title: The efficacy of initial hydrocortisone administration at preventing posttraumatic distress in adult trauma patients: a randomized trial.
abstract: OBJECTIVE/INTRODUCTION: Secondary pharmacological interventions have shown promise at reducing the development of posttraumatic stress disorder symptoms (PTSS) in preclinical studies. The present study examined the preliminary efficacy of a 10-day low-dose (20 mg bid) course of hydrocortisone at preventing PTSS in traumatic injury victims.
  
  
  METHODS
  Sixty-four traumatic injury patients (34% female) were randomly assigned in a double-blind protocol to receive either a 10-day course of hydrocortisone or placebo initiated within 12 hours of the trauma. One-month and 3-months posttrauma participants completed an interview to assess PTSS and self-report measures of depression and health-related quality of life.
  
  
  RESULTS
  Hydrocortisone recipients reported fewer PTSD and depression symptoms, and had greater improvements in health-related quality of life during the first 3 months posttrauma than did placebo recipients. Hydrocortisone recipients who had never received prior mental health treatment had the lowest PTSD scores.
  
  
  CONCLUSIONS
  Low-dose hydrocortisone may be a promising approach to the prevention of PTSD in acutely injured trauma patients, and may be particularly efficacious in acutely injured trauma victims without a history of significant psychopathology.
authors.affiliation: Department of Psychology, Kent State University, Kent, OH, USA. ddelahan@kent.edu
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Delahanty
authors.forename: Crystal
authors.initials: C
authors.lastname: Gabert-Quillen
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Ostrowski
authors.forename: Nicole R
authors.initials: NR
authors.lastname: Nugent
authors.forename: Beth
authors.initials: B
authors.lastname: Fischer
authors.forename: Adam
authors.initials: A
authors.lastname: Morris
authors.forename: Roger K
authors.initials: RK
authors.lastname: Pitman
authors.forename: John
authors.initials: J
authors.lastname: Bon
authors.forename: William
authors.initials: W
authors.lastname: Fallon
mesh_terms: D000328:Adult; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D014151:Anti-Anxiety Agents; D006854:Hydrocortisone
references.citation: J Neurosci. 1994 Apr;14(4):2047-53
references.pmid: 8198631
references.citation: Arch Gen Psychiatry. 2005 Jun;62(6):617-27
references.pmid: 15939839
references.citation: Biol Psychiatry. 2004 Mar 15;55(6):627-33
references.pmid: 15013832
references.citation: Br J Psychiatry. 2000 Jun;176:589-93
references.pmid: 10974967
references.citation: Am J Psychiatry. 2001 Sep;158(9):1480-5
references.pmid: 11532735
references.citation: Am J Psychiatry. 1992 May;149(5):671-5
references.pmid: 1575259
references.citation: Psychophysiology. 2007 Jul;44(4):660-9
references.pmid: 17521374
references.citation: Am J Psychiatry. 2003 Jul;160(7):1337-9
references.pmid: 12832251
references.citation: Am J Psychiatry. 1999 Apr;156(4):589-95
references.pmid: 10200739
references.citation: J Anxiety Disord. 2011 Apr;25(3):456-65
references.pmid: 21168991
references.citation: Brain Res Brain Res Rev. 1997 Jun;24(1):1-27
references.pmid: 9233540
references.citation: J Nerv Ment Dis. 2001 Nov;189(11):796-8
references.pmid: 11758665
references.citation: Proc Soc Exp Biol Med. 1964 Oct;117:118-21
references.pmid: 14219919
references.citation: JAMA. 2003 Aug 6;290(5):627-34
references.pmid: 12902366
references.citation: Ann N Y Acad Sci. 2004 Dec;1032:141-53
references.pmid: 15677401
references.citation: Compr Psychiatry. 1996 Sep-Oct;37(5):336-46
references.pmid: 8879908
references.citation: Ann Intern Med. 1976 Mar;84(3):304-15
references.pmid: 769625
references.citation: Front Neuroendocrinol. 2009 Aug;30(3):358-70
references.pmid: 19341764
references.citation: Lancet. 1999 Sep 18;354(9183):1008
references.pmid: 10501375
references.citation: Am J Psychiatry. 1998 May;155(5):630-7
references.pmid: 9585714
references.citation: Am J Psychiatry. 1993 Oct;150(10):1512-6
references.pmid: 8379556
references.citation: Life Sci. 1996;58(17):1475-83
references.pmid: 8622574
references.citation: Am J Orthopsychiatry. 2002 Oct;72(4):469-75
references.pmid: 15792032
references.citation: Am J Psychiatry. 1997 Dec;154(12):1690-5
references.pmid: 9396947
references.citation: Lancet. 1974 Jul 13;2(7872):81-4
references.pmid: 4136544
references.citation: Br J Psychiatry. 1989 Feb;154:221-8
references.pmid: 2775949
references.citation: Nat Neurosci. 2000 Apr;3(4):313-4
references.pmid: 10725918
references.citation: JAMA. 2003 Aug 6;290(5):643-9
references.pmid: 12902368
references.citation: Behav Res Ther. 1996 Jan;34(1):1-10
references.pmid: 8561759
references.citation: Anxiety. 1996;2(5):226-33
references.pmid: 9160627
references.citation: Arch Gen Psychiatry. 1999 Jun;56(6):527-33
references.pmid: 10359467
references.citation: Acta Neurol Scand. 1993 Jan;87(1):52-5
references.pmid: 8424312
references.citation: Biol Psychiatry. 2002 Jan 15;51(2):189-92
references.pmid: 11822998
references.citation: Issues Ment Health Nurs. 2005 Aug-Sep;26(7):721-38
references.pmid: 16126648
references.citation: Arch Gen Psychiatry. 2003 May;60(5):481-9
references.pmid: 12742869
references.citation: Eur J Neurosci. 2003 Mar;17(6):1296-302
references.pmid: 12670318
references.citation: Am J Psychiatry. 2003 Mar;160(3):580-2
references.pmid: 12611845
references.citation: Behav Res Ther. 1994 Mar;32(3):283-90
references.pmid: 8192626
references.citation: Biol Psychiatry. 1989 Jul;26(3):221-3
references.pmid: 2545287
references.citation: Psychol Med. 1999 Jul;29(4):793-9
references.pmid: 10473306
references.citation: Psychoneuroendocrinology. 1992 Aug;17(4):343-54
references.pmid: 1332100
references.citation: Biol Psychiatry. 2001 Dec 15;50(12):978-85
references.pmid: 11750894
references.citation: Med Care. 1992 Jun;30(6):473-83
references.pmid: 1593914
references.citation: Eur Neuropsychopharmacol. 2011 Nov;21(11):796-809
references.pmid: 21741804
references.citation: Biol Psychiatry. 2000 Nov 1;48(9):902-9
references.pmid: 11074228
references.citation: J Gen Intern Med. 2007 Jun;22(6):711-8
references.pmid: 17503104
references.citation: Adv Wound Care. 1998 Oct;11(6):277-85
references.pmid: 10326344
references.citation: Psychol Bull. 2003 Jan;129(1):52-73
references.pmid: 12555794
references.citation: J Trauma Stress. 1995 Jan;8(1):75-90
references.pmid: 7712061
references.citation: Crit Care Med. 1999 Dec;27(12):2678-83
references.pmid: 10628609
references.citation: Am J Psychiatry. 1990 Oct;147(10):1297-303
references.pmid: 2399996