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Varghese TP, Chand S, Varghese NM, Singh R, Yadav SK. Interplay of inflammatory biomarkers in heart disease patients with depressive symptoms: An update. Curr Probl Cardiol 2024; 49:102352. [PMID: 38128639 DOI: 10.1016/j.cpcardiol.2023.102352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023]
Abstract
The pathophysiological mechanisms that connect heart disease and depressive disorders have been identified as abnormal endothelial function, dysregulation of the Hypothalamic Pituitary Adrenal (HPA) axis and abnormal platelet activities. Among these mechanisms, both endothelial dysfunction and HPA axis dysregulation are influenced by low grade inflammation and play significant roles in both conditions. Consequently, it is hypothesized that inflammation is an integral part of the formation of atherosclerotic plaques, linking the occurrence of heart diseases to the activation and shedding of intercellular adhesion molecules (ICAMs), especially soluble ICAM-1. This process is accompanied by the local and systemic secretion of various inflammatory markers like interleukin-6, Tumour Necrosis Factor, and C-reactive protein. Therefore, this review primarily focuses on defining the potential role of different inflammatory biomarkers in depression and heart disease and assessing whether mediators could serve as predictive biomarkers for detecting depressive symptoms in patients with heart disease.
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Affiliation(s)
- Treesa P Varghese
- Associate Professor, Department of Pharmacy Practice, Yenepoya Pharmacy College & Research Centre (Yenepoya deemed to be University), Naringana, Mangalore, Karnataka, India.
| | - Sharad Chand
- Assistant Professor, Department of Pharmaceutical Sciences, School of Health Sciences and Technology, Dr. Vishwanath Karad MIT World Peace University, Pune, Maharashtra - 411038, India.
| | - Nila Mary Varghese
- Professor, Department of Pharmaceutics, ELIMS College of Pharmacy, Thrissur, Kerala, India.
| | - Rohit Singh
- Assistant Professor, Department of Pharmaceutical Sciences, School of Health Sciences and Technology, Dr. Vishwanath Karad MIT World Peace University, Pune, Maharashtra - 411038, India.
| | - Shiv Kumar Yadav
- Assistant Professor, Department of Pharmacy Practice, RC Patel Institute of Pharmaceutical Education and Research, Shirpur, India.
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2
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Stroud CB, Chen FR, Levin RY, Richman MM, Lamberth E, Doane LD. Individual differences in latent trait cortisol (LTC): Implications for the onset and course of future depressive symptoms. Psychoneuroendocrinology 2022; 146:105926. [PMID: 36155317 DOI: 10.1016/j.psyneuen.2022.105926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/12/2022] [Accepted: 09/09/2022] [Indexed: 11/17/2022]
Abstract
Research suggests that various indicators of hypothalamic pituitary adrenal (HPA) axis activity prospectively predict depression, but few studies have evaluated whether trait indicators of HPA axis activity are related to depression. Further, no prior study has examined links between trait cortisol and psychopathology using a trait indicator that captures HPA axis activity over multiple time points. Here we examined whether we could construct an across-wave latent trait cortisol (LTC) factor using cortisol samples collected over 13 weeks, and whether the across-wave LTC prospectively predicted new depressive symptom onsets and symptom duration. Emerging adults (n = 85; M age = 19.37 years) provided salivary cortisol samples four times a day (waking, 30 min and 45 min post-waking and bedtime) over three 3-day measurement waves separated by 6 weeks. Diagnostic interviews at 3 timepoints (baseline, 1- and 2.5 years post-baseline) assessed lifetime and current depressive symptoms. Results indicated that the across-wave LTC predicted new onsets of depressive symptoms and longer symptom duration. Follow-up tests revealed that the link between the across-wave LTC and new onsets was not significant after adjusting for past depressive symptoms. These findings suggest that an indicator of individual differences in HPA axis regulation has implications for depressive symptom onsets and course.
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Affiliation(s)
- Catherine B Stroud
- Department of Psychology, Williams College, Williamstown, MA 01267, USA.
| | - Frances R Chen
- Department of Criminal Justice and Criminology, Georgia State University, Atlanta, GA 30303, USA
| | - Rachel Y Levin
- Department of Psychology, Williams College, Williamstown, MA 01267, USA; Department of Psychology, University of Rochester, Rochester, NY 14627, USA
| | - Morgan M Richman
- Department of Psychology, Williams College, Williamstown, MA 01267, USA; Department of Medicine, University of Virginia, Charlottesville, VA 22903, USA
| | - Erin Lamberth
- Department of Psychology, Williams College, Williamstown, MA 01267, USA; Boston College School of Social Work, Boston College, Chestnut Hill, MA 02467, USA
| | - Leah D Doane
- Department of Psychology, Arizona State University, Tempe, AZ 85287-1104, USA
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3
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Rudd KL, Bush NR, Alkon A, Roubinov DS. Identifying profiles of multisystem physiological activity across early childhood: Examining developmental shifts and associations with stress and internalizing problems. Psychoneuroendocrinology 2021; 128:105196. [PMID: 33765640 PMCID: PMC8188642 DOI: 10.1016/j.psyneuen.2021.105196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/24/2021] [Accepted: 03/02/2021] [Indexed: 10/21/2022]
Abstract
Physiological regulation is an important predictor of health across the lifespan. Regulation occurs across multiple collaborative systems, yet few empirical studies explore multisystem activity and how this collaborative regulation develops early in life. The current study used latent profile analysis to evaluate multisystem regulation in the autonomic nervous system and hypothalamic pituitary adrenal (HPA) axis in 150 racially/ethnically diverse, low-income children at 18- and 36-months. At both timepoints, profiles of generally moderate activity (Moderate Arousal) and heightened baseline activity (Anticipatory Arousal) emerged. A profile of typically adaptive patterns across all systems (Active Copers) emerged at 18-months and a profile of heightened HPA Axis activity (HPA-axis Responders) emerged at 36-months. Persistent membership in the Anticipatory Arousal profile across time was associated with exposure to greater maternal stress at 18-months and child internalizing problems at 36-months. These findings highlight early multisystem profile development and suggest associations with stress and later behavior problems.
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Affiliation(s)
- Kristen L. Rudd
- University of California, San Francisco; Department of Psychiatry and Behavioral Sciences; San Francisco, CA
| | - Nicole R. Bush
- University of California, San Francisco; Department of Psychiatry and Behavioral Sciences; San Francisco, CA,University of California, San Francisco; Department of Pediatrics; San Francisco, CA,University of California, San Francisco; Weill Institute for Neurosciences; San Francisco, CA
| | - Abbey Alkon
- University of California, San Francisco; School of Nursing; San Francisco, CA
| | - Danielle S. Roubinov
- University of California, San Francisco; Department of Psychiatry and Behavioral Sciences; San Francisco, CA,University of California, San Francisco; Weill Institute for Neurosciences; San Francisco, CA
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Farrow P, Simmons JG, Pozzi E, Díaz-Arteche C, Richmond S, Bray K, Schwartz O, Whittle S. Associations between early life stress and anterior pituitary gland volume development during late childhood. Psychoneuroendocrinology 2020; 122:104868. [PMID: 33068951 DOI: 10.1016/j.psyneuen.2020.104868] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 09/04/2020] [Accepted: 09/04/2020] [Indexed: 01/15/2023]
Abstract
Early Life Stress (ELS) is thought to influence Hypothalamic-Pituitary-Adrenal-Axis (HPAA) functioning, contributing to an increased risk for psychopathology through dysregulation of biological stress responses. Research exploring relationships between ELS and HPAA functioning has largely focused on its key hormonal output, cortisol. However, findings have been inconsistent, potentially due to cortisol's distinctive diurnal patterns and dynamic nature complicating its accurate measurement. Thus, this study explored the link between ELS and a more stable, structural component of the HPAA, specifically, anterior pituitary gland volume (PGV) in a community sample of children (N = 129, 68 female). PGV was traced from Magnetic Resonance Imaging brain scans across two time-points at ages 8 (baseline) and 10 years (follow-up). ELS exposure was assessed at baseline through parent-report questionnaires and maternal affective behavior observed in mother-child interaction tasks. ELS variables were reduced to a 5-factor structure using exploratory factor analysis - Uninvolved Parenting, Negative Affective Parenting, Neglect, Trauma, and Dysfunctional Discipline. Direct and sex-moderated associations between ELS and PGV were explored using regression and linear mixed models analyses. PGV-mediated associations between ELS and internalizing symptoms were also investigated. Childhood Neglect was significantly associated with greater baseline anterior PGV, that was stable over the follow-up period. This effect was found in the whole sample, and in males, specifically. No mediation effects were found. Results suggest that neglect may play a unique role in HPAA neurodevelopment; however, it is important that future research extends into adolescence to more clearly characterize these neurodevelopmental associations and any subsequent psychopathological outcomes.
