Disturbances of cortisol awakening response in psychotic disorders and at-risk states – a literature review

Background and objective: According to the diathesis-stress model, disturbances of hypothalamic-pituitary-adrenal (HPA) axis are thought play a role in development, onset, progression psychosis. The aim this paper is present available body evidence on abnormalities cortisol awakening response (CAR) psychotic disorders at-risk states. Methods: Review literature from years 2011-2022 across three databases (Scopus, PubMed Google Scholar) was performed. With an to: i) ensure that review covers wide range research related presentations as manifested broad clinical populations (from CHR/UHR full-blown psychosis), ii) identify neurobiological background thereof, following combination search terms applied: "chr" OR "uhr" "arms" "first-episode schizophrenia" "psychosis" AND "cortisol" "HPA axis" "CAR" "cortisol response". Results conclusion: Research suggests HPA (in case, CAR) appear be important factor pathogenesis disorders. blunted patients with first-episode psychosis or schizophrenia. On other hand, subjects states, results were inconclusive. These findings, however, based small number studies; therefore, more area required