HPA axis reactivity in chronic pelvic pain: association with depression.
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.
Wingenfeld
Katja
K
Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. k.wingenfeld@uke.uni-hamburg.de
Hellhammer
Dirk H
DH
Schmidt
Iris
I
Wagner
Dieter
D
Meinlschmidt
Gunther
G
Heim
Christine
C
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
D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone