In:
Journal of Psychophysiology, Hogrefe Publishing Group, Vol. 28, No. 4 ( 2014-01-01), p. 257-264
Abstract:
Panic disorder (PD) has been associated with an altered reactivity of the hypothalamic-pituitary-adrenocortical (HPA) system in the dexamethasone-corticotropin-releasing-hormone (DEX-CRH) test. Recent findings showed that the duration of the PD and the severity of psychopathology are prominent moderators of the HPA-axis reactivity under hormonal stress induction. As major depression (MD) often occurs as comorbidity in patients with PD, a secondary MD might influence the reactivity of HPA-axis in the DEX-CRH test. For this study, the DEX-CRH test was implemented to observe the adreno-corticotropin-hormone (ACTH) and the cortisol release. The sample included 20 patients diagnosed with PD (mean age = 32.20 years, SD = 9.98), 20 patients with PD and comorbid MD (mean age = 37.63 years, SD = 11.31) in a Structured Clinical Interview (SCID), and 20 healthy controls (mean age = 31.97 years, SD = 10.53) matched by age and gender. The ACTH and the cortisol release increased significantly in all three groups due to the CRH injection (p 〈 .001). The two anxiety patient groups differed in the cortisol response pattern, however, not in the ACTH. Patients with pure PD showed a lower CRH-induced cortisol release than healthy controls (p 〈 .038) and patients with a comorbid major depression (p = .001); the latter showed the highest cortisol release in DEX-CRH test. Duration (AUCg: r = .353, p = .030; AUCi: r = .339, p = .037) and severity of psychopathology (AUCg: r = .496, p = .026; AUCi: r = .463, p = .040) significantly correlated with the cortisol release. Patients with/without comorbid MD showed some dissociation between the central and the peripheral HPA-axis functionality under the DEX-CRH test. Furthermore, it seems that a secondary depressive disorder is the decisive factor in explaining an increased reactivity of HPA-axis in patients with PD.
Type of Medium:
Online Resource
ISSN:
0269-8803
,
2151-2124
DOI:
10.1027/0269-8803/a000117
Language:
English
Publisher:
Hogrefe Publishing Group
Publication Date:
2014
detail.hit.zdb_id:
2091177-4
SSG:
5,2
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