{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T01:21:51Z","timestamp":1774574511599,"version":"3.50.1"},"reference-count":49,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,11,26]],"date-time":"2020-11-26T00:00:00Z","timestamp":1606348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004569","name":"Ministerstwo Nauki i Szkolnictwa Wy\u017cszego","doi-asserted-by":"publisher","award":["IP2015 052474"],"award-info":[{"award-number":["IP2015 052474"]}],"id":[{"id":"10.13039\/501100004569","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Patients with schizophrenia spectrum disorders have a reduced life expectancy, which is largely the consequence of a high co-occurrence of cardiovascular diseases. To date, several intrinsic and environmental factors underlying this phenomenon have been found. However, the association with psychosocial stress has not been extensively addressed. In this study, we tested the relationship between a history of adverse childhood experiences (ACEs), lifetime stressors, perceived stress and metabolic parameters in patients with schizophrenia spectrum disorders and in healthy controls. The participants included 85 inpatients with schizophrenia spectrum disorders and 56 healthy controls. Serum levels of glucose, insulin, low- and high-density lipoproteins (LDL and HDL), triglycerides, total cholesterol and high-sensitivity C-reactive protein (hsCRP) were determined. After adjustment for potential confounding factors, patients had significantly higher levels of glucose (F = 4.856, p = 0.030), triglycerides (F = 4.720, p = 0.032) and hsCRP (F = 7.499, p = 0.007) as well as significantly lower levels of HDL (F = 5.300, p = 0.023) compared to healthy controls. There were also significant effects of interactions between diagnosis and a history of ACEs on the levels of insulin (F = 4.497, p = 0.036) and homeostatic model assessment of insulin resistance (HOMA-IR) (F = 3.987, p = 0.048). More specifically, the levels of insulin and HOMA-IR were significantly higher in the subgroup of patients with schizophrenia spectrum disorders and a positive history of ACEs compared to other subgroups of participants. No significant associations between lifetime stressors and perceived stress with metabolic parameters were found. Our findings indicate that a history of ACEs might be associated with insulin resistance in patients with schizophrenia spectrum disorders. Therapeutic strategies targeting early-life stress should be considered with early interventions that aim to manage cardiometabolic comorbidity in patients with schizophrenia spectrum disorders.<\/jats:p>","DOI":"10.3390\/jcm9123822","type":"journal-article","created":{"date-parts":[[2020,11,26]],"date-time":"2020-11-26T22:00:33Z","timestamp":1606428033000},"page":"3822","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Metabolic Dysregulation and Psychosocial Stress in Patients with Schizophrenia Spectrum Disorders: A Case-Control Study"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5392-6398","authenticated-orcid":false,"given":"B\u0142a\u017cej","family":"Misiak","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patryk","family":"Piotrowski","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan Aleksander","family":"Besz\u0142ej","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1715-3866","authenticated-orcid":false,"given":"Sylwia","family":"Kalinowska","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26, 71-460 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Ch\u0119\u0107","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology, Institute of Psychology, University of Szczecin, Krakowska 69 Street, 71-017 Szczecin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1438-583X","authenticated-orcid":false,"given":"Jerzy","family":"Samochowiec","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26, 71-460 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1093\/schbul\/sbs082","article-title":"Is the prevalence of metabolic syndrome and metabolic abnormalities increased in early schizophrenia? a comparative meta-analysis of first episode, untreated and treated patients","volume":"39","author":"Mitchell","year":"2013","journal-title":"Schizophr. Bull."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1002\/wps.20614","article-title":"The impact of pharmacological and non-pharmacological interventions to improve physical health outcomes in people with schizophrenia: A meta-review of meta-analyses of randomized controlled trials","volume":"18","author":"Vancampfort","year":"2019","journal-title":"World Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/S2215-0366(17)30078-0","article-title":"Years of potential life lost and life expectancy in schizophrenia: A systematic review and meta-analysis","volume":"4","author":"McGrath","year":"2017","journal-title":"Lancet Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.neubiorev.2019.05.018","article-title":"Appetite regulating hormones in first-episode psychosis: A systematic review and meta-analysis","volume":"102","author":"Misiak","year":"2019","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.schres.2017.03.031","article-title":"Lipid profile disturbances in antipsychotic-naive patients with first-episode non-affective psychosis: A systematic review and meta-analysis","volume":"190","author":"Misiak","year":"2017","journal-title":"Schizophr. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/S2215-0366(16)30262-0","article-title":"The association between first-episode psychosis and abnormal glycaemic control: Systematic review and meta-analysis","volume":"3","author":"Perry","year":"2016","journal-title":"Lancet Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.psychres.2016.01.077","article-title":"Metabolic dysregulation in first-episode schizophrenia patients with respect to genetic variation in one-carbon metabolism","volume":"238","author":"Misiak","year":"2016","journal-title":"Psychiatry Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.schres.2014.03.005","article-title":"Cytokine function in medication-naive first episode psychosis: A systematic review and meta-analysis","volume":"155","author":"Upthegrove","year":"2014","journal-title":"Schizophr. