Longitudinal course of salivary cortisol in post-traumatic stress disorder.
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.
Kellner
Michael
M
University Hospital Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany.
Yehuda
Rachel
R
Arlt
Josef
J
Wiedemann
Klaus
K
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*
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D006854:Hydrocortisone