Childhood traumata, Dexamethasone Suppression Test and psychiatric symptoms: a trans-diagnostic approach
Childhood traumatic events and functional abnormalities of the hypothalamus-pituitary-adrenal (HPA) axis have been widely reported in psychiatric patients, although neither is specific for any diagnosis. Among the limited number of studies that have evaluated these topics, none has adopted a trans-d...
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| Veröffentlicht in: | Psychological medicine 2010-12, Vol.40 (12), p.2037-2048 |
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| creator | Faravelli, C. Amedei, S. Gorini Rotella, F. Faravelli, L. Palla, A. Consoli, G. Ricca, V. Batini, S. Sauro, C. Lo Spiti, A. dell'Osso, M. Catena |
| description | Childhood traumatic events and functional abnormalities of the hypothalamus-pituitary-adrenal (HPA) axis have been widely reported in psychiatric patients, although neither is specific for any diagnosis. Among the limited number of studies that have evaluated these topics, none has adopted a trans-diagnostic approach. The aim of the present research is to explore the relationship between childhood stressors, HPA axis function and psychiatric symptoms, independent of the diagnosis.
A total of 93 moderate to severely ill psychiatric out-patients of Florence and Pisa University Psychiatric Units and 33 healthy control subjects were recruited. The assessment consisted of salivary cortisol pre- and post-low dose (0.5 mg) Dexamethasone, early and recent life events, 121 psychiatric symptoms independent of diagnosis, SCID, BPRS.
In total, 33.5% of patients were Dexamethasone Suppression Test (DST) non-suppressors, compared with 6.1% of controls (p=0.001). Among patients, non-suppression was associated with particular symptoms (i.e. depressive and psychotic), but not to any specific diagnosis. Early stressful life events were significantly associated with higher salivary cortisol levels, with DST non-suppression and with approximately the same subset of symptoms. A recent stressful event seemed to be associated to the HPA response only in those subjects who were exposed to early traumata.
Our report suggests a relationship between life stress, HPA axis and psychopathology. A cluster of specific psychiatric symptoms seems to be stress related. Moreover, it seems that an abnormal HPA response is possibly triggered by an excessive pressure in vulnerable individuals. |
| doi_str_mv | 10.1017/S0033291710000115 |
| format | Article |
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A total of 93 moderate to severely ill psychiatric out-patients of Florence and Pisa University Psychiatric Units and 33 healthy control subjects were recruited. The assessment consisted of salivary cortisol pre- and post-low dose (0.5 mg) Dexamethasone, early and recent life events, 121 psychiatric symptoms independent of diagnosis, SCID, BPRS.
In total, 33.5% of patients were Dexamethasone Suppression Test (DST) non-suppressors, compared with 6.1% of controls (p=0.001). Among patients, non-suppression was associated with particular symptoms (i.e. depressive and psychotic), but not to any specific diagnosis. Early stressful life events were significantly associated with higher salivary cortisol levels, with DST non-suppression and with approximately the same subset of symptoms. A recent stressful event seemed to be associated to the HPA response only in those subjects who were exposed to early traumata.
Our report suggests a relationship between life stress, HPA axis and psychopathology. A cluster of specific psychiatric symptoms seems to be stress related. Moreover, it seems that an abnormal HPA response is possibly triggered by an excessive pressure in vulnerable individuals.</description><identifier>ISSN: 0033-2917</identifier><identifier>EISSN: 1469-8978</identifier><identifier>DOI: 10.1017/S0033291710000115</identifier><identifier>PMID: 20132583</identifier><identifier>CODEN: PSMDCO</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Adolescent ; Adrenal glands ; Adult ; Adult and adolescent clinical studies ; Aged ; Biological and medical sciences ; Case-Control Studies ; Child Abuse ; Child psychology ; Childhood ; Dexamethasone ; Diagnosis ; Diagnostic tests ; Female ; Glucocorticoids ; HPA axis ; Humans ; Hydrocortisone - analysis ; Hypothalamo-Hypophyseal System - physiopathology ; life event ; Male ; Medical sciences ; Mental Disorders - diagnosis ; Mental Disorders - etiology ; Mental Disorders - physiopathology ; Mental Disorders - psychology ; Middle Aged ; Miscellaneous ; Pituitary-Adrenal System - physiopathology ; Psychiatric symptoms ; Psychology. Psychoanalysis. Psychiatry ; psychopathology ; Psychopathology. Psychiatry ; Saliva - chemistry ; Stress, Psychological ; Stressful events ; Suppression ; Symptoms ; transdiagnostic ; Trauma ; vulnerability ; Young Adult</subject><ispartof>Psychological medicine, 2010-12, Vol.40 (12), p.2037-2048</ispartof><rights>Copyright © Cambridge University Press 2010</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c471t-c8d72723dfdd0819f9379b1297ed3b18eb92655ce45f5e2133559a994c8195423</citedby><cites>FETCH-LOGICAL-c471t-c8d72723dfdd0819f9379b1297ed3b18eb92655ce45f5e2133559a994c8195423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S0033291710000115/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,314,776,780,12825,27901,27902,30976,30977,55603</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23397939$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20132583$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Faravelli, C.</creatorcontrib><creatorcontrib>Amedei, S. Gorini</creatorcontrib><creatorcontrib>Rotella, F.</creatorcontrib><creatorcontrib>Faravelli, L.</creatorcontrib><creatorcontrib>Palla, A.</creatorcontrib><creatorcontrib>Consoli, G.</creatorcontrib><creatorcontrib>Ricca, V.</creatorcontrib><creatorcontrib>Batini, S.</creatorcontrib><creatorcontrib>Sauro, C. Lo</creatorcontrib><creatorcontrib>Spiti, A.</creatorcontrib><creatorcontrib>dell'Osso, M. Catena</creatorcontrib><title>Childhood traumata, Dexamethasone Suppression Test and psychiatric symptoms: a trans-diagnostic approach</title><title>Psychological medicine</title><addtitle>Psychol. Med</addtitle><description>Childhood traumatic events and functional abnormalities of the hypothalamus-pituitary-adrenal (HPA) axis have been widely reported in psychiatric patients, although neither is specific for any diagnosis. Among the limited number of studies that have evaluated these topics, none has adopted a trans-diagnostic approach. The aim of the present research is to explore the relationship between childhood stressors, HPA axis function and psychiatric symptoms, independent of the diagnosis.
