Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-17T18:21:46.964Z Has data issue: false hasContentIssue false
  • English
  • Français

Abnormal cortisol awakening response predicts worse cognitive function in patients with first-episode psychosis

Published online by Cambridge University Press:  09 June 2010

M. Aas ,
P. Dazzan ,
V. Mondelli ,
T. Toulopoulou ,
A. Reichenberg ,
M. Di Forti ,
H. L. Fisher ,
R. Handley ,
N. Hepgul  and
T. Marques
...Show all authors
M. Aas
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, King's CollegeLondon, UK
P. Dazzan
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's CollegeLondon, UK NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's CollegeLondon, UK
V. Mondelli
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, King's CollegeLondon, UK
T. Toulopoulou
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's CollegeLondon, UK
A. Reichenberg
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's CollegeLondon, UK NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's CollegeLondon, UK
M. Di Forti
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's CollegeLondon, UK NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's CollegeLondon, UK
H. L. Fisher
Affiliation:
MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's CollegeLondon, UK
R. Handley
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's CollegeLondon, UK
N. Hepgul
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, King's CollegeLondon, UK
T. Marques
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's CollegeLondon, UK
A. Miorelli
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's CollegeLondon, UK
H. Taylor
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, King's CollegeLondon, UK Department of Psychosis Studies, Institute of Psychiatry, King's CollegeLondon, UK
M. Russo
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's CollegeLondon, UK
B. Wiffen
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's CollegeLondon, UK
A. Papadopoulos
Affiliation:
Affective Disorder Unit, South London and Maudsley NHS Trust, London, UK
K. J. Aitchison
Affiliation:
MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's CollegeLondon, UK
C. Morgan
Affiliation:
NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's CollegeLondon, UK Department of Health Services and Population Research, Institute of Psychiatry, King's CollegeLondon, UK
R. M. Murray
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's CollegeLondon, UK NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's CollegeLondon, UK
C. M. Pariante*
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, King's CollegeLondon, UK NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's CollegeLondon, UK
*
*Address for correspondence: Dr C. M. Pariante, Section of Perinatal Psychiatry and Stress, Psychiatry and Immunology, The James Black Centre, Institute of Psychiatry, 125 Coldharbour Lane, London SE5 9NU, UK. (Email: carmine.pariante@kcl.ac.uk)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Cognitive impairment, particularly in memory and executive function, is a core feature of psychosis. Moreover, psychosis is characterized by a more prominent history of stress exposure, and by dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis. In turn, stress exposure and abnormal levels of the main HPA axis hormone cortisol are associated with cognitive impairments in a variety of clinical and experimental samples; however, this association has never been examined in first-episode psychosis (FEP).

Method

In this study, 30 FEP patients and 26 controls completed assessment of the HPA axis (cortisol awakening response and cortisol levels during the day), perceived stress, recent life events, history of childhood trauma, and cognitive function. The neuropsychological battery comprised general cognitive function, verbal and non-verbal memory, executive function, perception, visuospatial abilities, processing speed, and general knowledge.

Results

Patients performed significantly worse on all cognitive domains compared to controls. In patients only, a more blunted cortisol awakening response (that is, more abnormal) was associated with a more severe deficit in verbal memory and processing speed. In controls only, higher levels of perceived stress and more recent life events were associated with a worse performance in executive function and perception and visuospatial abilities.

Conclusions

These data support a role for the HPA axis, as measured by cortisol awakening response, in modulating cognitive function in patients with psychosis; however, this association does not seem to be related to the increased exposure to psychosocial stressors described in these patients.