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.schres.2016.09.012","article-title":"Prevalence of metabolic syndrome in female and male patients at risk of psychosis","volume":"181","author":"Cordes","year":"2017","journal-title":"Schizophr. Res."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Misiak, B., Wi\u015bniewski, M., Lis, M., Samochowiec, J., and Sta\u0144czykiewicz, B. (2020). Glucose homeostasis in unaffected first-degree relatives of schizophrenia patients: A systematic review and meta-analysis. Schizophr. Res.","DOI":"10.1016\/j.schres.2020.07.011"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.ajhg.2013.01.001","article-title":"Improved detection of common variants associated with schizophrenia by leveraging pleiotropy with cardiovascular-disease risk factors","volume":"92","author":"Andreassen","year":"2013","journal-title":"Am. J. Hum. Genet."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1111\/eip.12906","article-title":"Correlations between immune and metabolic serum markers and schizophrenia\/bipolar disorder polygenic risk score in first-episode psychosis","volume":"14","author":"Maj","year":"2019","journal-title":"Early Interv. Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"937","DOI":"10.3389\/fpsyt.2019.00937","article-title":"Stress, Allostatic Load, and Psychosis: One Step Forward in Research But Where to Go Next?","volume":"10","author":"Misiak","year":"2020","journal-title":"Front. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1093\/schbul\/sbs050","article-title":"Childhood adversities increase the risk of psychosis: A meta-analysis of patient-control, prospective-and cross-sectional cohort studies","volume":"38","author":"Varese","year":"2012","journal-title":"Schizophr. Bull."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1093\/schbul\/sbt065","article-title":"Life events and psychosis: A review and meta-analysis","volume":"39","author":"Beards","year":"2013","journal-title":"Schizophr. Bull."},{"key":"ref_16","first-page":"RA35","article-title":"Stress induced disturbances of the HPA axis: A pathway to type 2 diabetes?","volume":"9","author":"Rosmond","year":"2003","journal-title":"Med. Sci. Monit."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.bbi.2017.06.005","article-title":"Childhood maltreatment severity is associated with elevated C-reactive protein and body mass index in adults with schizophrenia and bipolar diagnoses","volume":"65","author":"Aas","year":"2017","journal-title":"Brain Behav. Immun."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1017\/S0033291711002947","article-title":"Childhood maltreatment is associated with increased body mass index and increased C-reactive protein levels in first-episode psychosis patients","volume":"42","author":"Hepgul","year":"2012","journal-title":"Psychol. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"104536","DOI":"10.1016\/j.psyneuen.2019.104536","article-title":"Childhood trauma and glucose metabolism in patients with first-episode psychosis","volume":"113","author":"Tosato","year":"2020","journal-title":"Psychoneuroendocrinology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1177\/0706743718762097","article-title":"Social Determinants of Health and Preclinical Glycemic Control in Newly Diagnosed First-Episode Psychosis Patients","volume":"63","author":"Rho","year":"2018","journal-title":"Can. J. Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.psyneuen.2018.06.021","article-title":"Decreased use of active coping styles contributes to elevated allostatic load index in first-episode psychosis","volume":"96","author":"Misiak","year":"2018","journal-title":"Psychoneuroendocrinology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"104645","DOI":"10.1016\/j.psyneuen.2020.104645","article-title":"A history of childhood trauma and allostatic load in patients with psychotic disorders with respect to stress coping strategies","volume":"115","author":"Piotrowski","year":"2020","journal-title":"Psychoneuroendocrinology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.schres.2019.06.009","article-title":"Allostatic load index and its clinical correlates at various stages of psychosis","volume":"210","author":"Piotrowski","year":"2019","journal-title":"Schizophr. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1001\/archpsyc.1991.01810320088015","article-title":"A Polydiagnostic Application of Operational Criteria in Studies of Psychotic Illness","volume":"48","author":"McGuffin","year":"1991","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"663","DOI":"10.4088\/JCP.v64n0607","article-title":"Chlorpromazine equivalent doses for the newer atypical antipsychotics","volume":"64","author":"Woods","year":"2003","journal-title":"J. Clin. Psychiatry"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1093\/schbul\/13.2.261","article-title":"The positive and negative syndrome scale (PANSS) for schizophrenia","volume":"13","author":"Kay","year":"1987","journal-title":"Schizophr. Bull."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1192\/bjp.134.4.382","article-title":"A new depression scale designed to be sensitive to change","volume":"134","author":"Montgomery","year":"1979","journal-title":"Br. J. Psychiatry"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1192\/bjp.133.5.429","article-title":"A rating scale for mania: Reliability, validity and sensitivity A Rating Scale for Mania: Reliability, Validity and Sensitivity","volume":"133","author":"Young","year":"2011","journal-title":"Br. J. Psychiatry J. Ment. