Depression and anxiety correlate differently with salivary free cortisol in the morning in patients with functional somatic syndrome.
Patients presenting with functional somatic syndrome (FSS) are common, and the symptoms are persistent and difficult to treat for doctors and costly for society. The aim of this study was to clarify the common pathophysiology of FSS, especially the relationship between hypothalamic-pituitary-adrenal (HPA) axis function and psychological characteristics of patients with FSS. The subjects were 45 patients with FSS and 29 healthy controls. Salivary free cortisol was measured in the morning, and psychological tests examining depression, anxiety and quality of life (QOL) were performed on the same day. In patients with FSS, depressive scores showed a significant negative correlation with salivary free cortisol in the morning, although in healthy controls, cortisol showed a significant positive correlation with depressive scores. In addition, the correlation between other psychological test scores and cortisol secretion in patients with FSS contrasted with that of controls. The relationship between cortisol and depression, anxiety or QOL, suggests that the HPA axis of patients with FSS is dysfunctional and does not function properly when patients with FSS are under stress. This dysfunction may explain the pathology of medically unexplained persistent symptoms of patients with FSS.
Mutsuura
Hiromi
H
Department of Psychosomatic Medicine, Kansai Medical University, Moriguchi-shi, Osaka 570-8507, Japan. mutsuurh@takii.kmu.ac.jp
Kanbara
Kenji
K
Fukunaga
Mikihiko
M
Yamamoto
Kazumi
K
Ban
Ikumi
I
Kitamura
Kana
K
Nakai
Yoshihide
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001007:Anxiety / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D003863:Depression / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D004415:Dyspepsia / Q000150:complications / Q000503:physiopathology; D015673:Fatigue Syndrome, Chronic / Q000150:complications / Q000503:physiopathology; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000503:physiopathology; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D011581:Psychological Tests; D011788:Quality of Life; D012463:Saliva / Q000737:chemistry*; D013315:Stress, Psychological / Q000175:diagnosis; D011795:Surveys and Questionnaires
D006854:Hydrocortisone