title: Persistence of anxiety disorders and concomitant changes in cortisol.
abstract: In a clinical sample of 116 children and adolescents we studied the relation between the course of an anxiety disorder during treatment and the concomitant changes in cortisol levels. Assessments at baseline, after three months, and at one-year follow-up were performed with the Anxiety Disorders Interview Schedule. When we compared cortisol levels at baseline and one-year follow-up, persistence of the anxiety disorder was associated with both increased daytime cortisol production (F=3.2, p=0.04) and a trend towards a decreased cortisol morning rise (F=2.4, p=0.09). At one-year follow-up daytime cortisol production was lowest in the early remitters (109.7±29.2 h mmol/l), higher in the late remitters (121.0±40.0 h mmol/l) and highest in the non-remitters (131.1±48.9 h mmol/l). Early remitters had the highest cortisol morning rise (1.1±1.5 h mmol/l), followed by the late remitters (0.8±1.8 h mmol/l), the non-remitters had the lowest cortisol morning rise (0.07±1.7 h mmol/l). Persistence of an anxiety disorder may thus lead to changes in HPA-axis functioning, underscoring the importance adequate treatment of anxiety disorders.
authors.affiliation: Department of Child and Adolescent Psychiatry, Erasmus MC, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands.
authors.forename: Bram
authors.initials: B
authors.lastname: Dierckx
authors.forename: Gwen
authors.initials: G
authors.lastname: Dieleman
authors.forename: Joke H M
authors.initials: JH
authors.lastname: Tulen
authors.forename: Philip D A
authors.initials: PD
authors.lastname: Treffers
authors.forename: Elisabeth M W J
authors.initials: EM
authors.lastname: Utens
authors.forename: Frank C
authors.initials: FC
authors.lastname: Verhulst
authors.forename: Henning
authors.initials: H
authors.lastname: Tiemeier
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000150:complications / Q000378:metabolism* / Q000628:therapy*; D002648:Child; D002652:Child Behavior / Q000502:physiology*; D002940:Circadian Rhythm; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D007398:Interpersonal Relations; D008297:Male; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D012463:Saliva / Q000378:metabolism; D013315:Stress, Psychological / Q000150:complications / Q000378:metabolism / Q000628:therapy
chemical_list: D006854:Hydrocortisone