Keywords

Cognitioncortisolhypothalamic–pituitary–adrenal (HPA) axispsychosisschizophreniastress
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 3 , March 2011 , pp. 463 - 476
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (2000). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association: Washington, DC.Google Scholar
Backhaus, J, Junghanns, K, Born, J, Hohaus, K, Faasch, F, Hohagen, F (2006). Impaired declarative memory consolidation during sleep in patients with primary insomnia: influence of sleep architecture and nocturnal cortisol release. Biological Psychiatry 60, 1324–1330.CrossRefGoogle ScholarPubMed
Backhaus, J, Junghanns, K, Hohagen, F (2004). Sleep disturbances are correlated with decreased morning awakening salivary cortisol. Psychoneuroendocrinology 29, 1184–1191.CrossRefGoogle ScholarPubMed
Bebbington, P, Nayani, T (1995). The psychosis screening questionnaire. International Journal of Methods in Psychiatric Research 5, 11–19.Google Scholar
Bebbington, PE, Bhugra, D, Brugha, T, Singleton, N, Farrell, M, Jenkins, R, Lewis, G, Meltzer, H (2004). Psychosis, victimisation and childhood disadvantage: evidence from the second British National Survey of Psychiatric Morbidity. British Journal of Psychiatry 185, 220–226.CrossRefGoogle ScholarPubMed
Belanoff, JK, Kalehzan, M, Sund, B, Fleming Ficek, SK, Schatzberg, AF (2001). Cortisol activity and cognitive changes in psychotic major depression. American Journal of Psychiatry 158, 1612–1616.CrossRefGoogle ScholarPubMed
Bifulco, A, Bernazzani, O, Moran, PM, Jacobs, C (2005). The childhood experience of care and abuse questionnaire (CECA.Q): validation in a community series. British Journal of Clinical Psychology 44, 563–581.CrossRefGoogle Scholar
Brickman, AM, Buchsbaum, MS, Bloom, R, Bokhoven, P, Paul-Odouard, R, Haznedar, MM, Dahlman, KL, Hazlett, EA, Aronowitz, J, Heath, D, Shihabuddin, L (2004). Neuropsychological functioning in first-break, never-medicated adolescents with psychosis. Journal of Nervous and Mental Diseases 192, 615–622.CrossRefGoogle ScholarPubMed
Brugha, TS, Cragg, D (1990). The List of Threatening Experiences: the reliability and validity of a brief life events questionnaire. Acta Psychiatrica Scandinavica 82, 77–81.CrossRefGoogle ScholarPubMed
Brunner, R, Schaefer, D, Hess, K, Parzer, P, Resch, F, Schwab, S (2006). Effect of high-dose cortisol on memory functions. Annals of the New York Academy of Sciences 1071, 434–437.CrossRefGoogle ScholarPubMed
Buchanan, TW, Kern, S, Allen, JS, Tranel, D, Kirschbaum, C (2004). Circadian regulation of cortisol after hippocampal damage in humans. Biological Psychiatry 56, 651–656.CrossRefGoogle ScholarPubMed
Ceskova, E, Kasparek, T, Zourkova, A, Prikryl, R (2006). Dexamethasone suppression test in first-episode schizophrenia. Neuroendocrinology Letters 27, 433–437.Google ScholarPubMed
Cohen, S, Kamarck, T, Mermelstein, R (1983). A global measure of perceived stress. Journal of Health and Social Behavior 24, 385–396.CrossRefGoogle ScholarPubMed
Copolov, D, Velakoulis, D, McGorry, P, Carina, M, Yung, A, Rees, S, Jackson, G, Rehn, A, Brewer, W, Pantelis, C (2000). Neurobiological findings in early phase schizophrenia. Brain Research Review 31, 157–165.CrossRefGoogle ScholarPubMed
Cowen, PJ (2010). Not fade away: the HPA axis and depression. Psychological Medicine 40, 1–4.CrossRefGoogle ScholarPubMed
