Abstract
Background: Limited studies of hypothalamic-pituitary-adrenal axis regulation in posttraumatic
stress disorder have been performed in premenopausal women. We therefore undertook
a study of hypothalamic-pituitary-adrenal axis regulation in this population.
Methods: Outpatient posttraumatic stress disorder subjects were compared with healthy,
age- and weight-matched nontraumatized subjects. Subjects were free from psychotropic
medications, alcohol and other illicit substances for at least 4 weeks before study.
Menstrual cycle phase was determined by monitoring the LH surge and plasma progesterone
levels. Corticotropin releasing factor and adrenocorticotropin stimulation tests,
as well as 24-hour urinary-free cortisol measurements were performed.
Results: Corticotropin releasing factor test: Baseline adrenocorticotropic hormone
and cortisol levels did not differ between the 12 PTSD and 11 comparison subjects,
but the posttraumatic stress disorder group had greater adrenocorticotropic hormone
and cortisol responses to corticotropin releasing factor, as well as a later cortisol
peak. Adrenocorticotropic hormone test: Baseline cortisol levels did not differ between
the 10 posttraumatic stress disorder subjects and seven controls, but the posttraumatic
stress disorder group showed greater cortisol responses to adrenocorticotropic hormone.
Peak cortisol responses to corticotropin releasing factor and adrenocorticotropic
hormone were correlated with each other and with 24-hour urinary-free cortisol excretion.
Conclusions: Pituitary and adrenal hyperreactivity to exogenous corticotropin releasing
factor and adrenocorticotropic hormone is demonstrated in premenopausal women with
chronic posttraumatic stress disorder. Cortisol hyperreactivity thus may play a role
in the pathophysiology of posttraumatic stress disorder in women.
Keywords
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Article info
Publication history
Accepted:
August 10,
2001
Received in revised form:
July 19,
2001
Received:
February 26,
2001
Identification
Copyright
© 2001 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