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Affiliation(s)
- Paige Farrow
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, VIC, Australia
| | - Julian G Simmons
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, VIC, Australia
| | - Elena Pozzi
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia; Orygen, Centre for Youth Mental Health, The University of Melbourne, VIC, Australia
| | - Carmela Díaz-Arteche
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia
| | - Sally Richmond
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, VIC, Australia
| | - Katherine Bray
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, VIC, Australia
| | - Orli Schwartz
- Orygen, Centre for Youth Mental Health, The University of Melbourne, VIC, Australia
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, VIC, Australia.
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McLean MA, Simcock G, Elgbeili G, Laplante DP, Kildea S, Hurrion E, Lequertier B, Cobham VE, King S. Disaster-related prenatal maternal stress, and childhood HPA-axis regulation and anxiety: The QF2011 Queensland Flood Study. Psychoneuroendocrinology 2020; 118:104716. [PMID: 32479967 DOI: 10.1016/j.psyneuen.2020.104716] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 05/01/2020] [Accepted: 05/12/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND The fetal programming hypothesis suggests that prenatal maternal stress (PNMS) influences aspects of fetal development, such as the Hypothalamic Pituitary Adrenal (HPA) axis, enhancing susceptibility to emotional problems. No study (to our knowledge) has investigated this pathway considering development of preschool anxiety symptoms. Using data from the Queensland Flood study (QF2011), our objective was to determine whether toddler HPA-axis functioning mediated the association between aspects of flood-related PNMS and child anxiety symptoms at 4-years, and whether relationships were moderated by the timing of the stressor in utero or by the child's sex. METHODS Women, pregnant during the 2011 Queensland floods (N = 230), were recruited soon afterwards and completed questionnaires regarding their objective hardship (e.g., loss of personal property), subjective distress (post-traumatic-like symptoms) and cognitive appraisal of the disaster. At 16 months, indexes of the child's diurnal cortisol rhythm (awakening response, total daily output, diurnal slope [N = 80]), and stress reactivity (N = 111), were obtained. At 4-years, N = 117 mothers reported on their own mood and their children's anxiety symptoms; of these, N = 80 also had valid child cortisol reactivity data, and N = 64 had diurnal cortisol rhythm data. RESULTS A greater cortisol awakening response at 16 months mediated the relationship between subjective PNMS and anxiety symptoms at 4-years. Greater toddler daily cortisol secretion predicted more anxiety symptoms, independent of PNMS. The laboratory stressor did not elicit a cortisol response. PNMS effects were not dependent upon child sex nor on gestational timing of flood exposure. CONCLUSIONS Indexes of diurnal cortisol in toddlerhood may represent vulnerability for anxiety symptoms in preschoolers, both independent of, and following, exposure to disaster-related prenatal maternal subjective distress.
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Affiliation(s)
- Mia A McLean
- Mater Research Institute-University of Queensland, Brisbane, Queensland, Australia; School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Gabrielle Simcock
- Mater Research Institute-University of Queensland, Brisbane, Queensland, Australia; School of Psychology, The University of Queensland, Brisbane, Queensland, Australia; Thompson Institute, University of Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Guillaume Elgbeili
- Schizophrenia and Neurodevelopmental Disorders Research, Douglas Mental Health University Institute, Verdun, Quebec, Canada
| | - David P Laplante
- Schizophrenia and Neurodevelopmental Disorders Research, Douglas Mental Health University Institute, Verdun, Quebec, Canada; Centre for Child Development and Mental Health, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - Sue Kildea
- Mater Research Institute-University of Queensland, Brisbane, Queensland, Australia; Molly Wardaguga Research Center, School of Nursing and Midwifery, Charles Darwin University, Brisbane, Queensland, Australia
| | - Elizabeth Hurrion
- Mater Research Institute-University of Queensland, Brisbane, Queensland, Australia
| | - Belinda Lequertier
- Mater Research Institute-University of Queensland, Brisbane, Queensland, Australia; School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Vanessa E Cobham
- Mater Research Institute-University of Queensland, Brisbane, Queensland, Australia; School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Suzanne King
- Thompson Institute, University of Sunshine Coast, Sippy Downs, Queensland, Australia; Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
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Muscatello RA, Andujar J, Taylor JL, Corbett BA. Exploring Key Physiological System Profiles at Rest and the Association with Depressive Symptoms in Autism Spectrum Disorder. J Autism Dev Disord 2020; 51:15-29. [PMID: 32350791 DOI: 10.1007/s10803-020-04516-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Depression is often associated with dysfunction in the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS). Individuals with autism spectrum disorder (ASD) may experience physiological dysregulation and psychological comorbidities; however, the extent to which the interactions between these systems predict internalizing symptoms in ASD has not been investigated. The study examined interactions with the HPA axis and ANS in 10-13-year-old children with ASD (n = 41) and typical development (TD; n = 46). The interrelated systems uniquely contributed to depressive symptoms in ASD above and beyond any system in isolation. A reciprocal, parasympathetic-dominant ANS was related to fewer affective symptoms in ASD. Findings highlight the importance of examining arousal across multiple systems to more precisely identify profiles associated with maladaptive psychiatric outcomes in ASD.
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Affiliation(s)
- Rachael A Muscatello
- Vanderbilt Brain Institute, Neuroscience Graduate Program, 1500 21st Avenue S., Nashville, TN, 37212, USA.
| | - Justin Andujar
- Vanderbilt University, Nashville, TN, USA.,Department of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Julie L Taylor
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Blythe A Corbett
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Psychology, Vanderbilt University, Nashville, TN, USA
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7
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Stoppe M, Meyer K, Schlingmann M, Olbrich S, Then Bergh F. Hyperstable arousal regulation in multiple sclerosis. Psychoneuroendocrinology 2019; 110:104417. [PMID: 31546115 DOI: 10.1016/j.psyneuen.2019.104417] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 08/20/2019] [Accepted: 08/22/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Fatigue is common in multiple sclerosis (MS) patients. Exhaustion of physiological reserves and mental stress are postulated causes, the latter supported by more pronounced hypothalamic-pituitary-adrenal (HPA) axis activation in fatigued patients. Divergent dysregulation of arousal appears to play important roles in depression- (hyperstable arousal) and in cancer-related (unstable arousal) fatigue, where HPA axis is hyperactive or hypoactive, respectively. OBJECTIVE This study assessed arousal regulation in multiple sclerosis patients, explored if fatigue can be physiologically described by altered arousal regulation, and if HPA axis activity corresponds to the type(s) of arousal regulation. METHODS 51 mildly-affected patients with relapsing-remitting MS (86% on disease-modifying treatment) and 20 healthy controls were analysed via Vigilance Algorithm Leipzig and combined dexamethasone/corticotropin releasing hormone test. RESULTS Hyperstable arousal pattern was significantly more frequent in patients than in controls (62.7% vs. 45.0%, p = 0.011). Patients scored higher on all fatigue, but not on sleepiness scales. All patients combined showed mild activation of the hypothalamic-pituitary-adrenal axis (p < 0.05 for post-CRH ACTH and AUC ACTH; cortisol n.s.). While fatigue was numerically more pronounced in both hyperstable and unstable arousal, HPA axis activity was highest in hyperstable and lowest in unstable arousal (p = 0.013 for post-CRH ACTH; p = 0.087 for AUC ACTH; cortisol n.s.). CONCLUSION Frequency of arousal patterns are altered in MS. An association with HPA axis activity was weak, possibly because the present sample was stable on immunotherapy.
