Background
We aim to characterize the baseline functioning of the hypothalamic-pituitary-adrenal
(HPA) axis in Gulf War veterans (GWV) and examine the extent to which posttraumatic
stress disorder (PTSD) and unexplained health symptoms—which commonly co-occur—have
similar or different biological correlates.
Methods
Thirty-one GWV, 20 with current PTSD and 11 without current or lifetime PTSD, and
16 healthy nondeployed subjects not exposed to the Gulf War theater underwent medical
and psychiatric examination followed by blood sampling every half-hour over 24 hours
for the measurement of cortisol and adrenocorticotropic hormone (ACTH).
Results
Gulf War veterans without PTSD or another psychiatric disorder had significantly lower
24-hour plasma ACTH levels, a significantly higher cortisol:ACTH ratio, and no difference
in cortisol levels compared to nondeployed subjects and to GWV with PTSD, controlling
for body mass index (BMI). Among GWV, health symptoms (mood and cognitive symptoms)
were positively associated with, and hyperarousal symptoms were negatively associated
with, the cortisol:ACTH ratio. Additionally, the self-reported acute effects of pesticides
and of pyridostigmine bromide during deployment were associated with lower ACTH levels,
controlling for BMI and PTSD.
Conclusions
The data provide evidence of HPA axis dysregulation in Gulf War veterans, which may
be related to Gulf War deployment exposures. Despite the overlap of chronic unexplained
health symptoms and PTSD in GWV, these symptom constellations appear to be biologically
distinct.
Key Words
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Article info
Publication history
Published online: July 09, 2007
Accepted:
April 9,
2007
Received in revised form:
April 4,
2007
Received:
December 22,
2006
Identification
Copyright
© 2007 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
