schizophrenia. For the purposes of the study, the patients were divided into two subgroups: responders and non-responders to antipsychotic medication.

RESULTS Patients with schizophrenia had significantly higher mean serum cortisol and DHEA-S levels than subjects in the control group. Responders had significantly higher serum cortisol and DHEA-S levels compared with non-responders. Elevated serum cortisol levels were associated with a positive response to antipsychotic therapy. The subgroup of responders showed greater reduction of the PANSS positive and negative scale scores at all three assessment points.

CONCLUSIONS Elevated serum cortisol levels may have predictive value for a positive response to antipsychotic medication in the context of acute schizophrenia exacerbation.

Key words: Cortisol, DHEA-S, Schizophrenia,Treatment response predictor.