Background: Previous studies suggested that alterations in serum cortisol and DHEA-S levels may play a role in the pathophysiology of schizophrenia. Imbalance in serum cortisol and DHEA-S levels may be related to responsivity to antipsychotic treatment.
Aim: To compare serum cortisol and DHEA-S levels between patients with schizophrenia and healthy controls and to evaluate their association with psychopathology in schizophrenic patients with different response to antipsychotic treatment.
Material and Methods: This clinical prospective study included 60 patients with schizophrenia and 40 healthy age and sex matched controls. All patients experienced an acute exacerbation of the illness (PANSS: P1 and P3 ≥ 4). Clinical evaluation of patients was performed using the Positive and Negative Symptom Scale. A questionnaire for socio-demographic and clinical data collection was used. For the purposes of the study, the examined group was divided in two subgroups: responders and nonresponders. Serum cortisol and DHEA-S levels were measuredat baseline in all participants and after 3 and 6 weeks of the antipsychotic treatment in patients with schizophrenia.
Results: Patients with schizophrenia had significantly higher serum cortisol and DHEA-S levels comparedwith control group. Responders had significantly higher serum cortisol and DHEA-S levels compared with nonresponders. Responders group had significant correlation between serum cortisol and PANSS positive scale score as well as between hostility and serum DHEA-S.
Conclusion: Elevated serum cortisol and DHEA-S levels may play a role in the pathophysiology of schizophrenia. Serum cortisol and DHEA-S are associated with psychopathology in schizophrenic patients with different response to antipsychotic therapy.
Danijela Janićević-Ivanovska, Aneta Spasovska-Trajkovska, Branko Stefanovski, Slavica Subeska-Stratrova and Jasmina Jovcevska
The Importance of Vanillylmandelic Acid Determination in Opiate Users
Although knowledge about the etiology of heroin dependence is rather poor, it is known that the influence of opiates on the opioid, adrenergic and indirectly of GABA on the dopaminergic receptors leads to changes of catecholamine levels in brain structures, which are supposed to be essential in explaining the etiology of the opioid dependence. It is well-known that by analyzing catecholamine, we get vanillylmandelic acid (VMA), which is found in the urine as a final product. Thus, by an indirect determination of VMA it is also possible to define the catecholamine concentration in the brain, which is the aim of this study. This prospective study included 51 dependent heroin users divided into 3 groups, depending on the length of the medical treatment with a conventional detox method (without treatment, second day of the treatment, and after the 10th day of treatment) as well as a control group consisting of 20 healthy subjects. We used the Pissano method chromatographic-spectrophotometric determination - for estimating the level of vanillylmandelic acid, and a scale for defining the severity of symptoms of the withdrawal syndrome (WS). The results showed that the highest average values of the urinary level of VMA were found in the subjects in withdrawal crisis with a high WS scale score in comparison with the other examined groups (statistically significant) as a result of the high adrenergic level. The average score on the scale of depression was high in the subjects in withdrawal crisis where we also found low values of the VMA urinary level. Being aware of the neurobiology of heroin dependence is of great importance for finding new pharmacological treatments for heroin addiction.