Predisposition or side effect of the duration: the reactivity of the HPA-axis under psychosocial stress in panic disorder
| Autor: | Gloria-Beatrice Wintermann, Clemens Kirschbaum, Katja Petrowski |
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| Rok vydání: | 2015 |
| Předmět: |
Cortisol secretion
Adult Male endocrine system medicine.medical_specialty Time Factors Hydrocortisone Physiology 03 medical and health sciences Young Adult 0302 clinical medicine Heart Rate Physiology (medical) Heart rate medicine Trier social stress test Humans Young adult Risk factor Psychiatry Saliva Retrospective Studies Psychiatric Status Rating Scales Analysis of Variance General Neuroscience Panic disorder Middle Aged medicine.disease 030227 psychiatry Neuropsychology and Physiological Psychology Panic Disorder Female Analysis of variance Psychology 030217 neurology & neurosurgery Stress Psychological medicine.drug |
| Zdroj: | International journal of psychophysiology : official journal of the International Organization of Psychophysiology. 107 |
| ISSN: | 1872-7697 |
| Popis: | Background Panic disorder (PD) has been associated with an altered reactivity of the hypothalamic–pituitary–adrenocortical (HPA) system under psychosocial stress. Until now it remains unclear whether a diminished cortisol release is an early risk factor predisposing for PD or a consequence of PD. In order to unravel this point, the present study compares the cortisol secretion between patients with a recent onset and a chronic course of PD. Methods The Trier Social Stress Test (TSST) was applied in patients with a duration of PD ≤ 1.5 years ( N = 35), patients with a duration of PD > 1.5 years ( N = 56) and healthy controls ( N = 95). Salivary cortisol and heart rate (HR) were assessed as primary outcomes. Results According to baseline cortisol/baseline HR and HR response there was no significant difference. Both patient groups (≤ 1.5/> 1.5 years) showed a blunted cortisol response with no significant group difference. In multiple linear regression models the attenuation of the HPA-axis was largely accounted for by group, smoking status, use of contraceptive pill and the interaction group by gender. Female patients with a chronic course showed the lowest cortisol response under the TSST. Conclusions It might be assumed that a decreased reactivity of the HPA-axis could be considered as etiological risk factor in the preliminary stages of PD. Above, female gender, smoking status and the use of contraceptive pill seem to further moderate the attenuated HPA-axis response pattern in patients with PD. |
| Databáze: | OpenAIRE |
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