Dazzan, P, Lloyd, T, Morgan, KD, Zanelli, J, Morgan, C, Orr, K, Hutchinson, G, Fearon, P, Allin, M, Rifkin, L, McGuire, PK, Doody, GA, Holloway, J, Leff, J, Harrison, G, Jones, PB, Murray, RM (2008). Neurological abnormalities and cognitive ability in first-episode psychosis. British Journal of Psychiatry 193, 197–202.CrossRefGoogle ScholarPubMed
Dazzan, P, Morgan, KD, Orr, K, Hutchinson, G, Chitnis, X, Suckling, J, Fearon, P, McGuire, PK, Mallett, RM, Jones, PB, Leff, J, Murray, RM (2005). Different effects of typical and atypical antipsychotics on grey matter in first episode psychosis: the AESOP study. Neuropsychopharmacology 30, 765–774.CrossRefGoogle ScholarPubMed
Dazzan, P, Morgan, KD, Orr, KG, Hutchinson, G, Chitnis, X, Suckling, J, Fearon, P, Salvo, J, McGuire, PK, Mallett, RM, Jones, PB, Leff, J, Murray, RM (2004). The structural brain correlates of neurological soft signs in AESOP first-episode psychoses study. Brain 127, 143–153.CrossRefGoogle ScholarPubMed
Di Forti, M, Morgan, C, Dazzan, P, Pariante, C, Mondelli, V, Marques, TR, Handley, R, Luzi, S, Russo, M, Paparelli, A, Butt, A, Stilo, SA, Wiffen, B, Powell, J, Murray, RM (2009). High-potency cannabis and the risk of psychosis. British Journal of Psychiatry 195, 488–491.CrossRefGoogle ScholarPubMed
Fisher, H, Morgan, C, Dazzan, P, Craig, TK, Morgan, K, Hutchinson, G, Jones, PB, Doody, GA, Pariante, C, McGuffin, P, Murray, RM, Leff, J, Fearon, P (2009 a). Gender differences in the association between childhood abuse and psychosis. British Journal of Psychiatry 194, 319–325.CrossRefGoogle ScholarPubMed
Fisher, HL, Craig, TK, Fearon, P, Morgan, K, Dazzan, P, Lappin, J, Hutchinson, G, Doody, GA, Jones, PB, McGuffin, P, Murray, RM, Leff, J, Morgan, C (2009 b). Reliability and comparability of psychosis patients' retrospective reports of childhood abuse. Schizophrenia Bulletin. Published online: 7 October 2009. doi:10.1093/schbul/sbp103.Google ScholarPubMed
Flashman, LA, Green, MF (2004). Review of cognition and brain structure in schizophrenia: profiles, longitudinal course, and effects of treatment. Psychiatric Clinics of North America 27, 1–18, vii.CrossRefGoogle ScholarPubMed
Garner, B, Pariante, CM, Wood, SJ, Velakoulis, D, Phillips, L, Soulsby, B, Brewer, WJ, Smith, DJ, Dazzan, P, Berger, GE, Yung, AR, van den Buuse, M, Murray, R, McGorry, PD, Pantelis, C (2005). Pituitary volume predicts future transition to psychosis in individuals at ultra-high risk of developing psychosis. Biological Psychiatry 58, 417–423.CrossRefGoogle ScholarPubMed
Gau, SS, Shang, CY (2010). Executive functions as endophenotypes in ADHD: evidence from the Cambridge Neuropsychological Test Battery (CANTAB). Journal of Child Psychology and Psychiatry. Published online: 18 January 2010. doi:10.1111/j.1469-7610.2010.02215.x.CrossRefGoogle ScholarPubMed
Gianaros, PJ, Jennings, JR, Sheu, LK, Greer, PJ, Kuller, LH, Matthews, KA (2007). Prospective reports of chronic life stress predict decreased grey matter volume in the hippocampus. NeuroImage 35, 795–803.CrossRefGoogle ScholarPubMed
Gomez, RG, Fleming, SH, Keller, J, Flores, B, Kenna, H, DeBattista, C, Solvason, B, Schatzberg, AF (2006). The neuropsychological profile of psychotic major depression and its relation to cortisol. Biological Psychiatry 60, 472–478.CrossRefGoogle ScholarPubMed
Gunduz-Bruce, H, Szeszko, PR, Gueorguieva, R, Ashtari, M, Robinson, DG, Kane, JM, Bilder, RM (2007). Cortisol levels in relation to hippocampal sub-regions in subjects with first episode schizophrenia. Schizophrenia Research 94, 281–287.CrossRefGoogle ScholarPubMed