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Affiliation(s)
- Muriel Stoppe
- Department of Neurology, University of Leipzig, Germany; Translational Centre for Regenerative Medicine, University of Leipzig, Germany
| | - Klara Meyer
- Department of Neurology, University of Leipzig, Germany
| | | | | | - Florian Then Bergh
- Department of Neurology, University of Leipzig, Germany; Translational Centre for Regenerative Medicine, University of Leipzig, Germany.
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Ahmad N, Abosoudah IF, Sobaihi MM, Algiraigri AH, Roujouleh F, Ghurab F, Chanoine JP. Adrenal function following acute discontinuation of glucocorticoids in children with acute lymphocytic leukemia: A prospective study. Pediatr Hematol Oncol 2019; 36:422-431. [PMID: 31429623 DOI: 10.1080/08880018.2019.1652710] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Children with acute lymphocytic leukemia (ALL) are enrolled in advanced treatment protocols involving high doses of glucocorticoids (GCs). Current protocols do not advocate tapering of GCs doses postinduction phase. Prolonged administration of supra-physiologic doses of GCs can induce transient suppression of the hypothalamic pituitary adrenal axis (HPA). Timely recognition of adrenal insufficiency is important in order to ensure that children at risk receive the necessary treatment and follow-up including stress coverage during illness and surgical procedures. Methods: 21 newly diagnosed patients with ALL aged 3-10 years old were prospectively enrolled in the study over a 2-year period. All enrolled patients received high doses of GCs as part of a chemotherapy treatment protocol. The HPA axis was assessed prior to the induction phase of chemotherapy and 1-2 weeks after un-tapered discontinuation of GCs. Results: All children had normal HPA axis at baseline. Postinduction 1 mcg ACTH stimulation test result was normal (cortisol > 500 nmol/L) in 75% of children and partially responsive in 25% (cortisol 300-500 nmol/L). None of the participants demonstrated clinically significant adrenal insufficiency following abrupt cessation of GCs. Conclusion: All children in our cohort had either normal or subnormal cortisol response during a low dose ACTH stimulation test 1 to 2 weeks following abrupt discontinuation of GCs, suggesting that any inhibition of the HPA axis is of short duration. We suggest that future studies investigate the timing of adrenal function recovery following GC discontinuation as well as whether tapering of the GC should be recommended.
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Affiliation(s)
- Noman Ahmad
- Consultant Pediatric Endocrinology, King Faisal Specialist Hospital and Research Center , Jeddah , Saudi Arabia
| | - Ibraheem Faisal Abosoudah
- Consultant Pediatric Oncology, King Faisal Specialist Hospital and Research Center , Jeddah , Saudi Arabia
| | - Mrouge Mohamed Sobaihi
- Consultant Pediatric Endocrinology, King Faisal Specialist Hospital and Research Center , Jeddah , Saudi Arabia
| | - Ali Hassan Algiraigri
- Consultant Pediatric Oncology, King Faisal Specialist Hospital and Research Center , Jeddah , Saudi Arabia.,King Abdulaziz university hospital , Jeddah , Saudi Arabia
| | - Farh Roujouleh
- Resident General Pediatrics, King Faisal Specialist Hospital and Research Center , Jeddah , Saudi Arabia
| | - Fatima Ghurab
- Resident General Pediatrics, King Faisal Specialist Hospital and Research Center , Jeddah , Saudi Arabia
| | - Jean-Pierre Chanoine
- Clinical Professor and Head, Endocrinology and Diabetes Unit, British Columbia Children's Hospital , Vancouver Canada
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Stroud CB, Chen FR, Curzi BE, Granger DA, Doane LD. Overestimating Self-Blame for Stressful Life Events and Adolescents' Latent Trait Cortisol: The Moderating Role of Parental Warmth. J Youth Adolesc 2019; 49:283-298. [PMID: 31446583 DOI: 10.1007/s10964-019-01112-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 08/13/2019] [Indexed: 12/29/2022]
Abstract
Cognitive interpretations of stressful events impact their implications for physiological stress processes. However, whether such interpretations are related to trait cortisol-an indicator of individual differences in stress physiology-is unknown. In 112 early adolescent girls (M age = 12.39 years), this study examined the association between self-blame estimates for past year events and latent trait cortisol, and whether maternal warmth moderated effects. Overestimating self-blame (versus objective indices) for independent (uncontrollable) events was associated with lower latent trait cortisol, and maternal warmth moderated the effect of self-blame estimates on latent trait cortisol for each dependent (at least partially controllable) and interpersonal events. Implications for understanding the impact of cognitive and interpersonal factors on trait cortisol during early adolescence are discussed.
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Affiliation(s)
- Catherine B Stroud
- Department of Psychology, Williams College, Williamstown, MA, 01267, USA.
| | - Frances R Chen
- Department of Criminal Justice and Criminology, Georgia State University, Atlanta, GA, 30303, USA.,Institute for Interdisciplinary Salivary Bioscience Research, University of California at Irvine, Irvine, CA, 92697-7085, USA
| | - Blair E Curzi
- Department of Psychology, Williams College, Williamstown, MA, 01267, USA
| | - Douglas A Granger
- Institute for Interdisciplinary Salivary Bioscience Research, University of California at Irvine, Irvine, CA, 92697-7085, USA.,The Johns Hopkins University School of Nursing, Bloomberg School of Public Health, and School of Medicine, The Johns Hopkins University, Baltimore, MD, 21218, USA.,Salivary Bioscience Laboratory and Department of Psychology, University of Nebraska, Lincoln, NE, USA
| | - Leah D Doane
- Department of Psychology, Arizona State University, Tempe, AZ, 85287-1104, USA
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10
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Kertes DA, Kamin HS, Liu J, Bhatt SS, Kelly M. Putting a finger on the problem: Finger stick blood draw and immunization at the well-child exam elicit a cortisol response to stress among one-year-old children. Psychoneuroendocrinology 2018; 93:103-106. [PMID: 29705575 PMCID: PMC7075369 DOI: 10.1016/j.psyneuen.2018.04.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/19/2018] [Accepted: 04/20/2018] [Indexed: 11/26/2022]
Abstract
Research examining stress reactivity of the hypothalamic-pituitary-adrenocortical (HPA) axis in young children has historically been hampered by a lack of reliable methods to invoke a cortisol stress response. This report details an effective method of eliciting a cortisol rise in one-year-old children (N = 83) by modifying and combining two naturalistic stressors previously used with infants and children. Salivary cortisol levels were collected from children before and after a finger stick blood draw and immunizations performed during their one year well-child checkup at their pediatrician's office. Results indicated that the stressor was successful at eliciting a significant cortisol response. An extensive set of potential demographic and clinical confounds were also assessed in order to identify methodological considerations important in studies of infant cortisol. The stress paradigm presented here provides a promising alternative for studies of infant HPA activity to enable investigators to more effectively evaluate early functioning of the biological stress system during this developmentally important life stage.
