Elevated morning serum interleukin (IL)-6 or evening salivary cortisol concentrations predict posttraumatic stress disorder in children and adolescents six months after a motor vehicle accident.
BACKGROUND
This study examined prospectively the activity of the hypothalamic-pituitary-adrenal axis, the sympathetic nervous system and inflammatory factors in children shortly after a motor vehicle accident (MVA) in relation to later posttraumatic stress disorder (PTSD) development.


METHODS
Fifty six children, aged 7-18, were studied after an MVA and 1 and 6 months later; 40 subjects served as controls. Morning serum cortisol and interleukin (IL)-6 and plasma catecholamine concentrations were measured within 24h after the event. Salivary cortisol was measured 5 times at defined time points during the same day. PTSD diagnoses 1 and 6 months later were based on K-SADS interview.


RESULTS
Morning serum IL-6 concentrations, measured within the first 24h after the accident, were higher in children that developed PTSD 6 months later than those who did not and those of the control group. Longitudinal IL-6 measurements revealed normalization of IL-6 in the PTSD group, while no differences between the three groups were detected 1 and 6 months later. Evening salivary cortisol and morning serum IL-6 after the accident were positively inter-related (r=0.54, p<0.001) and in separate regression analyses both predicted PTSD development 6 months later. In contrast, morning serum IL-6 did nor correlate with morning serum or salivary cortisol concentrations.


CONCLUSIONS
Immediate posttraumatic alterations in neuroendocrine or inflammatory factors-increased evening salivary cortisol and/or increased morning serum IL-6 concentrations-are involved in subsequent PTSD development in children and adolescents.
Pervanidou
Panagiota
P
First Department of Pediatrics, Athens University Medical School, Aghia Sophia Children's Hospital, Athens, Greece. ppervanid@med.uoa.gr
Kolaitis
Gerasimos
G
Charitaki
Stella
S
Margeli
Alexandra
A
Ferentinos
Spyros
S
Bakoula
Chrysa
C
Lazaropoulou
Christina
C
Papassotiriou
Ioannis
I
Tsiantis
John
J
Chrousos
George P
GP
D000063:Accidents, Traffic / Q000523:psychology*; D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D015850:Interleukin-6 / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D018986:Motor Vehicles; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012463:Saliva / Q000737:chemistry*; D013313:Stress Disorders, Post-Traumatic / Q000097:blood / Q000175:diagnosis*; D013997:Time Factors