Pituitary volume reduction in schizophrenia following cognitive behavioural therapy

Journal article

Premkumar, P., Bream, D., Sapara, A., Fannon, D., Anilkumar, A. P., Kuipers, E. and Kumari.V. (2018). Pituitary volume reduction in schizophrenia following cognitive behavioural therapy. Schizophrenia Research. 192, p. 416–422. https://doi.org/10.1016/j.schres.2017.04.035
AuthorsPremkumar, P., Bream, D., Sapara, A., Fannon, D., Anilkumar, A. P., Kuipers, E. and Kumari.V.
Abstract

Cognitive behavioural therapy (CBT) for psychosis (CBTp) aims to lower the stress of psychotic symptoms. Given that the pituitary is involved in stress regulation, CBT-led stress reduction may be accompanied by a change in pituitary volume. This study aimed to determine whether CBTp reduces pituitary volume in schizophrenia. The relation between pre-therapy memory and CBTp-led pituitary volume change was also examined given that poor memory relates to a blunted cortisol awakening response, denoting impaired stress response, in schizophre- nia. Pituitary volume was measured at baseline in 40 schizophrenia or schizoaffective disorder patients and 30 healthy participants before therapy. Pituitary volume was measured again 6–9 months after patients had either received CBTp in addition to standard care (CBTp + SC, n = 24), or continued with standard care alone (SC, n = 16). CBTp + SC and SC groups were compared on pituitary volume change from baseline to follow-up. Pre-ther- apy memory performance (Hopkins Verbal Learning and Wechsler Memory Scale – Logical memory) was corre- lated with baseline-to-follow-up pituitary volume change. Pituitary volume reduced over time in CBTp + SC patients. Additionally, pre-therapy verbal learning correlated more strongly with longitudinal pituitary volume reduction in the CBTp + SC group than the SC group. To conclude, CBTp reduces pituitary volume in schizophre- nia most likely by enhancing stress regulation and lowering the distress due to psychotic symptoms.

KeywordsCognitive behavioural therapy; Hypothalamic pituitary adrenal axis; Memory; Stress regulation
Year2018
JournalSchizophrenia Research
Journal citation192, p. 416–422
PublisherElsevier
Digital Object Identifier (DOI)https://doi.org/10.1016/j.schres.2017.04.035
Web address (URL)https://www.sciencedirect.com/science/article/pii/S0920996417302220?via%3Dihub
Publication dates
Print21 Apr 2017
Publication process dates
Accepted16 Apr 2017
Deposited06 Jan 2021
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