The research summarized below is another link in the chain of research consistently documenting the significant role of anxiety in mental illness, and in particular, acoounting for the bulk of the neuroscience findings in schizophrenia and bipolar research. I stand by my hypothesis which I formulated many years ago (my doctoral research involved the neuroendocrinology of stress) when I first started noticing the large overlap in the neuroscience research bases of severe mental illness and chronic and profound fear/stress/anxiety-i.e., the neuroscience of schziophrenia and bipolar disorder is largely the neuroscience of fear/anxiety/stress (and disuse and misuse as additional factors accounting for atrophic processes).
PubMed
The British Journal of Psychiatry (2004) 185: 5-10 © 2004
http://ezproxy.library.nyu.edu:2402/misc/terms.shtml The Royal College of Psychiatrists
Pituitary volume in psychosis
Carmine M. Pariante, MRCPsych PhD
Division of Psychological Medicine, Institute of Psychiatry , King's College London , UK
Konstantina Vassilopoulou , MD
Department of Psychiatry, Eginition Hospital , University of Athens , Greece
Dennis Velakoulis, FRANZCP
Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne , Australia
Lisa Phillips, MPsych(Clin)
Personal Assessment and Crisis Evaluation (PACE) Clinic, Orygen Research Centre, Australia
Bridget Soulsby, MSc
Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne , Australia
Stephen J. Wood, PhD
Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, and Brain Research Institute, Melbourne , Australia
Warrick Brewer, PhD and Deidre J. Smith, GradDipAdolPsych
Orygen Research Centre , Australia
Paola Dazzan, MSc MRCPsych
Division of Psychological Medicine, Institute of Psychiatry , King's College London, UK
Alison R. Yung, FRANZCP
Personal Assessment and Evaluation (PACE) Clinic, Orygen Research Centre, Australia
Ioannis M. Zervas, MD and George N. Christodoulou, MD
Department of Psychiatry, Eginition Hospital , University of Athens , Greece
Robin Murray, FRCPsych
Division of Psychological Medicine, Institute of Psychiatry , King's College London, UK
Patrick D. McGorry, FRANZCP
Early Psychosis Prevention and Intervention Centre (EPPIC), Orygen Research Centre , Australia
Christos Pantelis, MRCPsych FRANZCP
Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne , and Centre for Neuroscience, University of Melbourne , Australia
Correspondence: Dr Carmine M. Pariante, Division of Psychological Medicine, Box PO51, Institute of Psychiatry, King's College London, 1
Windsor Walk , Denmark Hill, London SE5 8AF , UK . Tel: +44(0)20 7848 0807; fax: +44 (0)20 7848 0051;
e-mail: spjucmp@iop.kcl.ac.uk
Declaration of interest None. Funding detailed in Acknowledgements.
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.
