title: Salivary cortisol responses to dexamethasone in adolescents with posttraumatic stress disorder.
abstract: 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.
authors.affiliation: Yale University School of Medicine, 100 York Street, New Haven, CT 06511, USA. deborah.lipschitz@yale.edu
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Lipschitz
authors.forename: Ann M
authors.initials: AM
authors.lastname: Rasmusson
authors.forename: Rachel
authors.initials: R
authors.lastname: Yehuda
authors.forename: Sheila
authors.initials: S
authors.lastname: Wang
authors.forename: Walter
authors.initials: W
authors.lastname: Anyan
authors.forename: Ralitza
authors.initials: R
authors.lastname: Gueoguieva
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Grilo
authors.forename: Dwain C
authors.initials: DC
authors.lastname: Fehon
authors.forename: Steven M
authors.initials: SM
authors.lastname: Southwick
mesh_terms: 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
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone; D006854:Hydrocortisone