title: Anxiety and salivary cortisol in symptomatic and nonsymptomatic panic patients and healthy volunteers performing simulated public speaking.
abstract: Anxiety and salivary cortisol were measured in subjects performing simulated public speaking (SPS), a procedure that has been neurobiologically related to panic disorder. The subjects were divided into three groups: 18 symptomatic panic patients, 16 nonsymptomatic, drug-treated panic patients, and 17 healthy controls. In the experimental session, subjective anxiety (Visual Analogue Mood Scale) and the total score of the Bodily Symptom Scale (BSS) were higher in symptomatic patients than in controls, with nonsymptomatic patients in between. Measures of cortisol taken at home showed that the level was higher at 9:00 h than at 23:00 h in every group, indicating a normal circadian regulation of the hypothalamic-pituitary-adrenal (HPA) axis in panic patients. Also in every group, the level of cortisol was high at the beginning of the experimental session and decreased after 70 min. This fall parallels the decrease in anxiety and BSS ratings, and appears to reflect habituation of initial, anticipatory anxiety. Preparation and performance of speech raised anxiety and BSS scores to the initial levels, but failed to increase cortisol measured over 60 min, starting at the end of the speech. Therefore, SPS does not seem to activate the HPA axis, as reported in panic attacks.
authors.affiliation: Department of Neurology, Psychiatry and Medical Psychology, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. 9 de julho, 980, 14025-000-Ribeirão Preto, SP, Brazil.
authors.forename: Cybele
authors.initials: C
authors.lastname: Garcia-Leal
authors.forename: Alexandre C B V
authors.initials: AC
authors.lastname: Parente
authors.forename: Cristina M
authors.initials: CM
authors.lastname: Del-Ben
authors.forename: Francisco S
authors.initials: FS
authors.lastname: Guimarães
authors.forename: Ayrton Custódio
authors.initials: AC
authors.lastname: Moreira
authors.forename: Lucila Leico Kagohara
authors.initials: LL
authors.lastname: Elias
authors.forename: Frederico G
authors.initials: FG
authors.lastname: Graeff
mesh_terms: D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001007:Anxiety / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism*; D002940:Circadian Rhythm; D002997:Clomipramine / Q000627:therapeutic use; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism; D008297:Male; D016584:Panic Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism*; D010913:Pituitary-Adrenal System / Q000378:metabolism; D012463:Saliva / Q000737:chemistry*; D012720:Severity of Illness Index; D013060:Speech
chemical_list: D000929:Antidepressive Agents, Tricyclic; D002997:Clomipramine; D006854:Hydrocortisone