title: HPA axis reactivity in chronic pelvic pain: association with depression.
abstract: OBJECTIVE
  Chronic pelvic pain (CPP) is a frequent gynecological complaint. The pathophysiology of CPP is not fully understood. The aim of this study was to determine whether the presence of depressive symptoms is associated with hypothalamic-pituitary-adrenal (HPA) axis dysfunction in CPP.
  
  
  METHODS
  We measured neuroendocrine responses to a standardized social stress test and to a standard adrenocorticotropin (ACTH)(1-24) stimulation test in 18 patients with CPP, stratified based on the presence of high versus low self-reported depressive symptoms, compared with 24 controls.
  
  
  RESULTS
  Women with CPP and low depression exhibited enhanced ACTH responses to psychosocial stress compared with women with CPP and high depression, whereas there were no differences in cortisol responses. In the ACTH(1-24) stimulation test, CPP patients with high depression demonstrated enhanced cortisol responses.
  
  
  CONCLUSIONS
  These results suggest a relationship between self-reported depression and reactivity of the HPA axis in patients with CPP.
authors.affiliation: Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. k.wingenfeld@uke.uni-hamburg.de
authors.forename: Katja
authors.initials: K
authors.lastname: Wingenfeld
authors.forename: Dirk H
authors.initials: DH
authors.lastname: Hellhammer
authors.forename: Iris
authors.initials: I
authors.lastname: Schmidt
authors.forename: Dieter
authors.initials: D
authors.lastname: Wagner
authors.forename: Gunther
authors.initials: G
authors.lastname: Meinlschmidt
authors.forename: Christine
authors.initials: C
authors.lastname: Heim
mesh_terms: D000324:Adrenocorticotropic Hormone; D000704:Analysis of Variance; D002908:Chronic Disease; D003863:Depression / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects / Q000503:physiopathology*; D017699:Pelvic Pain / Q000150:complications / Q000503:physiopathology*; D010913:Pituitary-Adrenal System / Q000187:drug effects / Q000503:physiopathology*; D013315:Stress, Psychological / Q000503:physiopathology
chemical_list: D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone