Impact of childhood trauma on hypothalamus-pituitary-adrenal axis activity in alcohol-dependent patients.
OBJECTIVE
Studies in animals and humans suggest that early life stress alters hypothalamus-pituitary-adrenal (HPA) axis activity. The same alterations are related to the symptoms and course of alcohol dependence. This study examined relationships between childhood trauma and HPA axis activity in alcohol-dependent patients controlling for psychopathology and characteristics of dependence.


METHODS
Thirty-eight consecutive patients (42% female) were examined at admission to detoxification (t1) and 14 days later (t2). Morning plasma levels of cortisol and adrenocorticotropin-releasing hormone (ACTH) were determined. Participants completed the Childhood Trauma Questionnaire (CTQ) and measures of anxiety, depression, and posttraumatic stress disorder.


RESULTS
Sexual abuse was related to higher levels of cortisol during acute withdrawal (r = 0.38, p = 0.02). Levels of ACTH were negatively correlated with the CTQ total score (t2: r = -0.42, p < 0.01), emotional abuse (t2: r = -0.33, p = 0.04), emotional neglect (t2: r = -0.33, p = 0.04), and physical neglect (t2: r = -0.33, p = 0.05) controlling for psychopathology and characteristics of dependence.


CONCLUSIONS
Our findings suggest, that childhood trauma is related to blunted ACTH and increased cortisol during withdrawal in alcohol-dependent patients. Early life stress might be a confounding variable in studies of HPA function in alcohol dependence and future studies should examine potential clinical consequences of these relationships.
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany. i.schaefer@uke.uni-hamburg.de
Ingo
I
Schäfer
Lisa
L
Teske
Juliane
J
Schulze-Thüsing
Katrin
K
Homann
Jens
J
Reimer
Christian
C
Haasen
Johanna
J
Hissbach
Klaus
K
Wiedemann
D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D000437:Alcoholism / Q000097:blood* / Q000150:complications / Q000523:psychology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D002649:Child Abuse; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D002666:Psychology, Child; D011594:Psychometrics; D013315:Stress, Psychological / Q000097:blood* / Q000150:complications
D006854:Hydrocortisone