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Effects of trauma exposure on the cortisol response to dexamethasone administration in PTSD and major depressive disorder

Yehuda, R., Halligan, S.L., Golier, J.A. , Grossman, R. and Bierer, L.M. (2004) Effects of trauma exposure on the cortisol response to dexamethasone administration in PTSD and major depressive disorder. Psychoneuroendocrinology, 29 (3). pp. 389-404. ISSN 0306-4530

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To link to this article DOI: 10.1016/S0306-4530(03)00052-0

Abstract/Summary

Objective: To evaluate cortisol suppression following 0.5 mg of dexamethasone (DEX) in trauma survivors (N = 52),with posttraumatic stress disorder (PTSD), major depressive disorder (MDD), both, or neither disorder, and in subjects never exposed to trauma (N = 10), in order to examine interactions between diagnosis and trauma history on cortisol negative feedback inhibition. Method: Lifetime trauma exposure and psychiatric diagnoses were assessed and blood samples were obtained at 8:00 a.m. for the determination of baseline cortisol. Participants ingested 0.5 mg of DEX at 11:00 p.m. and blood samples for determination of cortisol and DEX were obtained at 8:00 a.m. the following day. Results: PTSD was associated with enhanced cortisol suppression in response to DEX Among trauma survivors, the presence of a traumatic event prior to the "focal" trauma had a substantial impact on cortisol suppression in subjects with MDD. Such subjects were more likely to show cortisol alterations similar to those associated with PTSD, whereas subjects with MDD with no prior trauma were more likely to show alterations in the opposite direction, i.e. relative non-suppression. Conclusions: Cortisol hypersuppression in PTSD appears not to be dependent on the presence of traumatic events prior to the focal trauma. However, prior trauma exposure may affect cortisol suppression in MDD. This finding may have implications for understanding why only some depressed patients show non-suppression on the DST. Published by Elsevier Ltd.

Item Type:Article
Refereed:Yes
Divisions:Interdisciplinary centres and themes > Winnicott
Faculty of Life Sciences > School of Psychology and Clinical Language Sciences
ID Code:13803
Uncontrolled Keywords:dexamethasone suppression test, major depressive disorder, posttraumatic stress disorder, cortisol, neuroendocrinology, trauma , POSTTRAUMATIC-STRESS-DISORDER, PITUITARY-ADRENAL AXIS, PLASMA-CORTISOL, HOLOCAUST SURVIVORS, VIETNAM VETERANS, COMBAT VETERANS, PHYSICAL ABUSE, LIFE EVENTS, COMORBIDITY, CHILDHOOD

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