Hair cortisol concentrations and cortisol stress reactivity in generalized anxiety disorder, major depression and their comorbidity.
Hair cortisol concentrations and cortisol stress reactivity in generalized anxiety disorder, major depression and their comorbidity.
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DOI：
10.1016/j.jpsychires.2016.09.024
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发表时间：
2017
影响因子：
4.8
通讯作者：
S. Steudte-Schmiedgen;Susann Wichmann;T. Stalder;K. Hilbert;Markus Muehlhan;U. Lueken;K. Beesdo-Baum
中科院分区：
文献类型：
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作者：
S. Steudte-Schmiedgen;Susann Wichmann;T. Stalder;K. Hilbert;Markus Muehlhan;U. Lueken;K. Beesdo-Baum
广泛性焦虑症（GAD）患者皮质醇分泌的研究报告了异质性结果。此外，目前对GAD和/或共病抑郁症（MD）的内分泌变化的特异性的认识是有限的。因此，目前的研究调查了长期的综合皮质醇分泌，头发皮质醇浓度（HCC），和实验诱导的皮质醇应激反应与GAD，MD及其合并症。招募了17名GAD患者，包括8名共病MD（GAD-MD），12名MD患者和21名健康对照。除了心理测量数据，HCC（N= 43）和唾液皮质醇应激反应在特里尔社会压力测试（N= 45）进行了测定。结果显示，MD患者表现出较低的HCC相比，对照组和GAD患者，后两组之间没有差异。有趣的是，当根据MD合并症将GAD组分为两组时，发现MD患者的HCC发生率低于对照组和GAD-noMD患者，但与GAD-MD患者相比无差异。在GAD-MD或GAD-noMD患者和健康对照之间没有观察到HCC差异。未出现TSST组间差异。我们的研究结果表明MD与皮质醇分泌的长期衰减有关。虽然没有组间差异出现广泛性焦虑症患者，无论是与或不与MD，和对照组，目前的结果提供了初步的证据，MD决定长期内分泌变化，与纯广泛性焦虑症表现出独特的模式。未来的研究需要在更大样本的纯和共病组中证实我们的发现。
Studies investigating cortisol secretion in patients with generalized anxiety disorder (GAD) have reported heterogeneous findings. Further, current knowledge on the specificity of endocrine changes for GAD and/or comorbid major depression (MD) is limited. Hence, the current study investigated long-term integrated cortisol secretion, as indexed by hair cortisol concentrations (HCC), and experimentally-induced cortisol stress reactivity in relation to GAD, MD and their comorbidity. Carefully characterized groups of 17 GAD patients including 8 with comorbid MD (GAD-MD), 12 MD patients and 21 healthy controls were recruited. Alongside psychometric data, HCC (N= 43) and salivary cortisol stress reactivity in response to the Trier Social Stress Test (N= 45) were determined. Findings revealed that MD patients exhibited lower HCC compared to controls and GAD patients, with no differences between the latter two groups. Interestingly, when the GAD group was separated into two groups based on MD comorbidity, lower HCC in MD patients were found compared to controlsandGAD-noMD patients, but did not show differences when compared to GAD-MD patients. No HCC differences were seen between GAD-MD or GAD-noMD patients and healthy controls. No TSST group differences emerged. Our findings suggest MD to be related to long-term attenuation in cortisol secretion. While no group differences emerged between patients with GAD, neither with nor without MD, and controls, the current results provide tentative evidence that MD determines long-term endocrine changes, with pure GAD showing a distinct pattern. Future studies are needed to confirm our findings in larger samples of pure and comorbid groups.