Salivary cortisol response to awakening in chronic fatigue syndrome.
BACKGROUND
There is accumulating evidence of hypothalamic-pituitary-adrenal (HPA) axis disturbances in chronic fatigue syndrome (CFS). The salivary cortisol response to awakening has been described recently as a non-invasive test of the capacity of the HPA axis to respond to stress. The results of this test correlate closely with those of more invasive dynamic tests reported in the literature; furthermore, it can be undertaken in a naturalistic setting.


OBJECTIVE
To assess the HPA axis using the salivary cortisol response to awakening in CFS.


METHODS
We measured salivary cortisol upon awakening and 10, 20, 30 and 60 min afterwards in 56 patients with CFS and 35 healthy volunteers.


RESULTS
Patients had a lower cortisol response to awakening, measured by the area under the curve.


CONCLUSIONS
This naturalistic test of the HPA axis response to stress showed impaired HPA axis function in CFS.
Roberts
Amanda D L
AD
Section of General Hospital Psychiatry, Division of Psychological Medicine, Guy's, King's and St Thomas' School of Medicine and Dentistry, London, UK.
Wessely
Simon
S
Chalder
Trudie
T
Papadopoulos
Andrew
A
Cleare
Anthony J
AJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D003866:Depressive Disorder / Q000150:complications / Q000378:metabolism; D015673:Fatigue Syndrome, Chronic / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000378:metabolism*; D012463:Saliva / Q000378:metabolism*; D012737:Sex Factors; D012890:Sleep / Q000502:physiology*; D012907:Smoking; D013997:Time Factors
D006854:Hydrocortisone