title: Altered cortisol awakening response in posttraumatic stress disorder.
abstract: An altered function of the hypothalamic-pituitary-adrenal axis is assumed to be characteristic for Posttraumatic Stress Disorder (PTSD), although there is inconsistent empirical evidence. Only few studies examined the awakening cortisol response and a daytime profile in PTSD. Salivary cortisol levels were measured at seven intervals from awakening until 8 PM in trauma-exposed subjects with (N=29) and without PTSD (N=19) and in 15 non-exposed controls. While the three groups did not differ with respect to their first cortisol level immediately after awakening, the expected cortisol increase to awakening 15-60 min later was significantly lower in PTSD patients compared to non-PTSD subjects and healthy controls. This effect remained stable when trauma-exposed subjects with comorbid major depression were excluded from the analysis. A significant negative correlation between the overall cortisol secretion (AUC(G)) and overall PTSD symptomatology and hyper-arousal symptoms was found. The findings are discussed in light of the hypothesis of a counterregulation of hyper-arousal symptoms and chronic stress in PTSD.
authors.affiliation: Department of Clinical and Cognitive Neuroscience, Central Institute of Mental Health, University of Heidelberg, J 5, 68159 Mannheim, Germany. wessa@zi-mannheim.de
authors.forename: Michèle
authors.initials: M
authors.lastname: Wessa
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rohleder
authors.forename: Clemens
authors.initials: C
authors.lastname: Kirschbaum
authors.forename: Herta
authors.initials: H
authors.lastname: Flor
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D019540:Area Under Curve; D002940:Circadian Rhythm / Q000502:physiology*; D003863:Depression / Q000150:complications / Q000378:metabolism; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000502:physiology / Q000503:physiopathology; D012016:Reference Values; D012463:Saliva / Q000378:metabolism; D018709:Statistics, Nonparametric; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D014851:Wakefulness / Q000502:physiology*
chemical_list: D006854:Hydrocortisone