In search of the HPA axis activity in unipolar depression patients with childhood trauma: Combined cortisol awakening response and dexamethasone suppression test
In search of the HPA axis activity in unipolar depression patients with childhood trauma: Combined cortisol awakening response and dexamethasone suppression test
复制标题
寻找童年创伤单相抑郁症患者的 HPA 轴活动：联合皮质醇觉醒反应和地塞米松抑制试验
DOI：
10.1016/j.jpsychires.2016.03.009
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发表时间：
2016-07-01
影响因子：
4.8
通讯作者：
Xu, Yi
中科院分区：
文献类型：
--
作者：
Lu, Shaojia;Gao, Weijia;Xu, Yi
本研究的目的是研究儿童创伤对抑郁症患者和健康对照组HPA轴活动的影响，以确定HPA轴异常在抑郁症中的作用，并发现HPA轴功能的差异可能导致某些人更容易受到童年创伤的抑郁影响。将80名18~45岁的受试者分为4组(18例抑郁症儿童创伤暴露，CTE/MDD；17例抑郁症儿童时期无逆境，非CTE/MDD；23例健康儿童创伤，CTE/非MDD；n=22，无童年逆境，非CTE/非MDD)。每名受试者分别在清晨、清醒后即刻、清醒后30、45、60min采集唾液样本进行CAR评估，并进行1 mg地塞米松抑制试验(DST)。无论是否抑郁，CTE受试者都表现出增强的CAR，曲线下的CAR面积(AUCG)与他们的童年创伤问卷(CTQ)身体忽视得分和CTQ总分相关。此外，在四组受试者中，CTE/MDD组也显示出DST后皮质醇浓度最高，糖皮质激素反馈抑制减少。本研究结果提示，儿童创伤与CAR测量的HPA轴的过度活动有关，这可能反映了在早期生活应激暴露后易患抑郁症。此外，GR介导的负反馈控制功能障碍可能参与了CTE后抑郁的发生。(C)2016爱思唯尔有限公司。保留所有权利。
The aim of the present study was to examine the impact of childhood trauma on HPA axis activity both in depression patients and healthy controls in order to determine the role of HPA axis abnormalities in depression and to find the differences in HPA axis functioning that may lead certain individuals more susceptible to the depressogenic effects of childhood trauma. Eighty subjects aged 18-45 years were recruited into four study groups (n = 18, depression patients with childhood trauma exposures, CTE/ MDD; n = 17, depression patients without childhood adversity, non-CTE/MDD; n = 23, healthy persons with childhood trauma, CTE/non-MDD; and n = 22, healthy persons without childhood adversity, non-CTE/non-MDD). Each participant collected salivary samples in the morning at four time points: immediately upon awakening, 30, 45, and 60 min after awakening for the assessment of CAR and underwent a 1 mg-dexamethasone suppression test (DST). Regardless of depression, subjects with CTE exhibited an enhanced CAR and the CAR areas under the curve to ground (AUCg) were associated with their childhood trauma questionnaire (CTQ) physical neglect scores and CTQ total scores. In addition, the CTE/MDD group also showed a highest post-DST cortisol concentration and a decreased glucocorticoid feedback inhibition among four groups of subjects. The present findings suggested that childhood trauma was associated with hyperactivity of HPA axis as measured with CAR, potentially reflecting the vulnerability for developing depression after early life stress exposures. Moreover, dysfunction of the GR-mediated negative feedback control might contribute to the development of depression after CTE. (C) 2016 Elsevier Ltd. All rights reserved.