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Affiliation(s)
- Darlene A Kertes
- Department of Psychology, University of Florida, Gainesville, FL, USA.
| | - Hayley S Kamin
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Jingwen Liu
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Samarth S Bhatt
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Maria Kelly
- Department of Pediatrics, University of Florida, Gainesville, FL, USA
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11
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Premkumar P, Bream D, Sapara A, Fannon D, Anilkumar AP, Kuipers E, Kumari V. Pituitary volume reduction in schizophrenia following cognitive behavioural therapy. Schizophr Res 2018; 192:416-422. [PMID: 28434719 PMCID: PMC5821679 DOI: 10.1016/j.schres.2017.04.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 04/14/2017] [Accepted: 04/16/2017] [Indexed: 11/18/2022]
Abstract
Cognitive behavioural therapy (CBT) for psychosis (CBTp) aims to lower the stress of psychotic symptoms. Given that the pituitary is involved in stress regulation, CBT-led stress reduction may be accompanied by a change in pituitary volume. This study aimed to determine whether CBTp reduces pituitary volume in schizophrenia. The relation between pre-therapy memory and CBTp-led pituitary volume change was also examined given that poor memory relates to a blunted cortisol awakening response, denoting impaired stress response, in schizophrenia. Pituitary volume was measured at baseline in 40 schizophrenia or schizoaffective disorder patients and 30 healthy participants before therapy. Pituitary volume was measured again 6-9months after patients had either received CBTp in addition to standard care (CBTp+SC, n=24), or continued with standard care alone (SC, n=16). CBTp+SC and SC groups were compared on pituitary volume change from baseline to follow-up. Pre-therapy memory performance (Hopkins Verbal Learning and Wechsler Memory Scale - Logical memory) was correlated with baseline-to-follow-up pituitary volume change. Pituitary volume reduced over time in CBTp+SC patients. Additionally, pre-therapy verbal learning correlated more strongly with longitudinal pituitary volume reduction in the CBTp+SC group than the SC group. To conclude, CBTp reduces pituitary volume in schizophrenia most likely by enhancing stress regulation and lowering the distress due to psychotic symptoms.
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Affiliation(s)
- Preethi Premkumar
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK.
| | - Danielle Bream
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Adegboyega Sapara
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Dominic Fannon
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Elizabeth Kuipers
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK,NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK
| | - Veena Kumari
- Research & Development, Sovereign Health Group, San Clemente, CA, USA
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Vassoler FM, Toorie AM, Byrnes EM. Transgenerational blunting of morphine-induced corticosterone secretion is associated with dysregulated gene expression in male offspring. Brain Res 2017; 1679:19-25. [PMID: 29129606 DOI: 10.1016/j.brainres.2017.11.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 10/23/2017] [Accepted: 11/06/2017] [Indexed: 12/26/2022]
Abstract
A number of parental experiences, even when occurring prior to conception, have been shown to induce transgenerational effects beyond the first generation. In the case of exposure to drugs of abuse, studies in rodents suggest that offspring demonstrate significant differences in how they respond to the drug to which their parent was exposed. We have previously observed significant alterations in morphine analgesia, conditioned place preference and self-administration in the offspring of females exposed to morphine during adolescent development. In addition to effects on pain perception and reward, morphine also modulates the hypothalamic pituitary adrenal (HPA) axis. The purpose of the current study was to determine whether female adolescent morphine exposure results in transgenerational effects on regulation of the HPA axis by morphine in future generations. Adolescent morphine was administered to female Sprague Dawley rats using a 10 day, escalating dose regimen of morphine (5-25 mg/kg; from 30 to 39 days of age). Control animals received saline. Both saline and morphine exposed females (SAL-F0 and MOR-F0, respectively) were mated with drug naïve males beginning at least 3 weeks after the final injection. Plasma corticosterone levels were measured in male and female offspring (F1) during adulthood following 0, 0.1, or 10 mg/kg morphine. In addition, expression of corticotropin releasing hormone (Crh) and mu opioid receptor (Oprm1) in the paraventricular nucleus (PVN) were measured using quantitative PCR. MOR-F1 males, but not females, had blunted morphine-induced corticosterone secretion. This effect was specific to offspring from females exposed to morphine during adolescence as those exposed during adulthood produced offspring in which the effect was absent. In addition, MOR-F1 males had significantly lower levels of PVN Crh following saline. These effects were not driven by PVN oprm1 in the F1 males as there were no differences based on maternal adolescent exposure. To determine the persistence of the blunted morphine-induced corticosterone effect, SAL-F2 and MOR-F2 males were examined. Blunted morphine-induced corticosterone secretion extended into the MOR-F2 generation, as well as effects on Crh. In addition, there was additional dysregulation ofOprm1 expression in the PVN in MOR-F2 compared with SAL-F2 males. These findings suggest that sex-specific alterations in opioid-mediated regulation of the HPA axis are transgenerationally transmitted for at least two generations following female adolescent morphine exposure. These effects may play a role in the previously observed changes in morphine analgesia and reward-related behaviors observed in this phenotype. In addition, alterations in HPA functioning such as these may play a broad role in transgenerational epigenetic transmission.
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Affiliation(s)
- Fair M Vassoler
- Cummings School of Veterinary Medicine, Tufts University, USA.
| | - Anika M Toorie
- Cummings School of Veterinary Medicine, Tufts University, USA
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13
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Penney J, Mendell A, Zeng M, Tran K, Lymer J, Turner PV, Choleris E, MacLusky N, Lu R. LUMAN/CREB3 is a key regulator of glucocorticoid-mediated stress responses. Mol Cell Endocrinol 2017; 439:95-104. [PMID: 27789393 DOI: 10.1016/j.mce.2016.10.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 10/21/2016] [Accepted: 10/21/2016] [Indexed: 01/28/2023]
Abstract
Altered glucocorticoid sensitivity is believed to contribute to a number of human diseases, including inflammatory and autoimmune conditions as well as disorders characterized by abnormal hypothalamic-pituitary-adrenal axis (HPA) function. LUMAN (or CREB3), originally identified through its interaction with a cell cycle regulator HCFC1, is an endoplasmic reticulum membrane-bound transcription factor that is involved in the unfolded protein response. Here we demonstrate that LUMAN changes the glucocorticoid response by modulating the expression of the glucocorticoid receptor leading to an overall increase in GR activity. Luman-deficient mice exhibited a blunted stress response characterized by low levels of both anxiety and depressive-like behaviour in addition to low circulating corticosterone levels. These mice also have reduced dendritic branching in the CA3 region of the hippocampus, consistent with increased GR responses. These findings are consistent with the notion that elevated GR activities are the primary cause of the observed phenotype in these LUMAN-deficient mice. We thus postulate that LUMAN is a key regulator of GR-mediated signaling and modulates HPA axis reactivity.
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Affiliation(s)
- Jenna Penney
- Department of Molecular and Cellular Biology, University of Guelph, 488 Gordon Street, Guelph, Ontario, N1G 2W1, Canada
| | - Ari Mendell
- Department of Biomedical Sciences, University of Guelph, 488 Gordon Street, Guelph, Ontario, N1G 2W1, Canada
| | - Minghua Zeng
- Department of Molecular and Cellular Biology, University of Guelph, 488 Gordon Street, Guelph, Ontario, N1G 2W1, Canada
| | - Khoa Tran
- Department of Biomedical Sciences, University of Guelph, 488 Gordon Street, Guelph, Ontario, N1G 2W1, Canada
| | - Jennifer Lymer
- Department of Psychology, University of Guelph, 488 Gordon Street, Guelph, Ontario, N1G 2W1, Canada
| | - Patricia V Turner
- Department of Pathobiology, University of Guelph, 488 Gordon Street, Guelph, Ontario, N1G 2W1, Canada
| | - Elena Choleris
- Department of Psychology, University of Guelph, 488 Gordon Street, Guelph, Ontario, N1G 2W1, Canada
| | - Neil MacLusky
- Department of Biomedical Sciences, University of Guelph, 488 Gordon Street, Guelph, Ontario, N1G 2W1, Canada
| | - Ray Lu
- Department of Molecular and Cellular Biology, University of Guelph, 488 Gordon Street, Guelph, Ontario, N1G 2W1, Canada.
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14
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Stroud CB, Chen FR, Doane LD, Granger DA. Individual differences in early adolescents' latent trait cortisol (LTC): Relation to recent acute and chronic stress. Psychoneuroendocrinology 2016; 70:38-46. [PMID: 27155256 DOI: 10.1016/j.psyneuen.2016.04.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 04/21/2016] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
Abstract
Research suggests that environmental stress contributes to health by altering the regulation of the hypothalamic pituitary adrenal (HPA) axis. Recent evidence indicates that early life stress alters trait indicators of HPA axis activity, but whether recent stress alters such indicators is unknown. Using objective contextual stress interviews with adolescent girls and their mothers, we examined the impact of recent acute and chronic stress occurring during the past year on early adolescent girls' latent trait cortisol (LTC) level. We also examined whether associations between recent stress and LTC level: a) varied according to the interpersonal nature and controllability of the stress; and b) remained after accounting for the effect of early life stress. Adolescents (n=117;M age=12.39years) provided salivary cortisol samples three times a day (waking, 30min post-waking and bedtime) over 3days. Results indicated that greater recent interpersonal acute stress and greater recent independent (i.e., uncontrollable) acute stress were each associated with a higher LTC level, over and above the effect of early adversity. In contrast, greater recent chronic stress was associated with a lower LTC level. Findings were similar in the overall sample and a subsample of participants who strictly adhered to the timed schedule of saliva sample collection. Implications for understanding the impact of recent stress on trait-like individual differences in HPA axis activity are discussed.