Halari, R, Kumari, V, Mehrotra, R, Wheeler, M, Hines, M, Sharma, T (2004). The relationship of sex hormones and cortisol with cognitive functioning in schizophrenia. Journal of Psychopharmacology 18, 366–374.CrossRefGoogle ScholarPubMed
Heim, C, Nemeroff, CB (2002). Neurobiology of early life stress: clinical studies. Seminars in Clinical Neuropsychiatry 7, 147–159.CrossRefGoogle ScholarPubMed
Horan, WP, Ventura, J, Nuechterlein, KH, Subotnik, KL, Hwang, SS, Mintz, J (2005). Stressful life events in recent-onset schizophrenia: reduced frequencies and altered subjective appraisals. Schizophrenia Research 75, 363–374.CrossRefGoogle ScholarPubMed
Hsu, FC, Garside, MJ, Massey, AE, Lister-Williams, RH (2003). Effects of a single dose of cortisol on the neural correlates of episodic memory and error processing in healthy volunteers. Psychopharmacology (Berlin) 167, 431–442.CrossRefGoogle ScholarPubMed
Lee, BK, Glass, TA, McAtee, MJ, Wand, GS, Bandeen-Roche, K, Bolla, KI, Schwartz, BS (2007). Associations of salivary cortisol with cognitive function in the Baltimore memory study. Archives of General Psychiatry 64, 810–818.CrossRefGoogle ScholarPubMed
Loberg, EM, Hugdahl, K (2009). Cannabis use and cognition in schizophrenia. Frontiers in Human Neuroscience 3, 53.CrossRefGoogle ScholarPubMed
Lupien, SJ, Fiocco, A, Wan, N, Maheu, F, Lord, C, Schramek, T, Tu, MT (2005). Stress hormones and human memory function across the lifespan. Psychoneuroendocrinology 30, 225–242.CrossRefGoogle ScholarPubMed
Lupien, SJ, Maheu, F, Tu, M, Fiocco, A, Schramek, TE (2007). The effects of stress and stress hormones on human cognition: implications for the field of brain and cognition. Brain and Cognition 65, 209–237.CrossRefGoogle ScholarPubMed
Lysaker, PH, Meyer, P, Evans, JD, Marks, KA (2001). Neurocognitive and symptom correlates of self-reported childhood sexual abuse in schizophrenia spectrum disorders. Annals of Clinical Psychiatry 13, 89–92.CrossRefGoogle ScholarPubMed
McAllister-Williams, RH, Rugg, MD (2002). Effects of repeated cortisol administration on brain potential correlates of episodic memory retrieval. Psychopharmacology (Berlin) 160, 74–83.CrossRefGoogle ScholarPubMed
McGuffin, P, Farmer, A, Harvey, I (1991). A polydiagnostic application of operational criteria in studies of psychotic illness. Development and reliability of the OPCRIT system. Archives of General Psychiatry 48, 764–770.CrossRefGoogle ScholarPubMed
Mondelli, V, Dazzan, P, Hepgul, N, Di Forti, M, Aas, M, D'Albenzio, A, Di Nicola, M, Fisher, H, Handley, R, Marques, TR, Morgan, C, Navari, S, Taylor, H, Papadopoulos, A, Aitchison, KJ, Murray, RM, Pariante, CM (2010 a). Abnormal cortisol levels during the day and cortisol awakening response in first-episode psychosis: the role of stress and of antipsychotic treatment. Schizophrenia Research 116, 234–242.CrossRefGoogle ScholarPubMed
Mondelli, V, Pariante, CM, Navari, S, Aas, M, D'Albenzio, A, Di Forti, M, Handley, R, Hepgul, N, Marques, TR, Taylor, H, Papadopoulos, AS, Aitchison, KJ, Murray, RM, Dazzan, P (2010 b). Higher cortisol levels are associated with smaller left hippocampal volume in first-episode psychosis. Schizophrenia Research. Published online: 13 January 2010. doi:10.1016/j.schres.2009.12.021.CrossRefGoogle ScholarPubMed
Morgan, KD, Dazzan, P, Orr, KG, Hutchinson, G, Chitnis, X, Suckling, J, Lythgoe, D, Pollock, SJ, Rossell, S, Shapleske, J, Fearon, P, Morgan, C, David, A, McGuire, PK, Jones, PB, Leff, J, Murray, RM (2007). Grey matter abnormalities in first-episode schizophrenia and affective psychosis. British Journal of Psychiatry. Supplement 51, s111–s116.CrossRefGoogle ScholarPubMed
