Hypothalamic-pituitary-adrenal axis dysregulation in depersonalization disorder.
BACKGROUND
The purpose of this preliminary study was to investigate HPA axis function in dissociation.


METHODS
Nine subjects with DSM-IV depersonalization disorder (DPD), without lifetime Posttraumatic Stress Disorder (PTSD) or current major depression, were compared to nine healthy comparison (HC) subjects of comparable age and gender.


RESULTS
DPD subjects demonstrated significant hyposuppression to low-dose dexamethasone administration and significantly elevated morning plasma cortisol levels when covaried for depression scores, but no difference in 24-hour urinary cortisol excretion. Dissociation scores powerfully predicted suppression whereas depression scores did not contribute to the prediction.


CONCLUSIONS
Primary dissociative conditions, such as depersonalization disorder, may be associated with a pattern of HPA axis dysregulation that differs from PTSD and merits further study.
Simeon
D
D
Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA. daphne.simeon@mssm.edu
Guralnik
O
O
Knutelska
M
M
Hollander
E
E
Schmeidler
J
J
D000328:Adult; D003861:Depersonalization / Q000503:physiopathology* / Q000523:psychology; D003907:Dexamethasone; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D006854:Hydrocortisone / Q000652:urine; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008297:Male; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D011569:Psychiatric Status Rating Scales
D005938:Glucocorticoids; D003907:Dexamethasone; D006854:Hydrocortisone