Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-23T10:38:31.742Z Has data issue: false hasContentIssue false

Findings with 0.25 mg Dexamethasone Suppression Test in Eating Disorders: Association with Childhood Trauma

Published online by Cambridge University Press:  07 November 2014

Abstract

Introduction: While both blunted and enhanced cortisol suppression following a dexamethasone suppression test (DST) are described in eating disorders, some evidence suggests that enhanced cortisol suppression might be associated with the presence of trauma history. The objective of this study is to investigate hypothalamic-pituitary-adrenal axis response to a modified DST in eating disorders and its relationship with childhood trauma.

Methods: Fifty-two patients with eating disorders were studied with a 0.25 mg DST and with measures of childhood trauma.

Conclusion: Patients with bulimia symptoms had significantly greater cortisol suppression than controls and restrictive anorexia patients (F=8.2, P<.05). Cortisol suppression was significantly correlated with intensity of childhood traumatic events (F=0.32, P<.05). Hypersensitive hypothalamic-pituitary-adrenal axis response to DST in eating disorders may be related with a history of childhood trauma and suggests some biological similarities with posttraumatic syndromes that should be further explored.

Type
Original Research
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Fink, M. Should the dexamethasone test be resurrected? Acta Psychiatr Scand. 2005;112:245291.Google ScholarPubMed
2.Brambilla, F, Ferrari, E, Brunetta, M, et al.Psychoimmunoendocrine investigation in anorexia nervosa. Neuropsychobiology. 1993;27:916.CrossRefGoogle ScholarPubMed
3.Estour, B, Pugeat, M, Lang, F, et al.Rapid escape of cortisol from suppression in response to i.v. dexamethasone in anorexia nervosa. Clin Endocrinol (Oxf). 1990;33:4552.CrossRefGoogle ScholarPubMed
4.Schweitzer, I, Tuckwell, V, Maguire, K, Tiller, J. Personality pathology, depression and HPA axis functioning. Hum Psychopharmacol. 2001;16:303308.CrossRefGoogle ScholarPubMed
5.Fichter, MM, Pirke, KM, Pöllinger, J, Wolfram, G, Brunner, E. Disturbances in the hypothalamo-pituitary-adrenal and other neuroendocrine axes in bulimia. Biol Psychiatry. 1990;27:10211037.CrossRefGoogle ScholarPubMed
6.Neudeck, P, Jacoby, GE, Florin, I. Dexamethasone suppression test using saliva cortisol measurement in bulimia nervosa. Physiol Behav. 2001;72:9398.CrossRefGoogle ScholarPubMed
7.Steiger, H, Gauvin, L, Israël, M. Association of serotonin and cortisol indices with childhood abuse in bulimia nervosa. Arch Gen Psychiatry. 2001;58:837843.CrossRefGoogle ScholarPubMed
8.Díaz-Marsá, M, Carrasco, JL, Sáiz, J. A study of temperament and personality in anorexia and bulimia nervosa. J Personal Disord. 2000;14:352359.CrossRefGoogle ScholarPubMed
9.Kellner, M, Yehuda, R, Arlt, J, Wiedemann, K. Longitudinal course of salivary cortisol in post-traumatic stress disorder. Acta Psychiatr Scand. 2002;105:153155.CrossRefGoogle ScholarPubMed
10.Rinne, T, de Kloet, ER, Wouters, L, Goekoop, JG, DeRijk, RH, van den Brink, W. Hyperresponsiveness of hypothalamic-pituitary-adrenal axis to combined dexamethasone / corticotropin-releasing hormone challenge in female borderline personality disorder subjects with a history of sustained childhood abuse. Biol Psychiatry. 2002;52:11021112.CrossRefGoogle ScholarPubMed
11.Yehuda, R, Halligan, SL, Golier, JA, Grossman, R, Bierer, LM. Effects of trauma exposure on the cortisol response to dexamethasone administration in PTSD and major depressive disorder. Psychoneuroendocrinology. 2004;29:389404.CrossRefGoogle ScholarPubMed
12.Barton, C, March, S, Witertt, GA. The low dose dexamethasone suppression test: effect of time of administration and dose. J Endocrinol Invest. 2002;25:RC10RC12.CrossRefGoogle ScholarPubMed
13.Carrasco, JL, Díaz-Marsá, M, Pastrana, J, Molina, R, Brotons, LHorcajadas, L. Enhanced suppression of cortisol after dexamethasone test in borderline personality disorder. A pilot study [Spanish]. Actas Esp Psiquiatr. 2003;31:138141.Google ScholarPubMed
14.Henderson, M, Freeman, CP. A self-rating scale for bulimia. The ‘BITE’. Br J Psychiatry. 1987;150:1825.CrossRefGoogle ScholarPubMed
15.Bernstein, DP, Stein, JA, Newcomb, MD, et al.Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 2003;27:169190.CrossRefGoogle ScholarPubMed
16.Grossman, R, Yehuda, R, New, A. Dexamethasone suppression test findings in subjects with personality disorders: associations with posttraumatic stress disorder and major depression. Am J Psychiatry. 2003;160:12911297.CrossRefGoogle ScholarPubMed
17.Lange, W, Wulff, H, Berea, C, et al.Dexamethasone suppression test in borderline personality disorder. Effects of posttraumatic stress disorder. Psychoneuroendocrinology. 2005;30:919923.CrossRefGoogle ScholarPubMed
18.Westrin, A, Frii, K, Träskman-Bendz, L. The dexamethasone suppression test and DSM-III-R diagnoses in suicide attempters. Eur Psychiatry. 2003;18:350355.CrossRefGoogle ScholarPubMed
19.Silk, KR, Lee, S, Hill, EM, Lohr, NE. Borderline personality disorder symptoms and severity of sexual abuse. Am J Psychiatry. 1995;152:10591064.Google ScholarPubMed
20.Lacey, JH. Incest, incestuous fantasy & indecency. A clinical catchment area study of normal-weight bulimic women. Br J Psychiatry. 1990;157:399403.CrossRefGoogle ScholarPubMed
21.Grilo, CM, Levy, KN, Becker, DF, Edell, WS, McGlashan, TH. Comorbidity of DSM-III-R axis I and II disorders among female inpatients with eating disorders. Psychiatr Serv. 1996;47:426429.Google ScholarPubMed
22.Basurte, E, Diaz-Marsa, M, Martin, O, Carrasco, JL. Traumatic antecedents, impulsivity and HPA axis dysfunctions in eating disorders. A pilot study [Spanish]. Actas Esp Psiquiatr. 2004;32:149152.Google Scholar