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Affiliation(s)
- Catherine B Stroud
- Williams College, Department of Psychology, Williamstown, MA 01267, USA.
| | - Frances R Chen
- Department of Criminology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Leah D Doane
- Department of Psychology, Arizona State University, Tempe, AZ 85287-1104, USA
| | - Douglas A Granger
- Department of Psychology, Arizona State University, Tempe, AZ 85287-1104, USA; Institute for Interdisciplinary Salivary Bioscience Research, Arizona State University, Tempe, AZ 85287-3604, USA; The Johns Hopkins University School of Nursing, School of Medicine, and Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD 21218, USA; Salivary Bioscience Laboratory and Department of Psychology, University of Nebraska, Lincoln, NE 68588-0156, USA
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15
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Goodday SM, Horrocks J, Keown-Stoneman C, Grof P, Duffy A. Repeated salivary daytime cortisol and onset of mood episodes in offspring of bipolar parents. Int J Bipolar Disord 2016; 4:12. [PMID: 27230036 PMCID: PMC4882311 DOI: 10.1186/s40345-016-0053-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 05/12/2016] [Indexed: 12/04/2022] Open
Abstract
Background Differences in cortisol secretion may differentiate individuals at high compared to low genetic risk for bipolar disorder (BD) and predict the onset or recurrence of mood episodes. The objectives of this study were to determine if salivary cortisol measures are: (1) different in high-risk offspring of parents with BD (HR) compared to control offspring of unaffected parents (C), (2) stable over time, (3) associated with the development of mood episode onset/recurrence, and (4) influenced by comorbid complications. Methods Fifty-three HR and 22 C completed salivary cortisol sampling annually for up to 4 years in conjunction with semi-structured clinical interviews. The cortisol awakening response (CAR), daytime cortisol [area under the curve (AUC)], and evening cortisol (8:00 p.m.) were calculated. Results There were no differences in baseline CAR, AUC and evening cortisol between HR and C (p = 0.38, p = 0.30 and p = 0.84), respectively. CAR, AUC and evening cortisol were stable over yearly assessments in HR, while in Cs, evening cortisol increased over time (p = 0.008), and CAR and AUC remained stable. In HR, AUC and evening cortisol increased the hazard of a new onset mood disorder/recurrence by 2.7 times (p = 0.01), and 3.5 times (p = 0.01), respectively, but this was no longer significant after accounting for multiple comparisons. Conclusions Salivary cortisol is stable over time within HR offspring. However, between individuals, basal salivary cortisol is highly variable. More research is needed, with larger samples of prospectively studied HR youth using a more reliable method of cortisol measurement, to determine the potential role of cortisol in the development of mood disorders. Electronic supplementary material The online version of this article (doi:10.1186/s40345-016-0053-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sarah M Goodday
- Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada.
| | - Julie Horrocks
- Department of Mathematics & Statistics, University of Guelph, Guelph, ON, Canada
| | | | - Paul Grof
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Mood Disorders Centre of Ottawa, Ottawa University Health Services, Ottawa, ON, Canada
| | - Anne Duffy
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Mood Disorders Centre of Ottawa, Ottawa University Health Services, Ottawa, ON, Canada.,Department of Psychiatry, University of Calgary, Calgary, AB, Canada
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16
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Dogan MV, Lei MK, Beach SR, Brody G, Philibert RA. Alcohol and tobacco consumption alter hypothalamic pituitary adrenal axis DNA methylation. Psychoneuroendocrinology 2016; 66:176-84. [PMID: 26821212 PMCID: PMC4788520 DOI: 10.1016/j.psyneuen.2016.01.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 01/15/2016] [Accepted: 01/15/2016] [Indexed: 12/21/2022]
Abstract
Alcohol and cigarette consumption have profound effects on genome wide DNA methylation and are common, often cryptic, comorbid features of many psychiatric disorders. This cryptic consumption is a possible impediment to understanding the biology of certain psychiatric disorders because if the effects of substance use are not taken into account, their presence may confound efforts to identify effects of other behavioral disorders. Since the hypothalamic pituitary adrenal (HPA) axis is known to be dysregulated in these disorders, we examined the potential for confounding effects of alcohol and cigarette consumption by examining their effects on peripheral DNA methylation at two key HPA axis genes, NR3C1 and FKBP5. We found that the influence of alcohol and smoke exposure is more prominent at the FKBP5 gene than the NR3C1 gene. Furthermore, in both genes, loci that were consistently significantly associated with smoking and alcohol consumption demethylated with increasing exposure. We conclude that epigenetic studies of complex disorders involving the HPA axis need to carefully control for the effects of substance use in order to minimize the possibility of type I and type II errors.
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Affiliation(s)
- Meeshanthini V. Dogan
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA,Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Man-Kit Lei
- Center for Family Research, University of Georgia, Athens, GA, USA.
| | | | - Gene Brody
- Center for Family Research, University of Georgia, Athens, GA, USA
| | - Robert A. Philibert
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA,Department of Psychiatry, University of Iowa, Iowa City, IA, USA,Corresponding author. Department of Psychiatry, Rm 2-126 MEB, 500 Newton Road, Iowa City, IA, 52242, USA; phone 319-353-4986
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17
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Abstract
Recent findings have established a connection between inflammation and major depression and specifically the role of the hypothalamic-pituitary-adrenal (HPA) axis in depression. This article reviews clinical and experimental studies examining the role of the HPA axis, HPA hyperactivity (resulting in increased cortisol levels), as well as the proinflammatory cytokines tumor necrosis factor, C-reactive protein, and the interleukins, in depressed patients. Similarly this paper will review data supporting increased cytokine levels in depression and specifically differential effects in treatment-resistant patients, as well as potentially distinguishing in particular depression subtypes. Understanding the role of the immune system and inflammation in patients with major depression is essential in order to develop efficacious treatments potentially targeting inflammation in relation to the depression in order to reduce patient symptomatology and comorbidities.
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Affiliation(s)
- Melissa Furtado
- START Clinic for Mood and Anxiety Disorders, Toronto, ON, Canada
| | - Martin A Katzman
- START Clinic for Mood and Anxiety Disorders, Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; The Northern Ontario School of Medicine, Thunder Bay, ON, Canada; Department of Psychology, Lakehead University, Thunder Bay, ON, Canada; Adler Graduate Professional School, Toronto, ON, Canada.
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18
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Furtado M, Katzman MA. Neuroinflammatory pathways in anxiety, posttraumatic stress, and obsessive compulsive disorders. Psychiatry Res 2015; 229:37-48. [PMID: 26296951 DOI: 10.1016/j.psychres.2015.05.036] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 05/27/2015] [Accepted: 05/29/2015] [Indexed: 12/12/2022]
Abstract
As prevalence of anxiety, posttraumatic stress, and obsessive compulsive disorders continue to rise worldwide, increasing focus has been placed on immune mediated theories in understanding the underlying mechanisms of these disorders. Associations between the dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and these disorders have been recognized in the scientific literature, specifically in regard to cortisol levels, as well as changes in pro- and anti-inflammatory cytokines. The present commentary will systematically assess the scientific literature within the past decade in regard to the psychoneuroimmunology of anxiety, posttraumatic stress, and obsessive compulsive disorders. Understanding the mechanisms of these disorders is essential in order to determine efficacious and targeted treatment strategies, which may lead to substantial improvements in overall functioning, as well as significant decreases in societal and economic burden.
