title: Cortisol awakening response in drug-naïve panic disorder.
abstract: BACKGROUND
  It is unclear whether hypothalamic-pituitary-adrenal axis is involved in the pathophysiology of panic disorder (PD). The findings remain inconsistent. Cortisol awakening response (CAR) is a noninvasive biomarker of stress system activity. We designed the study to assess CAR in drug-naïve PD patients.
  
  
  METHODS
  We assessed CAR in 14 psychotropic drug-naïve outpatients with PD and 14 healthy controls. The severity of PD was assessed with Panic and Agoraphobia Scale. The severity of anxiety and depression was screened with Hospital Anxiety and Depression Scale.
  
  
  RESULTS
  No significant difference in CAR between PD patients and control group was found. No correlations were observed between CAR and anxiety severity measures in PD patients and controls.
  
  
  CONCLUSIONS
  The number of participating subjects was relatively small, and the study results apply to nonsuicidal drug-naïve PD patients without agoraphobia and with short-illness duration. There was a lack of control on subjects' compliance with the sampling instructions.
  
  
  CONCLUSIONS
  The study provides no support for elevated CAR levels in drug-naïve PD patients without agoraphobia.
authors.affiliation: Department of Psychiatry, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Jakuszkowiak-Wojten
authors.affiliation: Department of Psychiatry, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Landowski
authors.affiliation: Department of Psychiatry, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Mariusz S
authors.initials: MS
authors.lastname: Wiglusz
authors.affiliation: Department of Psychiatry, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Wiesław Jerzy
authors.initials: WJ
authors.lastname: Cubała
keywords: CAR; HPA axis; PD; cortisol awakening response; hypothalamic–pituitary–adrenal axis; panic disorder