Salivary cortisol in panic attacks.
OBJECTIVE
Documentation of hypothalamic-pituitary-adrenal (HPA) axis disturbance in panic disorder has been inconsistent. Increased cortisol levels have been associated with altered HPA function due to stress. The authors examined salivary cortisol levels in spontaneously occurring, unprovoked panic attacks.


METHODS
Patients with panic disorder (N=25) collected saliva samples when panic attacks occurred. Levels of cortisol in the saliva samples were determined and were compared with levels in comparison samples of saliva obtained 24 hours after the panic attack occurred.


RESULTS
During spontaneous panic attacks there was a subtle but significant elevation of cortisol levels, compared with levels obtained 24 hours later. No significant correlations were found between the cortisol elevations during panic attacks and the severity of the attack as measured by using the Acute Panic Inventory or the severity of illness as measured by using the Panic and Agoraphobia Scale.


CONCLUSIONS
Saliva sampling may be a useful method for investigating neuroendocrine parameters during spontaneously occurring panic attacks.
Bandelow
B
B
Department of Psychiatry, The University of Göttingen, Germany. bbandel@gwdg.de
Wedekind
D
D
Pauls
J
J
Broocks
A
A
Hajak
G
G
Rüther
E
E
D000328:Adult; D000553:Ambulatory Care; D019540:Area Under Curve; D002940:Circadian Rhythm / Q000502:physiology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D008297:Male; D016584:Panic Disorder / Q000175:diagnosis*; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012463:Saliva / Q000737:chemistry*; D012720:Severity of Illness Index
D006854:Hydrocortisone