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Affiliation(s)
- Melissa Furtado
- START Clinic for Mood and Anxiety Disorders, Toronto, Ontario, Canada
| | - Martin A Katzman
- START Clinic for Mood and Anxiety Disorders, Toronto, Ontario, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Ontario, Canada; The Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada; Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada; Adler Graduate Professional School, Toronto, Ontario, Canada.
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19
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Abstract
Approximately 1 in 6 infants are born prematurely each year. Typically, these infants spend 25 days in the Neonatal Intensive Care Unit (NICU) where they experience 10-18 painful and inflammatory procedures each day. Remarkably, pre-emptive analgesics and/or anesthesia are administered less than 25% of the time. Unalleviated pain during the perinatal period is associated with permanent decreases in pain sensitivity, blunted cortisol responses and high rates of neuropsychiatric disorders. To date, the mechanism(s) by which these long-term changes in stress and pain behavior occur, and whether such alterations can be prevented by appropriate analgesia at the time of insult, remains unclear. Work in our lab using a rodent model of early life pain suggests that inflammatory pain experienced on the day of birth blunts adult responses to stress- and pain-provoking stimuli, and dysregulates the hypothalamic pituitary adrenal (HPA) axis in part through a permanent upregulation in central endogenous opioid tone. This review focuses on the long-term impact of neonatal inflammatory pain on adult anxiety- and stress-related responses, and underlying neuroanatomical changes in the context of endogenous pain control and the HPA axis. These two systems are in a state of exaggerated developmental plasticity early in postnatal life, and work in concert to respond to noxious or aversive stimuli. We present empirical evidence from animal and clinical studies, and discuss historical perspectives underlying the lack of analgesia/anesthetic use for early life pain in the modern NICU.
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Affiliation(s)
- Nicole C Victoria
- Neuroscience Institute, Georgia State University, 100 Piedmont Ave, Atlanta, GA 30303, USA.
| | - Anne Z Murphy
- Neuroscience Institute, Georgia State University, 100 Piedmont Ave, Atlanta, GA 30303, USA.
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20
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Doane LD, Chen FR, Sladek MR, Van Lenten SA, Granger DA. Latent trait cortisol (LTC) levels: reliability, validity, and stability. Psychoneuroendocrinology 2015; 55:21-35. [PMID: 25705799 DOI: 10.1016/j.psyneuen.2015.01.017] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 01/21/2015] [Accepted: 01/22/2015] [Indexed: 12/26/2022]
Abstract
The regulation of the hypothalamic pituitary adrenal (HPA) axis has received empirical attention as a mechanism contributing to individual differences in health and human development. A variety of sampling tactics and strategies index daily HPA axis functioning including the cortisol awakening response (CAR), the diurnal slope, and the area under the curve (AUGg). In an ethnically diverse sample (54% European-American, 23% Latino) of 82 adolescents (24% male, M age=18.05 years), we assessed salivary cortisol 45 times over the transition to college: 5 times per day, over 3 sequential days, across 3 waves (initially, 5, and 9 months later). Samples were collected at waking; 30 min, 3, and 8h post waking; and bedtime. Latent state-trait modeling indicated that the waking and 30 min post waking samples contributed to indices of within and across wave latent trait cortisol (LTC) levels. As such, a latent trait factor of cortisol was derived to reflect both within- and across-wave trait components of the variance in cortisol. LTC was distinct from the CAR, differentially predicted components of the diurnal profile across the day, and was highly stable across assessment waves (months). As preliminary evidence for convergent validity of LTC levels, childhood trauma was positively associated with LTC. Findings document the reliability, divergent and convergent validity, and stability of a latent trait factor of individual differences in HPA axis activity that may provide a cost efficient alternative to existing strategies and minimize participant burden.
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Affiliation(s)
- Leah D Doane
- Department of Psychology, Arizona State University, Tempe, AZ 85287-1104, USA.
| | - Frances R Chen
- Department of Criminology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Michael R Sladek
- Department of Psychology, Arizona State University, Tempe, AZ 85287-1104, USA
| | - Scott A Van Lenten
- Department of Psychology, Arizona State University, Tempe, AZ 85287-1104, USA
| | - Douglas A Granger
- Department of Psychology, Arizona State University, Tempe, AZ 85287-1104, USA; Institute for Interdisciplinary Salivary Bioscience Research, Arizona State University, Tempe, AZ 85287-3604, USA; The Johns Hopkins University School of Nursing and Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD 21218, USA
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21
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Bangasser DA, Valentino RJ. Sex differences in stress-related psychiatric disorders: neurobiological perspectives. Front Neuroendocrinol 2014; 35:303-19. [PMID: 24726661 PMCID: PMC4087049 DOI: 10.1016/j.yfrne.2014.03.008] [Citation(s) in RCA: 427] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 02/26/2014] [Accepted: 03/28/2014] [Indexed: 12/14/2022]
Abstract
Stress is associated with the onset and severity of several psychiatric disorders that occur more frequently in women than men, including posttraumatic stress disorder (PTSD) and depression. Patients with these disorders present with dysregulation of several stress response systems, including the neuroendocrine response to stress, corticolimbic responses to negatively valenced stimuli, and hyperarousal. Thus, sex differences within their underlying circuitry may explain sex biases in disease prevalence. This review describes clinical studies that identify sex differences within the activity of these circuits, as well as preclinical studies that demonstrate cellular and molecular sex differences in stress responses systems. These studies reveal sex differences from the molecular to the systems level that increase endocrine, emotional, and arousal responses to stress in females. Exploring these sex differences is critical because this research can reveal the neurobiological underpinnings of vulnerability to stress-related psychiatric disorders and guide the development of novel pharmacotherapies.
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Affiliation(s)
- Debra A Bangasser
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA, United States.
| | - Rita J Valentino
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, United States
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22
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Abstract
Few studies have evaluated cortisol concentrations in horses with colic. In humans with septic shock, high cortisol levels are associated with an increased risk of death. The objectives of this study were to compare the serum total cortisol concentrations (STCCs) in horses with colic to those without colic, and to assess whether the STCC relates to the pathological nature or outcome of the disease. STCCs were determined at presentation in horses with colic and in systemically healthy 'control' horses. Horses with colic were grouped based on clinical and clinico-pathological parameters at admission, treatment, lesion type and location, and outcome. Univariable and multivariable logistic regression were performed using two different outcome measures: (a) whether the horse had colic or not (yes vs. no), and (b) horse STCC (≥200 nmol/L vs. <200 nmol/L). Horses were more likely to have colic if they presented with high STCCs (≥200 nmol/L compared with <200 nmol/L). Horses with colic and with STCCs ≥200nmol/L were more likely to have moderate or severe colic signs (compared with mild colic) and heart rates >45 beats per min (compared with ≤45 beats per min). It was concluded that colic in horses is associated with elevated STCCs, and increased STCC in horses with colic appears to relate to the severity of the disease. STCCs may provide additional decision-making and prognostic information in horses with colic but further studies are required to avoid misinterpretations associated with the wide variation in STCCs.
