Salivary cortisol responses to dexamethasone in adolescents with posttraumatic stress disorder.
OBJECTIVE
Previous studies of adults with posttraumatic stress disorder (PTSD) have found various abnormalities in the regulation of the hypothalamic-pituitary-adrenal axis, including enhanced suppression of cortisol following low-dose dexamethasone. The purpose of the present study was to investigate salivary cortisol responses to low-dose dexamethasone in adolescents with PTSD.


METHODS
Forty-eight adolescents (20 with current PTSD, 9 trauma controls without PTSD, and 19 healthy nontraumatized controls) were enrolled in the study. On day 1, baseline saliva samples were obtained at 8 a.m. and 0.5 mg of dexamethasone was administered at 11 p.m. Cortisol and dexamethasone levels were assessed at 8 a.m. the following day.


RESULTS
Adolescents with current PTSD showed no difference in the suppression of salivary cortisol in response to low-dose (0.5 mg) dexamethasone compared to trauma controls without PTSD and nontraumatized controls. More severely affected PTSD subjects with co-occurring major depression showed higher pre- and post-dexamethasone salivary cortisol levels compared to controls.


CONCLUSIONS
The present study did not find evidence for enhanced suppression of salivary cortisol at 8 a.m. following low-dose dexamethasone in multiply traumatized adolescents with PTSD. This result differs from findings in adults with PTSD. Further investigations of hypothalamic-pituitary-adrenal axis abnormalities in traumatized children and adolescents are needed.
Lipschitz
Deborah S
DS
Yale University School of Medicine, 100 York Street, New Haven, CT 06511, USA. deborah.lipschitz@yale.edu
Rasmusson
Ann M
AM
Yehuda
Rachel
R
Wang
Sheila
S
Anyan
Walter
W
Gueoguieva
Ralitza
R
Grilo
Carlos M
CM
Fehon
Dwain C
DC
Southwick
Steven M
SM
D000293:Adolescent; D002648:Child; D003907:Dexamethasone / Q000494:pharmacology; D005260:Female; D005938:Glucocorticoids / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis* / Q000378:metabolism; D008297:Male; D012463:Saliva / Q000737:chemistry*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000378:metabolism*; D011795:Surveys and Questionnaires
D005938:Glucocorticoids; D003907:Dexamethasone; D006854:Hydrocortisone