title: Longitudinal course of salivary cortisol in post-traumatic stress disorder.
abstract: OBJECTIVE
  In chronic post-traumatic stress disorder (PTSD) lowered cortisol secretion and hypersuppression to dexamethasone has been described repeatedly. However, so far no longitudinal data on the natural course or on the effect of therapy are available.
  
  
  METHODS
  We measured basal and post-dexamethasone morning salivary cortisol in a drug-free patient with chronic PTSD (DSM-IV) monthly for nearly 2 years and assessed PTSD and depressive symptoms.
  
  
  RESULTS
  Salivary cortisol decreased dramatically 3 months after the traumatic event and in the further course showed an inverse relation to fluctuating but gradually improving PTSD symptoms. Post-dexa-methasone cortisol was suppressed below the detection limit early after trauma and rose again more than 1 year post-trauma.
  
  
  CONCLUSIONS
  Both the potential renormalization of low cortisol levels in improving chronic PTSD and the putative vulnerability to develop PTSD in subjects with increased dexamethasone suppression need further research.
authors.affiliation: University Hospital Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Kellner
authors.forename: Rachel
authors.initials: R
authors.lastname: Yehuda
authors.forename: Josef
authors.initials: J
authors.lastname: Arlt
authors.forename: Klaus
authors.initials: K
authors.lastname: Wiedemann
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008137:Longitudinal Studies; D012463:Saliva / Q000378:metabolism*; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy / Q000378:metabolism*
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D006854:Hydrocortisone