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Affiliation(s)
- T S Mair
- Bell Equine Veterinary Clinic, Mereworth, Maidstone, Kent ME18 5GS, UK
| | - C E Sherlock
- Bell Equine Veterinary Clinic, Mereworth, Maidstone, Kent ME18 5GS, UK.
| | - L A Boden
- Institute of Comparative Epidemiology, Faculty of Veterinary Medicine, University of Glasgow, 464 Bearsden Road, Glasgow G61 1QH, UK
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23
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Adam EK, Vrshek-Schallhorn S, Kendall AD, Mineka S, Zinbarg RE, Craske MG. Prospective associations between the cortisol awakening response and first onsets of anxiety disorders over a six-year follow-up--2013 Curt Richter Award Winner. Psychoneuroendocrinology 2014; 44:47-59. [PMID: 24767619 PMCID: PMC4108290 DOI: 10.1016/j.psyneuen.2014.02.014] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 02/21/2014] [Accepted: 02/24/2014] [Indexed: 01/02/2023]
Abstract
Cross-sectional associations have been found between anxiety disorders (ADs) and hypothalamic-pituitary-adrenal (HPA) axis functioning, as measured by levels of salivary cortisol, but prospective data are lacking, as are studies examining specific ADs. We have previously shown that one aspect of the diurnal rhythm of cortisol, the cortisol awakening response (CAR), prospectively predicts both new onsets and recurrences of major depressive disorder (MDD). Here we sought to examine whether it also predicts ADs. Participants (N=232) were drawn from the larger Northwestern-UCLA Youth Emotion Project, a two-site, longitudinal study of older adolescents, which aims to identify common and specific risk factors for mood and anxiety disorders. After baseline interviews for mental health diagnoses, a subset of adolescents completed a three-day cortisol sampling protocol measuring the CAR and other diurnal rhythm indices. Participants with past or current anxiety disorders at the time of cortisol measurement were excluded and Cox regression (survival analysis) was used to predict first onsets of ADs over the subsequent six years. AD onsets (N=25), the largest subset of which were social anxiety disorder (SAD) onsets (N=11), were observed over six annual follow up diagnostic interviews. Even when statistically adjusting for past and prospective MDD onsets and other covariates, a higher CAR significantly predicted increased first onsets of ADs (HR=2.20, p<.05). A higher CAR was also a strong and significant predictor of the subset of SAD onsets (HR=5.37, p<.005). Implications for the etiology of ADs, with a focus on SAD, are discussed.
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Affiliation(s)
- Emma K. Adam
- School of Education and Social Policy, Northwestern University, United States,Cells to Society Center, Institute for Policy Research, Northwestern University, United States,Corresponding author at: School of Education and Social Policy, Northwestern University, 2120 Campus Drive, Evanston, IL 60208, United States. Telephone: 1-847-467-2010, Fax: 1- 847-467-1418,
| | - Suzanne Vrshek-Schallhorn
- Department of Psychology, Northwestern University, United States,Corresponding author at: School of Education and Social Policy, Northwestern University, 2120 Campus Drive, Evanston, IL 60208, United States. Telephone: 1-847-467-2010, Fax: 1- 847-467-1418,
| | | | - Susan Mineka
- Department of Psychology, Northwestern University, United States
| | - Richard E. Zinbarg
- Department of Psychology, Northwestern University, United States,The Family Institute at Northwestern University, United States
| | - Michelle G. Craske
- Department of Psychology, University of California – Los Angeles, United States
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24
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Crumeyrolle-Arias M, Jaglin M, Bruneau A, Vancassel S, Cardona A, Daugé V, Naudon L, Rabot S. Absence of the gut microbiota enhances anxiety-like behavior and neuroendocrine response to acute stress in rats. Psychoneuroendocrinology 2014; 42:207-17. [PMID: 24636517 DOI: 10.1016/j.psyneuen.2014.01.014] [Citation(s) in RCA: 370] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 01/16/2014] [Accepted: 01/22/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Establishment of the gut microbiota is one of the most important events in early life and emerging evidence indicates that the gut microbiota influences several aspects of brain functioning, including reactivity to stress. To better understand how the gut microbiota contributes to a vulnerability to the stress-related psychiatric disorders, we investigated the relationship between the gut microbiota, anxiety-like behavior and HPA axis activity in stress-sensitive rodents. We also analyzed the monoamine neurotransmitters in the brain upper structures involved in the regulation of stress and anxiety. METHODS Germfree (GF) and specific pathogen free (SPF) F344 male rats were first subjected to neurological tests to rule out sensorimotor impairments as confounding factors. Then, we examined the behavior responses of rats to social interaction and open-field tests. Serum corticosterone concentrations, CRF mRNA expression levels in the hypothalamus, glucocorticoid receptor (GR) mRNA expression levels in the hippocampus, and monoamine concentrations in the frontal cortex, hippocampus and striatum were compared in rats that were either exposed to the open-field stress or not. RESULTS GF rats spent less time sniffing an unknown partner than SPF rats in the social interaction test, and displayed a lower number of visits to the aversive central area, and an increase in latency time, time spent in the corners and number of defecations in the open-field test. In response to the open-field stress, serum corticosterone concentrations were 2.8-fold higher in GF than in SPF rats. Compared to that of SPF rats, GF rats showed elevated CRF mRNA expression in the hypothalamus and reduced GR mRNA expression in the hippocampus. GF rats also had a lower dopaminergic turnover rate in the frontal cortex, hippocampus and striatum than SPF rats. CONCLUSIONS In stress-sensitive F344 rats, absence of the gut microbiota exacerbates the neuroendocrine and behavioral responses to acute stress and the results coexist with alterations of the dopaminergic turnover rate in brain upper structures that are known to regulate reactivity to stress and anxiety-like behavior.
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Affiliation(s)
- Michèle Crumeyrolle-Arias
- INSERM, UMRS952 Physiopathologie des Maladies du Système Nerveux Central, F-75005 Paris, France; CNRS, UMR7224 Physiopathologie des Maladies du Système Nerveux Central, F-75005 Paris, France; UPMC, Physiopathologie des Maladies du Système Nerveux Central, F-75005 Paris, France
| | - Mathilde Jaglin
- INRA, UMR1319 Micalis, F-78350 Jouy-en-Josas, France; AgroParisTech, Micalis, F-78350 Jouy-en-Josas, France
| | - Aurélia Bruneau
- INRA, UMR1319 Micalis, F-78350 Jouy-en-Josas, France; AgroParisTech, Micalis, F-78350 Jouy-en-Josas, France
| | | | - Ana Cardona
- Institut Pasteur, Plateforme Imagerie Dynamique, Paris, France
| | - Valérie Daugé
- INSERM, UMRS952 Physiopathologie des Maladies du Système Nerveux Central, F-75005 Paris, France; CNRS, UMR7224 Physiopathologie des Maladies du Système Nerveux Central, F-75005 Paris, France; UPMC, Physiopathologie des Maladies du Système Nerveux Central, F-75005 Paris, France; CNRS, Micalis, F-78350 Jouy-en-Josas, France
| | - Laurent Naudon
- INSERM, UMRS952 Physiopathologie des Maladies du Système Nerveux Central, F-75005 Paris, France; CNRS, UMR7224 Physiopathologie des Maladies du Système Nerveux Central, F-75005 Paris, France; UPMC, Physiopathologie des Maladies du Système Nerveux Central, F-75005 Paris, France; CNRS, Micalis, F-78350 Jouy-en-Josas, France
| | - Sylvie Rabot
- INRA, UMR1319 Micalis, F-78350 Jouy-en-Josas, France; AgroParisTech, Micalis, F-78350 Jouy-en-Josas, France.
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Stokholm ZA, Hansen ÅM, Grynderup MB, Bonde JP, Christensen KL, Frederiksen TW, Lund SP, Vestergaard JM, Kolstad HA. Recent and long-term occupational noise exposure and salivary cortisol level. Psychoneuroendocrinology 2014; 39:21-32. [PMID: 24275001 DOI: 10.1016/j.psyneuen.2013.09.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 09/26/2013] [Accepted: 09/30/2013] [Indexed: 11/18/2022]
Abstract
Environmental and occupational noise exposure have been related to increased risk of cardiovascular disease, hypothetically mediated by stress-activation of the hypothalamic-pituitary-adrenal (HPA) axis. The objective of this study was to investigate the relation between recent and long-term occupational noise exposure and cortisol level measured off work to assess a possible sustained HPA-axis effect. We included 501 industrial, finance, and service workers who were followed for 24h during work, leisure, and sleep. Ambient occupational noise exposure levels were recorded every 5s by personal dosimeters and we calculated the full-shift LAEq value and estimated duration and cumulative exposure based on their work histories since 1980. For 332 workers who kept a log-book on the use of hearing protection devices (HPD), we subtracted 10 dB from every noise recording obtained during HPD use and estimated the noise level at the ear. Salivary cortisol concentration was measured at 20.00 h, the following day at awakening, and 30 min after awakening on average 5, 14 and 14.5h after finishing work. The mean ambient noise exposure level was 79.9 dB(A) [range: 55.0-98.9] and the mean estimated level at the ear 77.7 dB(A) [range: 55.0-94.2]. In linear and mixed regression models that adjusted for age, sex, current smoking, heavy alcohol consumption, personal income, BMI, leisure-time noise exposure level, time since occupational noise exposure ceased, awakening time, and time of saliva sampling, we observed no statistically significant exposure response relation between recent, or long-term ambient occupational noise exposure level and any cortisol parameter off work. This was neither the case for recent noise level at the ear. To conclude, neither recent nor long-term occupational noise exposure levels were associated with increased cortisol level off work. Thus, our results do not indicate that a sustained activation of the HPA axis, as measured by cortisol, is involved in the causal pathway between occupational noise exposure and cardiovascular disease.
