title: 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.
abstract: 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.
authors.affiliation: First Department of Pediatrics, Athens University Medical School, Aghia Sophia Children's Hospital, Athens, Greece. ppervanid@med.uoa.gr
authors.forename: Panagiota
authors.initials: P
authors.lastname: Pervanidou
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Kolaitis
authors.forename: Stella
authors.initials: S
authors.lastname: Charitaki
authors.forename: Alexandra
authors.initials: A
authors.lastname: Margeli
authors.forename: Spyros
authors.initials: S
authors.lastname: Ferentinos
authors.forename: Chrysa
authors.initials: C
authors.lastname: Bakoula
authors.forename: Christina
authors.initials: C
authors.lastname: Lazaropoulou
authors.forename: Ioannis
authors.initials: I
authors.lastname: Papassotiriou
authors.forename: John
authors.initials: J
authors.lastname: Tsiantis
authors.forename: George P
authors.initials: GP
authors.lastname: Chrousos
mesh_terms: 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