ReviewSchizophrenia bulletin2003
The stress cascade and schizophrenia: etiology and onset.
Review in Schizophrenia bulletin, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 157 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
157 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Revisiting the link between childhood adversity and stress-sensitive brain regions in psychosis and bipolar disorder: a systematic review and meta-analysis.Translational psychiatry · 2026Pooled it
- Biobehavioral Interactions between Endocannabinoid and Hypothalamicpituitary- adrenal Systems in Psychosis: A Systematic Review.Current neuropharmacology · 2024Pooled it
- Psychosis-like experiences and resilience: A systematic and critical review of the literature.Psychological services · 2022Pooled it
- Childhood Trauma and Neurocognition in Adults With Psychotic Disorders: A Systematic Review and Meta-analysis.Schizophrenia bulletin · 2019Pooled it
- Using virtual reality to investigate psychological processes and mechanisms associated with the onset and maintenance of psychosis: a systematic review.Social psychiatry and psychiatric epidemiology · 2016Pooled it
- The role of cortisol in first episode of psychosis: a systematic review.Current psychiatry reports · 2014Pooled it
- Neural correlates of daily-life affective stress reactivity in early psychosis: A study combining functional MRI and experience sampling methodology.Schizophrenia research · 2023Trial
- Exercise Intervention in Individuals at Clinical High Risk for Psychosis: Benefits to Fitness, Symptoms, Hippocampal Volumes, and Functional Connectivity.Schizophrenia bulletin · 2022Trial
- Relationships between smartphone social behavior and relapse in schizophrenia: A preliminary report.Schizophrenia research · 2019Trial
- A Supervised Exercise Intervention for Youth at Risk for Psychosis: An Open-Label Pilot Study.The Journal of clinical psychiatryTrial
- Risk of major psychiatric disorder after adolescent pregnancy: A nationwide cohort study of 149,870 girls.Psychiatry and clinical neurosciences · 2026Article
- Associative memory neurons are recruited in PFC-centered circuits to encode schizophrenia-like behavior by dopaminergic receptor-II.Molecular psychiatry · 2026Article
- Neurophysiological evidence for emotion regulation abnormalities in individuals at clinical high-risk for psychosis.European archives of psychiatry and clinical neuroscience · 2026Article
- Genetic architecture of suicidal ideation continuum: latent profile analysis of data using the million veteran program cohort.Molecular psychiatry · 2026Article
- Stress and delusions in postgraduate medical students: the mediating role of anxiety and depression and the moderating role of trait impulsivity.BMC psychiatry · 2026Article
- Associations among stress perception, clinical symptoms, and hippocampal subfield volumes in first-episode patients with schizophrenia.Frontiers in psychiatry · 2026Article
- A new two-hit animal model for schizophrenia research: Consequences on social behavior.IBRO neuroscience reports · 2025Article
- Gut-brain-immune axis implications for mental health and disease.Molecular and cellular biochemistry · 2025Review
- Evaluation of CRH, ACTH, Cortisol, and Chromogranin Levels in the Acute Stage of Schizophrenia.Clinical medicine & research · 2025Article
- Childhood adversities and suicidal ideation among young adults with serious mental illnesses: The mediating roles of perceived stress, dispositional hope, and mental health hope.Journal of affective disorders · 2025Article
97 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Psychosocial stress is included in most etiologic models of schizophrenia, frequently as a precipitating factor for psychosis in vulnerable individuals. Nonetheless, the stress-diathesis model has not been tested prospectively in prodromal patients as a predictor of psychosis. The biological effects of stress are mediated by the hypothalamic-pituitary-adrenal (HPA) axis, which governs the release of steroids, including cortisol. The past few decades have witnessed an increased understanding of the neural effects of stress and cortisol, including both normal and abnormal diatheses. As few biological markers have been evaluated as risk factors for psychosis in prodromal patients, the HPA axis and its interaction with intervening life events are apt candidates for study. In this article, we review the HPA axis and its neural effects, present a model for how stress might precipitate psychosis in vulnerable individuals, review the empirical evidence of a link between stress and schizophrenia symptoms, and propose a research design and appropriate statistical models to test the stress-diathesis model for psychosis onset in prodromal patients.
Indexed as
Identifiers
14989406What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.