The Association between Serum Cortisol and Folate Levels and Positive and Negative Symptoms in Patients with first episode of Schizophrenia: A Case-Control Study

Abstract

AbstractThis study aimed to investigate the relationship between serum cortisol and folate levels and the positive and negative symptoms of patients with schizophrenia, comparing them with a control group. The study included 66 individuals, comprising 33 patients with first episode of schizophrenia and 33 controls. Demographic information, the Simpson-Angus Extrapyramidal Side Effect Scale (SAS), and the Positive and Negative Syndrome Scale (PANSS) were used to collect data on demographic characteristics, symptom severity, and extrapyramidal symptoms. Blood samples were obtained from each patient to measure cortisol and folate levels. The results showed that the mean ± SD cortisol and folate levels in the schizophrenia group were 54.98 ± 26.90 and 2.21 ± 2.20, which were significantly lower compared to the control group, where the levels were 96.10 ± 57.15 and 14.69 ± 11.68 (P < 0.0001). There was no significant correlation between cortisol and folate levels and the total scores on the SAS, PANSS, and their subscales in the schizophrenia group. However, patients with a history of psychiatric illness had significantly lower cortisol levels compared to the control group (P = 0.017), and patients with a history of hypothyroidism had significantly lower serum folate levels (P = 0.020). Folate levels were significantly higher in smokers (P = 0.036). In conclusion, the study found significantly lower serum folate and cortisol levels in patients with first episode of schizophrenia. However, there was no association between PANSS and SAS scores and serum cortisol and folate levels.