Twenty-four-hour cortisol secretion patterns in prepubertal children with anxiety or depressive disorders
Twenty-four-hour cortisol secretion patterns in prepubertal children with anxiety or depressive disorders
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DOI：
10.1016/j.biopsych.2004.05.005
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发表时间：
2004-08-01
影响因子：
10.6
通讯作者：
Weissman, MM
中科院分区：
文献类型：
--
作者：
Feder, A;Coplan, JD;Weissman, MM
背景资料：以往的研究发现，在青春期前的焦虑或抑郁症儿童的下丘脑-垂体-肾上腺（HPA）轴功能的异常很少。在这项研究中，我们结合了两项独立的连续研究的数据，以获得更大的样本量。我们的目标是确定焦虑或抑郁儿童皮质醇分泌的昼夜节律模式的潜在改变。共124名青春期前的受试者从两个独立的样本（76与抑郁症31与焦虑症，和17名健康对照组）进行了研究。在24小时内每小时采集一次皮质醇血样进行检查。分析进行对齐皮质醇样本的时钟时间，额外的分析对齐样本的睡眠发作时间进行subsample的subjects.Results：在合并后的样本，显着的发现出现了以前未检测到。与抑郁和健康的对照组儿童相比，焦虑儿童的夜间皮质醇水平显着降低，夜间皮质醇水平最初上升缓慢。相比之下，抑郁症儿童没有表现出明确的模式的差异与健康对照children.Conclusions：anastomosis儿童似乎表现出改变模式的夜间皮质醇分泌，最初缓慢或延迟夜间上升之前达到类似的峰值水平的皮质醇附近的时间觉醒。这些发现表明，在HPA轴功能的微妙变化在青春期前儿童焦虑症。
Background: Previous studies found few abnormalities in hypothalamic-pituitary-adrenal (HPA) axis function in prepubertal children with anxiety or depressive disorders. In this study, we combined data from two independent, consecutive studies to achieve a larger sample size. Our goal was to identify potential alterations in the circadian pattern of cortisol secretion in anxious or depressed children.Methods. A total of 124 prepubertal subjects from two independent samples (76 with major depressive disorder 31 with anxiety disorders, and 17 healthy control subjects) were studied. Blood samples collected for cortisol at hourly intervals over a 24-hour period were examined. Analyses were performed aligning cortisol samples by clock-time, Additional analyses aligning samples by sleep-onset time were performed with a subsample of subjects.Results: In the combined sample, significant findings emerged that were previous undetected. Anxious children exhibited significantly lower nighttime cortisol levels and an initially sluggish rise in cortisol during the nighttime when compared with depressed and healthy control children. In contrast, depressed children did not show a clear-cut pattern of differences compared with healthy control children.Conclusions: Anxious children seem to exhibit an altered pattern of nighttime cortisol secretion, with an initially sluggish or delayed nocturnal rise before reaching similar peak levels of cortisol near the time of awakening. These findings suggest subtle alterations in HPA axis function in prepubertal children with anxiety disorders.