Dissociative symptoms and neuroendocrine dysregulation in depression.
BACKGROUND
Dissociative symptoms are traditionally attributed to psychological stressors that produce dissociated memories related to stressful life events. Dissociative disorders and dissociative symptoms including psychogenic amnesia, fugue, dissociative identity-disorder, depersonalization, derealization and other symptoms or syndromes have been reported as an epidemic psychiatric condition that may be coexistent with various psychiatric diagnoses such as depression, schizophrenia, borderline personality disorder or anxiety disorders. According to recent findings also the somatic components of dissociation may occur and influence brain, autonomic and neuroendocrine functions. At this time there are only few studies examining neuroendocrine response related to dissociative symptoms that suggest significant dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis. The aim of the present study is to perform examination of HPA axis functioning indexed by basal cortisol and prolactin and test their relationship to psychic and somatoform dissociative symptoms.


METHODS
Basal cortisol and prolactin and psychic and somatoform dissociative symptoms were assessed in 40 consecutive inpatients with diagnosis of unipolar depression mean age 43.37 (SD=12.21).


RESULTS
The results show that prolactin and cortisol as indices of HPA axis functioning manifest significant relationship to dissociative symptoms. Main results represent highly significant correlations obtained by simple regression between psychic dissociative symptoms (DES) and serum prolactin (R=0.55, p=0.00027), and between somatoform dissociation (SDQ-20) and serum cortisol (R=-0.38, p=0.015).


CONCLUSIONS
These results indicate relationship between HPA-axis reactivity and dissociative symptoms in unipolar depressive patients that could reflect passive coping behavior and disengagement.
Bob
Petr
P
Department of Psychiatry, 1st Faculty of Medicine, Charles University, Prague, Czech Republic. petr.bob@lf1.cuni.cz
Fedor-Freybergh
Peter
P
Jasova
Denisa
D
Bizik
Gustav
G
Susta
Marek
M
Pavlat
Josef
J
Zima
Tomas
T
Benakova
Hana
H
Raboch
Jiri
J
D000328:Adult; D003866:Depressive Disorder / Q000097:blood / Q000503:physiopathology*; D004213:Dissociative Disorders / Q000097:blood / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D011388:Prolactin / Q000097:blood; D013315:Stress, Psychological; D011795:Surveys and Questionnaires
D011388:Prolactin; D006854:Hydrocortisone