URINARY FREE-CORTISOL LEVELS IN POSTTRAUMATIC-STRESS-DISORDER PATIENTS
URINARY FREE-CORTISOL LEVELS IN POSTTRAUMATIC-STRESS-DISORDER PATIENTS
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DOI：
10.1097/00005053-198603000-00003
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发表时间：
1986-03-01
影响因子：
1.9
通讯作者：
PODD, L
中科院分区：
文献类型：
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作者：
MASON, JW;GILLER, EL;PODD, L
采用放射免疫法测定创伤后应激障碍(PTSD)、重度抑郁障碍、双相情感障碍、躁狂症、偏执型精神分裂症和未分化精神分裂症患者住院期间每隔2周尿游离皮质醇水平(每天微克)。住院期间PTSD患者平均皮质醇水平(33.3±-3.2)显著低于抑郁症(49.6±/-5.9)、双相I、躁狂症(62.7+/-6.7)和未分化精神分裂症(50.1+/-8.9)，但与偏执型精神分裂症(37.5+/-3.9)相似。在入院后的第一个样本中，不同群体之间的差异是明显的。PTSD患者皮质醇水平低而稳定的这一发现尤其值得注意，首先是因为焦虑和抑郁的明显迹象，通常认为这会伴随皮质醇水平上升，其次是因为伴随而来的交感神经系统活动的慢性增加，这在先前的PTSD心理生理学研究中显示出来，并反映在我们自己的PTSD样本中报告的显著和持续的尿儿茶酚胺升高。这一发现表明，防御性组织可能是创伤后应激障碍和偏执型精神分裂症患者皮质醇水平较低的基础。这些数据还表明，激素标准作为创伤后应激障碍临床诊断的辅助手段可能有用。
Urinary free-cortisol levels (micrograms per day) were measured by radioimmunoassay at 2-week intervals during the course of hospitalization in the following patient groups: posttraumatic stress disorder (PTSD); major depressive disorder; bipolar I, manic; paranoid schizophrenia; and undifferentiated schizophrenia. The mean cortisol level during hospitalization was significantly lower in PTSD (33.3+/-3.2) than in major depressive disorder (49.6+/-5.9), bipolar I, manic (62.7+/-6.7), and undifferentiated schizophrenia (50.1+/-8.9), but was similar to that in paranoid schizophrenia (37.5+/-3.9). The same differences across groups are evident in the first sample following hospital admission. This finding of low, stable cortisol levels in PTSD patients is especially noteworthy, first because of the overt signs of anxiety and depression, which would usually be expected to accompany cortisol elevations, and second because of the concomitant chronic increase in sympathetic nervous system activity shown in prior psychophysiological studies of PTSD and reflected in marked and sustained urinary catecholamine elevations previously reported in our own PTSD sample. The findings suggest a possible role of defensive organization as a basis for the low, constricted cortisol levels in PTSD and paranoid schizophrenic patients. The data also suggest the possible usefulness of hormonal criteria as an adjunct to the clinical diagnosis of PTSD.