Effects of trauma exposure on the cortisol response to dexamethasone administration in PTSD and major depressive disorder
Effects of trauma exposure on the cortisol response to dexamethasone administration in PTSD and major depressive disorder
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DOI：
10.1016/s0306-4530(03)00052-0
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发表时间：
2004-04-01
影响因子：
3.7
通讯作者：
Bierer, LM
中科院分区：
文献类型：
--
作者：
Yehuda, R;Halligan, SL;Bierer, LM
目的：评估0.5 mg地塞米松（DEX）对创伤幸存者（N = 52）、创伤后应激障碍（PTSD）、重度抑郁症（MDD）、两者都有或两者都没有的创伤幸存者（N = 10）和从未经历过创伤的受试者（N = 10）的皮质醇负反馈抑制作用，以检验诊断和创伤史之间的相互作用。方法：评估终身创伤暴露和精神诊断，并于上午8点采血测定基线皮质醇。参与者在晚上11点摄入0.5 mg DEX，第二天早上8点采集血液样本用于测定皮质醇和DEX。在创伤幸存者中，创伤事件在“局灶性”创伤之前的存在对重度抑郁症受试者的皮质醇抑制有实质性影响。这些受试者更有可能表现出与PTSD相关的皮质醇变化，而没有先前创伤的重度抑郁症受试者更有可能表现出相反方向的变化，即相对非抑郁性。结论：创伤后应激障碍的皮质醇过度抑制似乎不依赖于局灶性创伤之前创伤事件的存在。然而，先前的创伤暴露可能会影响重度抑郁症患者的皮质醇抑制。这一发现可能有助于理解为什么只有一些抑郁症患者在DST上表现出非抑制。Elsevier Ltd.出版。
Objective: To evaluate cortisol suppression following 0.5 mg of dexamethasone (DEX) in trauma survivors (N = 52),with posttraumatic stress disorder (PTSD), major depressive disorder (MDD), both, or neither disorder, and in subjects never exposed to trauma (N = 10), in order to examine interactions between diagnosis and trauma history on cortisol negative feedback inhibition.Method: Lifetime trauma exposure and psychiatric diagnoses were assessed and blood samples were obtained at 8:00 a.m. for the determination of baseline cortisol. Participants ingested 0.5 mg of DEX at 11:00 p.m. and blood samples for determination of cortisol and DEX were obtained at 8:00 a.m. the following day.Results: PTSD was associated with enhanced cortisol suppression in response to DEX Among trauma survivors, the presence of a traumatic event prior to the "focal" trauma had a substantial impact on cortisol suppression in subjects with MDD. Such subjects were more likely to show cortisol alterations similar to those associated with PTSD, whereas subjects with MDD with no prior trauma were more likely to show alterations in the opposite direction, i.e. relative non-suppression.Conclusions: Cortisol hypersuppression in PTSD appears not to be dependent on the presence of traumatic events prior to the focal trauma. However, prior trauma exposure may affect cortisol suppression in MDD. This finding may have implications for understanding why only some depressed patients show non-suppression on the DST. Published by Elsevier Ltd.