Cortisol and treatment effect in children with disruptive behavior disorders: a preliminary study.
OBJECTIVE
Basal cortisol and cortisol stress responsivity are valuable biological characteristics of children with disruptive behavior disorder (DBD). In this study, the predictive value of cortisol to outcome of intervention was investigated.


METHODS
Basal cortisol levels and cortisol levels under stress were studied in 22 children with DBD before the start of a psychotherapeutic treatment. The disruptive behavior of the child was assessed before treatment and after cessation (9 months later).


RESULTS
Children with DBD with relatively high and low basal cortisol levels differed in the severity of problem behavior at pretreatment, with the low basal cortisol group having more severe problems. During stress, children with DBD showed either increasing or decreasing cortisol values. Although these cortisol responsivity groups were similar in the severity of behavioral problems at pretreatment, the behavioral problems of the group with high cortisol stress responsivity were significantly lower after the intervention than the behavioral problems of the group with low cortisol stress responsivity.


CONCLUSIONS
In children with DBD, the basal cortisol level was related to the severity of behavioral problems at pretreatment but not to the severity of behavioral problems after treatment. The cortisol response pattern during stress was related to treatment outcome.
van de Wiel
Nicolle M H
NM
Department of Child and Adolescent Psychiatry, University Medical Center, The Netherlands.
van Goozen
Stephanie H M
SH
Matthys
Walter
W
Snoek
Heddeke
H
van Engeland
Herman
H
D000293:Adolescent; D000374:Aggression / Q000502:physiology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D001521:Behavior Therapy; D002648:Child; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D005196:Family Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D017063:Outcome Assessment, Health Care; D010552:Personality Assessment; D011615:Psychotherapy, Group
D006854:Hydrocortisone