A total of 93 moderate to severely ill psychiatric out-patients of Florence and Pisa University Psychiatric Units and 33 healthy control subjects were recruited. The assessment consisted of salivary cortisol pre- and post-low dose (0.5 mg) Dexamethasone, early and recent life events, 121 psychiatric symptoms independent of diagnosis, SCID, BPRS.
In total, 33.5% of patients were Dexamethasone Suppression Test (DST) non-suppressors, compared with 6.1% of controls (p=0.001). Among patients, non-suppression was associated with particular symptoms (i.e. depressive and psychotic), but not to any specific diagnosis. Early stressful life events were significantly associated with higher salivary cortisol levels, with DST non-suppression and with approximately the same subset of symptoms. A recent stressful event seemed to be associated to the HPA response only in those subjects who were exposed to early traumata.
Our report suggests a relationship between life stress, HPA axis and psychopathology. A cluster of specific psychiatric symptoms seems to be stress related. Moreover, it seems that an abnormal HPA response is possibly triggered by an excessive pressure in vulnerable individuals.</description><subject>Adolescent</subject><subject>Adrenal glands</subject><subject>Adult</subject><subject>Adult and adolescent clinical studies</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Case-Control Studies</subject><subject>Child Abuse</subject><subject>Child psychology</subject><subject>Childhood</subject><subject>Dexamethasone</subject><subject>Diagnosis</subject><subject>Diagnostic tests</subject><subject>Female</subject><subject>Glucocorticoids</subject><subject>HPA axis</subject><subject>Humans</subject><subject>Hydrocortisone - analysis</subject><subject>Hypothalamo-Hypophyseal System - physiopathology</subject><subject>life event</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental Disorders - diagnosis</subject><subject>Mental Disorders - etiology</subject><subject>Mental Disorders - physiopathology</subject><subject>Mental Disorders - psychology</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Pituitary-Adrenal System - physiopathology</subject><subject>Psychiatric symptoms</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>psychopathology</subject><subject>Psychopathology. Psychiatry</subject><subject>Saliva - chemistry</subject><subject>Stress, Psychological</subject><subject>Stressful events</subject><subject>Suppression</subject><subject>Symptoms</subject><subject>transdiagnostic</subject><subject>Trauma</subject><subject>vulnerability</subject><subject>Young Adult</subject><issn>0033-2917</issn><issn>1469-8978</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkVFrFDEQx4Mo9qx-AF9kEcSXrmaSzSbxTa72KhRUrj6HbJLtpt5u1mQXet_eLHe2oIh5mcD_NzP_mUHoJeB3gIG_32JMKZHAAecHwB6hFVS1LIXk4jFaLXK56CfoWUq3GaFQkafohOQfYYKuULfu_M52Idhiinru9aTPinN3p3s3dTqFwRXbeRyjS8mHobh2aSr0YIsx7U3n9RS9KdK-H6fQpw-FXooMqbRe3wwhTVnUOTlo0z1HT1q9S-7FMZ6i7xefrteX5dWXzef1x6vSVBym0gjLCSfUttZiAbKVlMsGiOTO0gaEaySpGTOuYi1zBChlTGopK5NhVhF6it4e6ua2P-dsV_U-Gbfb6cGFOSlBJaslI-K_JK8h7w-qKpOv_yBvwxyHPIYSwCgmmC-N4QCZGFKKrlVj9L2OewVYLedSf50r57w6Fp6b3tn7jN_3ycCbI6CT0bs2b9f49MBRKrmkMnPlgfNpcnf3uo4_VM0pZ6refFMbOL8Ua_xVbTNPj2Z130Rvb9zDSP-2-wuZtbnk</recordid><startdate>20101201</startdate><enddate>20101201</enddate><creator>Faravelli, C.</creator><creator>Amedei, S. 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Gorini ; Rotella, F. ; Faravelli, L. ; Palla, A. ; Consoli, G. ; Ricca, V. ; Batini, S. ; Sauro, C. Lo ; Spiti, A. ; dell'Osso, M. 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Psychoanalysis. Psychiatry</topic><topic>psychopathology</topic><topic>Psychopathology. Psychiatry</topic><topic>Saliva - chemistry</topic><topic>Stress, Psychological</topic><topic>Stressful events</topic><topic>Suppression</topic><topic>Symptoms</topic><topic>transdiagnostic</topic><topic>Trauma</topic><topic>vulnerability</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Faravelli, C.