title: Abnormal salivary cortisol levels in social phobic patients in response to acute psychological but not physical stress.
abstract: BACKGROUND
  Little is known about the hypothalamic-pituitary-adrenal axis response to acute stressful behavioral challenges in patients with social phobia.
  
  
  METHODS
  Eighteen patients with social phobia and 17 normal volunteers participated in two behavioral stressors: a speech task and physical exercise.
  
  
  RESULTS
  Normal volunteers (n = 14) demonstrated a significant 50% increase in salivary cortisol levels to the speech task. Three nonresponding normal volunteers demonstrated a 17% decrease. In contrast, patients with social phobia demonstrated dichotomous changes. Seven social phobia patients demonstrated a significantly higher 90% increase in salivary cortisol to the speech task, whereas the remaining patients (n = 11) were nonresponders demonstrating a 32% decrease in cortisol. Both patient groups were significantly more anxious than the normal volunteers. In contrast to the response to a speech task, social phobics showed a cortisol response to physical exercise of similar magnitude as normal volunteers.
  
  
  CONCLUSIONS
  The results indicated dichotomies in magnitude and in distribution of the cortisol response to a speech task between social phobia patients and normal volunteers. Social phobia patients responded differently than normal volunteers to a stressor associated with social evaluation but not to physical exercise. These results suggest adaptation of distinct biological processes specific to different stressful conditions in social phobia.
authors.affiliation: Department of Psychiatry, Behavioral Psychopharmacology Laboratory, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6140, USA.
authors.forename: P M
authors.initials: PM
authors.lastname: Furlan
authors.forename: N
authors.initials: N
authors.lastname: DeMartinis
authors.forename: E
authors.initials: E
authors.lastname: Schweizer
authors.forename: K
authors.initials: K
authors.lastname: Rickels
authors.forename: I
authors.initials: I
authors.lastname: Lucki
mesh_terms: D000208:Acute Disease; D000222:Adaptation, Physiological / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis* / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D010698:Phobic Disorders / Q000175:diagnosis* / Q000378:metabolism* / Q000503:physiopathology; D010812:Physical Stimulation; D010913:Pituitary-Adrenal System / Q000378:metabolism / Q000503:physiopathology; D012463:Saliva / Q000737:chemistry*; D012720:Severity of Illness Index; D013060:Speech / Q000502:physiology; D013315:Stress, Psychological / Q000175:diagnosis / Q000378:metabolism* / Q000523:psychology
chemical_list: D006854:Hydrocortisone