The cortisol and glucocorticoid receptor response to low dose dexamethasone administration in aging combat veterans and holocaust survivors with and without posttraumatic stress disorder.
BACKGROUND
Because alterations in cortisol negative feedback inhibition associated with aging are generally opposite of those observed in posttraumatic stress disorder (PTSD), we examined the cortisol and glucocorticoid receptor (GR) response to dexamethasone (DEX) in older trauma survivors.


METHODS
Twenty-three Holocaust survivors (9 men, 14 women), 27 combat veterans (all male), and 10 comparison subjects (7 men, 3 women) provided samples for plasma or salivary cortisol and glucocorticoid receptor determination in mononuclear leukocytes at 8:00 AM on the day of, and following, 0.5 mg of DEX at 11:00 PM.


RESULTS
Greater percent suppression of cortisol and lymphocyte GR was observed in older trauma survivors with PTSD compared to survivors without PTSD and comparison subjects. There was a significant main effect of depression in the direction of reduced suppression following DEX, consistent with the effects of DEX in major depressive disorder patients. Responses to DEX were uncorrelated with PTSD symptom severity, but cortisol suppression was associated with years elapsed since the most recent, but not focal, traumatic event.


CONCLUSIONS
The response to DEX is generally similar in older and younger trauma survivors, but the findings suggest that age, symptom severity, and lifetime trauma exposure characteristics may influence this response.
Yehuda
Rachel
R
The Traumatic Stress Program and the Department of Psychiatry, Mount Sinai School of Medicine and the Bronx Veterans Affairs Medical Center, New York, NY 10468, USA.
Halligan
Sarah L
SL
Grossman
Robert
R
Golier
Julia A
JA
Wong
Cheryl
C
D000368:Aged; D000375:Aging / Q000378:metabolism*; D003130:Combat Disorders / Q000378:metabolism* / Q000523:psychology; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D017767:Holocaust / Q000523:psychology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000378:metabolism*; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011965:Receptors, Glucocorticoid / Q000097:blood / Q000378:metabolism*; D012463:Saliva / Q000378:metabolism; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000378:metabolism* / Q000523:psychology; D017741:Survivors / Q000523:psychology; D014728:Veterans / Q000523:psychology
D011965:Receptors, Glucocorticoid; D003907:Dexamethasone; D006854:Hydrocortisone