</creatorcontrib><creatorcontrib>Amedei, S. Gorini</creatorcontrib><creatorcontrib>Rotella, F.</creatorcontrib><creatorcontrib>Faravelli, L.</creatorcontrib><creatorcontrib>Palla, A.</creatorcontrib><creatorcontrib>Consoli, G.</creatorcontrib><creatorcontrib>Ricca, V.</creatorcontrib><creatorcontrib>Batini, S.</creatorcontrib><creatorcontrib>Sauro, C. Lo</creatorcontrib><creatorcontrib>Spiti, A.</creatorcontrib><creatorcontrib>dell'Osso, M. 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Gorini</au><au>Rotella, F.</au><au>Faravelli, L.</au><au>Palla, A.</au><au>Consoli, G.</au><au>Ricca, V.</au><au>Batini, S.</au><au>Sauro, C. Lo</au><au>Spiti, A.</au><au>dell'Osso, M. Catena</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Childhood traumata, Dexamethasone Suppression Test and psychiatric symptoms: a trans-diagnostic approach</atitle><jtitle>Psychological medicine</jtitle><addtitle>Psychol. Med</addtitle><date>2010-12-01</date><risdate>2010</risdate><volume>40</volume><issue>12</issue><spage>2037</spage><epage>2048</epage><pages>2037-2048</pages><issn>0033-2917</issn><eissn>1469-8978</eissn><coden>PSMDCO</coden><abstract>Childhood traumatic events and functional abnormalities of the hypothalamus-pituitary-adrenal (HPA) axis have been widely reported in psychiatric patients, although neither is specific for any diagnosis. Among the limited number of studies that have evaluated these topics, none has adopted a trans-diagnostic approach. The aim of the present research is to explore the relationship between childhood stressors, HPA axis function and psychiatric symptoms, independent of the diagnosis.
A total of 93 moderate to severely ill psychiatric out-patients of Florence and Pisa University Psychiatric Units and 33 healthy control subjects were recruited. The assessment consisted of salivary cortisol pre- and post-low dose (0.5 mg) Dexamethasone, early and recent life events, 121 psychiatric symptoms independent of diagnosis, SCID, BPRS.
In total, 33.5% of patients were Dexamethasone Suppression Test (DST) non-suppressors, compared with 6.1% of controls (p=0.001). Among patients, non-suppression was associated with particular symptoms (i.e. depressive and psychotic), but not to any specific diagnosis. Early stressful life events were significantly associated with higher salivary cortisol levels, with DST non-suppression and with approximately the same subset of symptoms. A recent stressful event seemed to be associated to the HPA response only in those subjects who were exposed to early traumata.
Our report suggests a relationship between life stress, HPA axis and psychopathology. A cluster of specific psychiatric symptoms seems to be stress related. Moreover, it seems that an abnormal HPA response is possibly triggered by an excessive pressure in vulnerable individuals.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>20132583</pmid><doi>10.1017/S0033291710000115</doi><tpages>12</tpages></addata></record> |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; Cambridge University Press Journals Complete |
| subjects | Adolescent Adrenal glands Adult Adult and adolescent clinical studies Aged Biological and medical sciences Case-Control Studies Child Abuse Child psychology Childhood Dexamethasone Diagnosis Diagnostic tests Female Glucocorticoids HPA axis Humans Hydrocortisone - analysis Hypothalamo-Hypophyseal System - physiopathology life event Male Medical sciences Mental Disorders - diagnosis Mental Disorders - etiology Mental Disorders - physiopathology Mental Disorders - psychology Middle Aged Miscellaneous Pituitary-Adrenal System - physiopathology Psychiatric symptoms Psychology. Psychoanalysis. Psychiatry psychopathology Psychopathology. Psychiatry Saliva - chemistry Stress, Psychological Stressful events Suppression Symptoms transdiagnostic Trauma vulnerability Young Adult |
| title | Childhood traumata, Dexamethasone Suppression Test and psychiatric symptoms: a trans-diagnostic approach |
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