Morrens, M, Krabbendam, L, Bak, M, Delespaul, P, Mengelers, R, Sabbe, B, Hulstijn, W, van Os, J, Myin-Germeys, I (2007). The relationship between cognitive dysfunction and stress sensitivity in schizophrenia: a replication study. Social Psychiatry and Psychiatric Epidemiology 42, 284–287.CrossRefGoogle ScholarPubMed
Myin-Germeys, I, Delespaul, P, van Os, J (2005). Behavioural sensitization to daily life stress in psychosis. Psychological Medicine 35, 733–741.CrossRefGoogle ScholarPubMed
Myin-Germeys, I, Krabbendam, L, Jolles, J, Delespaul, PA, van Os, J (2002). Are cognitive impairments associated with sensitivity to stress in schizophrenia? An experience sampling study. American Journal of Psychiatry 159, 443–449.CrossRefGoogle ScholarPubMed
Myin-Germeys, I, van Os, J, Schwartz, JE, Stone, AA, Delespaul, PA (2001). Emotional reactivity to daily life stress in psychosis. Archives of General Psychiatry 58, 1137–1144.CrossRefGoogle ScholarPubMed
Nelson, HE, Willison, J (1991). National Adult Reading Test (NART): Test Manual, 2nd edn. NFER Nelson: Windsor.Google Scholar
Newcomer, JW, Craft, S, Askins, K, Hershey, T, Bardgett, ME, Csernansky, JG, Gagliardi, AE, Vogler, G (1998). Glucocorticoid interactions with memory function in schizophrenia. Psychoneuroendocrinology 23, 65–72.CrossRefGoogle ScholarPubMed
Newcomer, JW, Craft, S, Hershey, T, Askins, K, Bardgett, ME (1994). Glucocorticoid-induced impairment in declarative memory performance in adult humans. Journal of Neuroscience 14, 2047–2053.CrossRefGoogle ScholarPubMed
Pariante, CM, Dazzan, P, Danese, A, Morgan, KD, Brudaglio, F, Morgan, C, Fearon, P, Orr, K, Hutchinson, G, Pantelis, C, Velakoulis, D, Jones, PB, Leff, J, Murray, RM (2005). Increased pituitary volume in antipsychotic-free and antipsychotic-treated patients of the AESOP first-onset psychosis study. Neuropsychopharmacology 30, 1923–1931.CrossRefGoogle ScholarPubMed
Pariante, CM, Lightman, SL (2008). The HPA axis in major depression: classical theories and new developments. Trends in Neuroscience 31, 464–468.CrossRefGoogle ScholarPubMed
Pariante, CM, Vassilopoulou, K, Velakoulis, D, Phillips, L, Soulsby, B, Wood, SJ, Brewer, W, Smith, DJ, Dazzan, P, Yung, AR, Zervas, IM, Christodoulou, GN, Murray, R, McGorry, PD, Pantelis, C (2004). Pituitary volume in psychosis. British Journal of Psychiatry 185, 5–10.CrossRefGoogle ScholarPubMed
Perez, CM, Widom, CS (1994). Childhood victimization and long-term intellectual and academic outcomes. Child Abuse and Neglect 18, 617–633.CrossRefGoogle ScholarPubMed
Porter, RJ, Gallagher, P, Thompson, JM, Young, AH (2003). Neurocognitive impairment in drug-free patients with major depressive disorder. British Journal of Psychiatry 182, 214–220.CrossRefGoogle ScholarPubMed
Read, J, van Os, J, Morrison, AP, Ross, CA (2005). Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavica 112, 330–350.CrossRefGoogle ScholarPubMed
Reichenberg, A, Harvey, PD (2007). Neuropsychological impairments in schizophrenia: integration of performance-based and brain imaging findings. Psychological Bulletin 133, 833–858.CrossRefGoogle ScholarPubMed
Ringen, PA, Vaskinn, A, Sundet, K, Engh, JA, Jonsdottir, H, Simonsen, C, Friis, S, Opjordsmoen, S, Melle, I, Andreassen, OA (2009). Opposite relationships between cannabis use and neurocognitive functioning in bipolar disorder and schizophrenia. Psychological Medicine. Published online: 6 November 2009. doi:10.1017/S0033291709991620.Google Scholar
