Childhood trauma, life events, cortisol and stress in paranoid schizophrenia

This study aimed to investigate stress as marked by life events, cortisol and childhood trauma in in paranoid schizophrenia patients with an illness duration of 0-5 versus 6-10 years in comparison with healthy control participants; in addition, it was aimed to examine the relationship between life events and childhood trauma and exacerbation of illness and basal cortisol levels in paranoid schizophrenia patients and to investigate the relationship between the change in psychotic symptoms of patients in assessments during hospitalization and discharge and the change in cortisol levels.For testing the proposed relationships, cortisol awakening response were evaluated at the first (as basal cortisol level) and the third days of hospitalization and one day prior to hospital discharge after antipsychotic treatment in paranoid schizophrenia patients with an illness duration of 0-5 versus 6-10 years who were hospitalized due to exacerbation of psychotic symptoms; on the days of hospitalization and discharge, severity of psychotic symptoms was assessed and SANS and SAPS were applied on the same days of first and third cortisol assessments; and life events and childhood trauma were assessed prior to hospital discharge of patients.Results showed that, compared to healthy controls, schizophrenia patients reported more life events and experienced more distress [F(2, 60) = 6.52, p<.01, ?2 = .18] and adaptation problems [F(2, 60) = 6.36, p<.01, ?2 = .18]; 6-10 year patient group reported being exposed to more childhood trauma [F(2, 60) = 5.83, p<.01, ?2 = .16], especially to emotional abuse [(F(2, 60) = 7.69, p<.01, ?2 = .20]; life events in one month prior to psychotic exacerbation and childhood trauma predicted the number of exacerbations indicating an association with exacerbation of psychotic symptoms [R2 = .37, Finc (2, 37) = 4.07, p<.05]; basal cortisol levels were significantly higher in 0-6 year patient group; the differences in basal cortisol levels identified at the time of hospitalization [F(2, 59) = 3.76, p<.05, ?2 = .11] disappeared at the third day of hospitalization [F(2, 59) = 1.80]; and following hospitalization, decreases in SANS total score, alogia and avolution scores correlated with decreases in cortisol levels (r = .33, p<.05, r = .35, p<.05, r = .34, p<.05, respectively).In conclusion, despite the challenging nature of stress assessment and evaluation, life events and childhood trauma have an important influence on models related to the etiology of schizophrenia and the course of illness. In order to further understand the possibility of marking the stress and stress response with cortisol as a biological marker apart from these experiences, studies controlling more number of variables with homogeneous samples are needed.Key words: Schizophrenia, life events, childhood trauma, cortisol.