A pilot study of a neuroendocrine test battery in posttraumatic stress disorder

Dinan, Timothy G.; Barry, Siobhan; Yatham, Lakshmi N.; Mobayed, Mamoun; Brown, I. N.

doi:10.1016/0006-3223(90)90453-9

Cited by 47 publications

(13 citation statements)

References 34 publications

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“…The widely utilized dexamethasone suppression test (DST) provided an opportunity to explore this question. Before our own studies, there were five reports in the literature examining the cortisol response to a standard 1-mg dose of dexamethasone (26)(27)(28)(29)(30). Although each of the five studies hypothesized that PTSD patients would show the classic "nonsuppression" to dexamethasone, none of these studies could demonstrate a nonsuppression in PTSD patients that did not have a concurrent major depressive disorder.…”

Section: Neuroendocrine Challenge Testing In Combat Veterans With Ptsdmentioning

confidence: 95%

Long-lasting hormonal alterations to extreme stress in humans: normative or maladaptive?

Yehuda

Resnick

Kahana

et al. 1993

Psychosomatic Medicine

131

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The biological consequences of stress have been studied for over half a decade, however, little is known about persistent biological alterations after extreme stress in humans. Posttraumatic stress disorder (PTSD) is a syndrome that occurs in some individuals after exposure to extreme stress. In this review, we summarize some of our studies of hypothalamic-pituitary-adrenal axis alterations in PTSD and compare and contrast these findings with knowledge concerning biological changes following stress.

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Section: Neuroendocrine Challenge Testing In Combat Veterans With Ptsdmentioning

confidence: 95%

Long-lasting hormonal alterations to extreme stress in humans: normative or maladaptive?

Yehuda

Resnick

Kahana

et al. 1993

Psychosomatic Medicine

131

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“…Male patients with combat-related PTSD [Kosten et al, 1990;Kudler et al, 1987;Olivera and Fero, 1990] and female patients with sexual assault-related PTSD [Dinan et al, 1990] have been shown to suppress normally with the standard 1 mg dexamethasone suppression test (DST). Studies utilizing lower doses of DST (0.5 mg) suggest that PTSD may be associated with a super-suppression of the cortisol response in comparison to normal controls [Yehuda et al, 1993;Stein et al, 1997a], which appears to be in contrast to patients with major depression who are non-suppressers with the standard 1 mg DST test.…”

Section: Affected Systems In the Neural Circuitry In Ptsd Crf/hpa-aximentioning

confidence: 98%

Circuits and systems in stress. II. Applications to neurobiology and treatment in posttraumatic stress disorder

2002

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This paper follows the preclinical work on the effects of stress on neurobiological and neuroendocrine systems and provides a comprehensive working model for understanding the pathophysiology of posttraumatic stress disorder (PTSD). Studies of the neurobiology of PTSD in clinical populations are reviewed. Specific brain areas that play an important role in a variety of types of memory are also preferentially affected by stress, including hippocampus, amygdala, medial prefrontal cortex, and cingulate. This review indicates the involvement of these brain systems in the stress response, and in learning and memory. Affected systems in the neural circuitry of PTSD are reviewed (hypothalamic-pituitary-adrenal axis (HPA-axis), catecholaminergic and serotonergic systems, endogenous benzodiazepines, neuropeptides, hypothalamic-pituitary-thyroid axis (HPT-axis), and neuro-immunological alterations) as well as changes found with structural and functional neuroimaging methods. Converging evidence has emphasized the role of early-life trauma in the development of PTSD and other trauma-related disorders. Current and new targets for systems that play a role in the neural circuitry of PTSD are discussed. This material provides a basis for understanding the psychopathology of stress-related disorders, in particular PTSD.

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“…However, not all studies find low cortisol with PTSD alone (Liberzon et al, 1999;Pitman and Orr, 1990;Lemieux and Coe, 1995;Maes et al, 1999;Smith et al, 1989;Baker et al, 1999), perhaps because of subject selection, diagnostic criteria utilized, or other methodological issues. Although hypersuppression in response to dexamethasone has been reported in sexual abuse victims, most of whom had PTSD, compared to normal controls (Stein et al, 1997), normal suppression (Dinan et al, 1990;Halbreich et al, 1989) has also been reported. We did not measure plasma ACTH in response to fenfluramine.…”

Section: Hpa Axis Hypoactivity In Ptsd+mdementioning

confidence: 99%

Lower Cortisol Levels in Depressed Patients with Comorbid Post-Traumatic Stress Disorder

Oquendo

Echavarría

Galfalvy

et al. 2002

Neuropsychopharmacol

104

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Post-traumatic stress disorder (PTSD) is often comorbid with major depressive episodes (MDEs) and both conditions carry a higher rate of suicidal behavior. Hypothalamic-pituitary-adrenal (HPA) axis and serotonin abnormalities are associated with both conditions and suicidal behavior, but their inter-relation is not known. We determined cortisol response to placebo or fenfluramine in MDE, MDE and PTSD (MDE+PTSD), and healthy volunteers (HVs) and examined the relation of cortisol responses to suicidal behavior. A total of 58 medication-free patients with MDE (13 had MDE+PTSD) and 24 HVs were studied. They received placebo on the first day and fenfluramine on the second day. Cortisol levels were drawn before challenge and for 5 h thereafter. The MDE+PTSD group had the lowest plasma cortisol, the MDE group had the highest, and HVs had intermediate levels. There were no group differences in cortisol response to fenfluramine. Suicidal behavior, sex, and childhood history of abuse were not predictors of baseline or postchallenge plasma cortisol. Cortisol levels increased with age. This study finds elevated cortisol levels in MDE and is the first report of lower cortisol levels in MDE+PTSD. The findings underscore the impact of comorbidity of PTSD with MDE and highlight the importance of considering comorbidity in psychobiology.

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A pilot study of a neuroendocrine test battery in posttraumatic stress disorder

Cited by 47 publications

References 34 publications

Long-lasting hormonal alterations to extreme stress in humans: normative or maladaptive?

Long-lasting hormonal alterations to extreme stress in humans: normative or maladaptive?

Circuits and systems in stress. II. Applications to neurobiology and treatment in posttraumatic stress disorder

Lower Cortisol Levels in Depressed Patients with Comorbid Post-Traumatic Stress Disorder

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