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/S0033-3182(95)71666-8","article-title":"Global Assessment of Functioning","volume":"36","author":"Hall","year":"1995","journal-title":"Psychosomatics"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1348\/014466505X35344","article-title":"The childhood experience of care and abuse questionnaire (CECA.Q): Validation in a community series","volume":"44","author":"Bifulco","year":"2005","journal-title":"Br. J. Clin. Psychol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1093\/schbul\/sbp103","article-title":"Reliability and comparability of psychosis patients\u2019 retrospective reports of childhood abuse","volume":"37","author":"Fisher","year":"2011","journal-title":"Schizophr. Bull."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1111\/j.1600-0447.1990.tb01360.x","article-title":"The List of Threatening Experiences: The reliability and validity of a brief life events questionnaire","volume":"82","author":"Brugha","year":"1990","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"385","DOI":"10.2307\/2136404","article-title":"A global measure of perceived stress","volume":"24","author":"Cohen","year":"1983","journal-title":"J. Health Soc. Behav."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1093\/schbul\/sbr148","article-title":"Prevalence of metabolic syndrome and metabolic abnormalities in schizophrenia and related disorders-a systematic review and meta-analysis","volume":"39","author":"Mitchell","year":"2013","journal-title":"Schizophr. Bull."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1002\/j.2051-5545.2009.tb00199.x","article-title":"Metabolic syndrome in people with schizophrenia: A review","volume":"8","author":"Schreurs","year":"2009","journal-title":"World Psychiatry"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2394","DOI":"10.1016\/j.psyneuen.2013.06.030","article-title":"Pituitary gland volume in patients with schizophrenia, subjects at ultra high-risk of developing psychosis and healthy controls: A systematic review and meta-analysis","volume":"38","author":"Nordholm","year":"2013","journal-title":"Psychoneuroendocrinology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.psyneuen.2014.07.013","article-title":"Morning cortisol levels in schizophrenia and bipolar disorder: A meta-analysis","volume":"49","author":"Girshkin","year":"2014","journal-title":"Psychoneuroendocrinology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.neubiorev.2016.05.027","article-title":"Cortisol awakening response in patients with psychosis: Systematic review and meta-analysis","volume":"68","author":"Berger","year":"2016","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.neubiorev.2014.09.004","article-title":"HPA axis response to social stress is attenuated in schizophrenia but normal in depression: evidence from a meta-analysis of existing studies","volume":"47","author":"Ciufolini","year":"2014","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"513","DOI":"10.3389\/fpsyt.2020.00513","article-title":"Cortisol responses to naturally occurring psychosocial stressors across the psychosis spectrum: A systematic review and meta-analysis","volume":"11","author":"Cullen","year":"2020","journal-title":"Front. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/B978-0-12-387718-5.00006-7","article-title":"Abnormalities in Metabolism and Hypothalamic-Pituitary-Adrenal Axis Function in Schizophrenia","volume":"101","author":"Guest","year":"2011","journal-title":"Int. Rev. Neurobiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3109\/10253890.2010.534831","article-title":"The glucocorticoid contribution to obesity","volume":"14","author":"Spencer","year":"2011","journal-title":"Stress"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/j.biopsych.2013.01.032","article-title":"Stress as a common risk factor for obesity and addiction","volume":"73","author":"Sinha","year":"2013","journal-title":"Biol. Psychiatry"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"ckx189.201","DOI":"10.1093\/eurpub\/ckx189.201","article-title":"Resilience in people with schizophrenia. Results from the Italian Network for Research on Psychoses","volume":"27","author":"Rucci","year":"2017","journal-title":"Eur. J. Public Health"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1111\/eip.12880","article-title":"Stress coping strategies and their clinical correlates in patientswith psychosis at various stages of illness: A case-control study","volume":"14","author":"Piotrowski","year":"2019","journal-title":"Early Interv. Psychiatry"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.psychres.2018.12.083","article-title":"Coping styles and symptomatic manifestation of first-episode psychosis: Focus on cognitive performance","volume":"272","author":"Stramecki","year":"2019","journal-title":"Psychiatry Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"17m11776","DOI":"10.4088\/JCP.17m11776","article-title":"Childhood adversity and schizophrenia: The protective role of resilience in mental and physical health and metabolic markers","volume":"79","author":"Lee","year":"2018","journal-title":"J. Clin. Psychiatry"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1038\/ng.3973","article-title":"Genome-wide association analysis identifies 30 new susceptibility loci for schizophrenia","volume":"49","author":"Li","year":"2017","journal-title":"Nat. Genet."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.ebiom.2018.07.037","article-title":"Glucose and Insulin-Related Traits, Type 2 Diabetes and Risk of Schizophrenia: A Mendelian Randomization Study","volume":"34","author":"Li","year":"2018","journal-title":"EBioMedicine"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/12\/3822\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:37:28Z","timestamp":1760179048000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/12\/3822"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,26]]},"references-count":49,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["jcm9123822"],"URL":"https:\/\/doi.org\/10.3390\/jcm9123822","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,26]]}}}