Ryan, MC, Sharifi, N, Condren, R, Thakore, JH (2004). Evidence of basal pituitary-adrenal overactivity in first episode, drug naive patients with schizophrenia. Psychoneuroendocrinology 29, 1065–1070.CrossRefGoogle ScholarPubMed
Saffer, D, Metcalfe, M, Coppen, A (1985). Abnormal dexamethasone suppression test in type II schizophrenia. British Journal of Psychiatry 147, 721–723.CrossRefGoogle ScholarPubMed
Sandstrom, A, Rhodin, IN, Lundberg, M, Olsson, T, Nyberg, L (2005). Impaired cognitive performance in patients with chronic burnout syndrome. Biological Psychology 69, 271–279.CrossRefGoogle ScholarPubMed
Schenkel, LS, Spaulding, WD, DiLillo, D, Silverstein, SM (2005). Histories of childhood maltreatment in schizophrenia: relationships with premorbid functioning, symptomatology, and cognitive deficits. Schizophrenia Research 76, 273–286.CrossRefGoogle ScholarPubMed
Suzuki, M, Konno, C, Furihata, R, Osaki, K, Uchiyama, M (2009). Insomnia associated with psychiatric disorders [in Japanese]. Nippon Rinsho 67, 1507–1512.Google ScholarPubMed
Szeszko, PR, Betensky, JD, Mentschel, C, Gunduz-Bruce, H, Lencz, T, Ashtari, M, Malhotra, AK, Bilder, RM (2006). Increased stress and smaller anterior hippocampal volume. Neuroreport 17, 1825–1828.CrossRefGoogle ScholarPubMed
Thornberry, TP, Ireland, TO, Smith, CA (2001). The importance of timing: the varying impact of childhood and adolescent maltreatment on multiple problem outcomes. Developmental Psychopathology 13, 957–979.CrossRefGoogle ScholarPubMed
Walder, DJ, Walker, EF, Lewine, RJ (2000). Cognitive functioning, cortisol release, and symptom severity in patients with schizophrenia. Biological Psychiatry 48, 1121–1132.CrossRefGoogle ScholarPubMed
Weber, DL, Clark, CR, McFarlane, AC, Moores, KA, Morris, P, Egan, GF (2005). Abnormal frontal and parietal activity during working memory updating in post-traumatic stress disorder. Psychiatry Research 140, 27–44.CrossRefGoogle ScholarPubMed
Wechsler, D (1997 a). WAIS-III Administration and Scoring Manual. The Psychological Corporation: San Antonio, TX.Google Scholar
Wechsler, D (1997 b). WMS-III Technical Manual. The Psychological Corporation: San Antonio, TX.Google Scholar
WHO (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. World Health Organization: Geneva.Google Scholar
Widom, CS, Czaja, SJ, Dutton, MA (2008). Childhood victimization and lifetime revictimization. Child Abuse and Neglect 32, 785–796.CrossRefGoogle ScholarPubMed
Wolf, OT (2003). HPA axis and memory. Best Practice and Research Clinical Endocrinology and Metabolism 17, 287–299.CrossRefGoogle ScholarPubMed
Yehuda, R (2005). Neuroendocrine aspects of PTSD. Handbook of Experimental Pharmacology 169, 371–403.CrossRefGoogle Scholar
Young, AH, Gallagher, P, Watson, S, Del-Estal, D, Owen, BM, Ferrier, IN (2004). Improvements in neurocognitive function and mood following adjunctive treatment with mifepristone (RU-486) in bipolar disorder. Neuropsychopharmacology 29, 1538–1545.CrossRefGoogle ScholarPubMed
Zanelli, J, Reichenberg, A, Morgan, K, Fearon, P, Kravariti, E, Dazzan, P, Morgan, C, Zanelli, C, Demjaha, A, Jones, PB, Doody, GA, Kapur, S, Murray, RM (2010). Specific and generalized neuropsychological deficits: a comparison of patients with various first-episode psychosis presentations. American Journal of Psychiatry 167, 78–85.CrossRefGoogle ScholarPubMed
Supplementary material: File

Aas Supplementary Material

Table .doc

Download Aas Supplementary Material(File)
File 113.7 KB