Saliva cortisol in posttraumatic stress disorder: A community epidemiologic study
Saliva cortisol in posttraumatic stress disorder: A community epidemiologic study
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DOI：
10.1016/j.biopsych.2004.05.011
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发表时间：
2004-08-01
影响因子：
10.6
通讯作者：
Breslau, N
中科院分区：
文献类型：
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作者：
Young, EA;Breslau, N
背景资料：压力激活下丘脑-垂体-肾上腺（HPA）轴，因此预计创伤后应激障碍（PTSD）与该轴的激活有关;然而，研究发现PTSD中皮质醇增加和减少。为了解决这个问题，我们收集唾液皮质醇在家里的一个子样本的纵向流行病学sample.Methods：六百八十四人随机选择的总样本913，要求收集唾液样本后，并在傍晚。其中，538人提供了样本，其中516人符合入选标准。这些都是68暴露于创伤与终身PTSD，265暴露于创伤，没有PTSD，和183从未暴露于traumatic.Results：在这三个组的比较，终身PTSD显示夜间唾液皮质醇升高相比，暴露/没有PTSD。当分析中包括终身共病的重度抑郁症（MDD）时，只有PTSD和MDD共病的人显示今晚皮质醇升高。单独患有PTSD的人（从未患过MDD）唾液皮质醇水平正常，而终生患有MDD的人也是如此。无论是创伤暴露还是PTSD单独与唾液皮质醇的变化相关，然而，在PTSD与轻度MDD共病的患者中发现皮质醇升高。
Background: Stress activates the hypothalamic-pituitary-adrenal (HPA) axis, so it was expected that posttraumatic stress disorder (PTSD) would be associated with activation of this axis; however, studies have found both increased and decreased cortisol in PTSD. To address this question, we collected saliva cortisol at home in a subsample of a longitudinal epidemiologic sample.Methods: Six hundred eighty-four persons randomly selected from the total sample of 913 were, requested to collect saliva samples upon and in the early evening. Of these, 538 responded with samples, 516 of whom met inclusion criteria. These were 68 exposed to trauma with lifetime PTSD, 265 exposed to trauma with no PTSD, and 183 never exposed to trauma.Results: In a comparison of these three groups, lifetime PTSD revealed elevated evening saliva cortisol compared with exposed/no PTSD. When lifetime comorbidity with major depressive disorder (MDD) was included in the analysis, only persons with comorbid PTSD and MDD showed this evening elevation in cortisol. Persons with PTSD alone (never MDD) showed normal saliva cortisol levels, as did subjects with lifetime MDD alone.Conclusions. Neither exposure to trauma nor PTSD alone is associated with alterations in saliva cortisol; however, elevated cortisol is found in PTSD comorbid with litetime MDD.