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Affiliation(s)
- Zara Ann Stokholm
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8000 Aarhus C, Denmark.
| | - Åse Marie Hansen
- National Research Centre for the Working Environment, 2100 Copenhagen Ø, Denmark; Department of Public Health, University of Copenhagen, 1014 Copenhagen K, Denmark
| | - Matias Brødsgaard Grynderup
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8000 Aarhus C, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, 2400 Copenhagen NV, Denmark
| | - Kent Lodberg Christensen
- Department of Internal Medicine and Cardiology A, Aarhus University Hospital, 8000 Aarhus C, Denmark
| | - Thomas Winther Frederiksen
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8000 Aarhus C, Denmark
| | - Søren Peter Lund
- National Research Centre for the Working Environment, 2100 Copenhagen Ø, Denmark
| | - Jesper Medom Vestergaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8000 Aarhus C, Denmark
| | - Henrik Albert Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8000 Aarhus C, Denmark
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Grynderup MB, Kolstad HA, Mikkelsen S, Andersen JH, Bonde JP, Buttenschøn HN, Kærgaard A, Kærlev L, Rugulies R, Thomsen JF, Vammen MA, Mors O, Hansen AM. A two-year follow-up study of salivary cortisol concentration and the risk of depression. Psychoneuroendocrinology 2013; 38:2042-50. [PMID: 23597874 DOI: 10.1016/j.psyneuen.2013.03.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 02/15/2013] [Accepted: 03/19/2013] [Indexed: 11/16/2022]
Abstract
Stress is a suspected cause of depression. High cortisol concentration, a biomarker of an activated stress response, has been found in depressed patients. The aim of this study was to determine if a high level of salivary cortisol is a risk factor of depression. In 2007, we enrolled 4467 public employees. Morning and evening salivary cortisol concentration were measured for each participant. Participants reporting high levels of depressive, burnout, or stress symptoms, assessed by questionnaires were assigned to a psychiatric interview. In this interview 98 participants were diagnosed with depression and subsequently excluded. Two years later in 2009, 2920 participants who had provided at least one valid saliva cortisol measurement at baseline participated at follow up. The psychiatric interviews were repeated and 62 cases of newly onset depression were diagnosed. Odds ratios of depression were estimated for every 1.0nmol/l increase in morning, evening, and daily mean cortisol concentration, as well as for the difference between morning and evening cortisol concentration. The risk of depression decreased by increasing daily mean cortisol concentration and by increasing difference between morning and evening concentrations, while morning and evening cortisol concentrations were not significantly associated with depression. The adjusted odds ratios for 1.0nmol/l increase in morning, evening, and daily mean cortisol concentration were 0.69 (95% CI: 0.45, 1.05), 0.87 (95% CI: 0.59, 1.28), and 0.53 (95% CI: 0.32, 0.90), respectively. The adjusted odds ratio for 1.0nmol/l increase in difference between morning and evening concentration were 0.64 (95% CI: 0.45, 0.90). This study did not support the hypothesis that high salivary cortisol concentration is a risk factor of depression, but indicate that low mean salivary cortisol concentration and a small difference between morning and evening cortisol concentration may be risk factors of depression.
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Laudenslager ML, Calderone J, Philips S, Natvig C, Carlson NE. Diurnal patterns of salivary cortisol and DHEA using a novel collection device: electronic monitoring confirms accurate recording of collection time using this device. Psychoneuroendocrinology 2013; 38:1596-606. [PMID: 23490073 DOI: 10.1016/j.psyneuen.2013.01.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 12/01/2012] [Accepted: 01/14/2013] [Indexed: 11/24/2022]
Abstract
The accurate indication of saliva collection time is important for defining the diurnal decline in salivary cortisol as well as characterizing the cortisol awakening response. We tested a convenient and novel collection device for collecting saliva on strips of filter paper in a specially constructed booklet for determination of both cortisol and DHEA. In the present study, 31 healthy adults (mean age 43.5 years) collected saliva samples four times a day on three consecutive days using filter paper collection devices (Saliva Procurement and Integrated Testing (SPIT) booklet) which were maintained during the collection period in a large plastic bottle with an electronic monitoring cap. Subjects were asked to collect saliva samples at awakening, 30 min after awakening, before lunch and 600 min after awakening. The time of awakening and the time of collection before lunch were allowed to vary by each subjects' schedule. A reliable relationship was observed between the time recorded by the subject directly on the booklet and the time recorded by electronic collection device (n=286 observations; r(2)=0.98). However, subjects did not consistently collect the saliva samples at the two specific times requested, 30 and 600 min after awakening. Both cortisol and DHEA revealed diurnal declines. In spite of variance in collection times at 30 min and 600 min after awakening, the slope of the diurnal decline in both salivary cortisol and DHEA was similar when we compared collection tolerances of ±7.5 and ±15 min for each steroid. These unique collection booklets proved to be a reliable method for recording collection times by subjects as well as for estimating diurnal salivary cortisol and DHEA patterns.
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Abstract
Appetitive behaviors such as substance use and eating are under significant regulatory control by the hypothalamic-pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes. Recent research has begun to examine how these systems interact to cause and maintain poor regulation of these appetitive behaviors. A range of potential molecular, neuroendocrine, and hormonal mechanisms are involved in these interactions and may explain individual differences in both risk and resilience to a range of addictions. This manuscript provides a commentary on research presented during the International Society of Psychoneuroendocrinology's mini-conference on sex differences in eating and addiction with an emphasis on how HPG and HPA axis interactions affect appetitive behaviors in classic addictions and may be used to help inform the ongoing debate about the validity of food addiction.
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Faravelli C, Lo Sauro C, Godini L, Lelli L, Benni L, Pietrini F, Lazzeretti L, Talamba GA, Fioravanti G, Ricca V. Childhood stressful events, HPA axis and anxiety disorders. World J Psychiatry 2012; 2:13-25. [PMID: 24175164 PMCID: PMC3782172 DOI: 10.5498/wjp.v2.i1.13] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 10/24/2011] [Accepted: 01/21/2012] [Indexed: 02/05/2023] Open
Abstract
Anxiety disorders are among the most common of all mental disorders and their pathogenesis is a major topic in psychiatry, both for prevention and treatment. Early stressful life events and alterations of hypothalamic pituitary adrenal (HPA) axis function seem to have a significant role in the onset of anxiety. Existing data appear to support the mediating effect of the HPA axis between childhood traumata and posttraumatic stress disorder. Findings on the HPA axis activity at baseline and after stimuli in panic disordered patients are inconclusive, even if stressful life events may have a triggering function in the development of this disorder. Data on the relationship between stress, HPA axis functioning and obsessive-compulsive disorder (OCD) are scarce and discordant, but an increased activity of the HPA axis is reported in OCD patients. Moreover, normal basal cortisol levels and hyper-responsiveness of the adrenal cortex during a psychosocial stressor are observed in social phobics. Finally, abnormal HPA axis activity has also been observed in generalized anxiety disordered patients. While several hypothesis have attempted to explain these findings over time, currently the most widely accepted theory is that early stressful life events may provoke alterations of the stress response and thus of the HPA axis, that can endure during adulthood, predisposing individuals to develop psychopathology. All theories are reviewed and the authors conclude that childhood life events and HPA abnormalities may be specifically and transnosographically related to all anxiety disorders, as well as, more broadly, to all psychiatric disorders.
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Affiliation(s)
- Carlo Faravelli
- Carlo Faravelli, Carolina Lo Sauro, Department of Psychology, University of Florence, 50135 Firenze, Florence, Italy
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