title: Increased nocturnal secretion of ACTH and cortisol in obsessive compulsive disorder.
abstract: Information on the function of the hypothalamic-pituitary-adrenal (HPA) axis, the main mammalian system of stress response, in obsessive compulsive disorder (OCD) is inconsistent. In this study, nine inpatients with a DSM-IV diagnosis of OCD without comorbid major depression (Yale-Brown Obsessive Compulsive Scale [Y-BOCS] score >15; HAMD-21 total score 16) and nine healthy matched controls were included. Blood of patients (seven males; 31.8 +/- 9.3 years, Y-BOCS: 27.3 +/- 4.3, HAMD-21: 13.3 +/-1.9) and controls (seven males, 31.6 +/- 9.1 years) was drawn every 20 min between 23:00 and 7:00 h during sleep using a long catheter for later ACTH and cortisol analysis. Secretion patterns of cortisol and ACTH were similar in both groups, in OCD, however, at a higher level. Area under the curve plasma concentrations of both ACTH (p<0.05) and cortisol (p<0.005) were significantly greater in patients with OCD (ACTH: 674.3 +/- 57.4; cortisol: 2148.4 +/-271.7) than in controls (ACTH: 460.2 +/- 61.0; cortisol: 1191.2 +/- 124.1). In conclusion, our findings suggest that the activity of the HPA axis in patients with OCD is increased compared to healthy controls.
authors.affiliation: Max-Planck Institute of Psychiatry, Munich, Kraepelinstrasse 2-10, 80804 Munich, Germany. kluge@mpipsykl.mpg.de
authors.forename: Michael
authors.initials: M
authors.lastname: Kluge
authors.forename: Petra
authors.initials: P
authors.lastname: Schüssler
authors.forename: Heike E
authors.initials: HE
authors.lastname: Künzel
authors.forename: Martin
authors.initials: M
authors.lastname: Dresler
authors.forename: Alexander
authors.initials: A
authors.lastname: Yassouridis
authors.forename: Axel
authors.initials: A
authors.lastname: Steiger
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D001143:Arousal / Q000502:physiology; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000097:blood*; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D012016:Reference Values; D012636:Secretory Rate / Q000502:physiology
chemical_list: D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone