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Post traumatic stress disorder and the adrenal gland

Published online by Cambridge University Press:  13 June 2014

John P Tobin
John P Tobin*
Affiliation:
St Bricin's Military Hospital, Infirmary Road, Dublin 7, Ireland
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Abstract

Low serum and urinary Cortisol has been a consistent finding in post traumatic stress disorder (PTSD). Glucocorticoid receptor numbers are increased. PTSD patients have a significantly lower adrenocorticotropic hormone (ACTH) in response to corticotrophin releasing hormone (CRH) when compared to a control group of normal volunteers. The dexamethasone suppression test exhibits an exaggerated suppression response of Cortisol to dexamethasone, when the dose utilised is lower than that utilised to test patients with depression. Increased urine levels of noradrenaline and dopamine has been noted in patients with PTSD. This is believed to be related to the hyperarousal state of PTSD.

Keywords

CortisolHypothalamic pituitary axis (HPA)Glucocorticoid receptor numberCorticotrophin releasing hormone (CRH)Dexamethasone Suppression TestNoradrenalinePost traumatic stress disorder (PTSD).
Type
Reviews
Information
Irish Journal of Psychological Medicine , Volume 18 , Issue 1 , March 2001 , pp. 27 - 29
Copyright
Copyright © Cambridge University Press 2001

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References

1.Elhert, V. Psychobiology of Post Traumatic Stress Disorder. Nervanarzt 1999: 70(9): 773–9.Google Scholar
2.Heim, C, Elhert, V, Hellhammer, DH. The potential role of hypocortisolism in the pathophysiology of stress related bodily disorders. Psychoneuroendocrinology 2000; 25(1): 1–35.CrossRefGoogle ScholarPubMed
3.Galien, J, Yedunda, R. Neuroendocrine activity and memory – related impairments in post traumatic stress disorder. Developmental Psychiatry 1998; (4); 857–69.Google Scholar
4.Mason, JW, Giller, EL, Koster, TR. Urinary Free Cortisol Levels in post traumatic stress disorder. J Nervous and Mental Disease 1986; 174: 145–9.CrossRefGoogle Scholar
5.Yehuda, R, Southwick, SM, Nussbaurn, G. Urinary CorrisoJ Excretion in patients with PTSD. J Nervous and Mental Disease 1990; 178: 366–9.CrossRefGoogle Scholar
6.Halbreich, U, Olympia, J, Carson, S. Hypothalamo – Pituitary – Adrenal Acitivity in endogenously depressed and PTSD patients. Psychoneuroendocrinology 1989; 14: 365–70.CrossRefGoogle Scholar
7.Maes, M. Increased 24 hour urinary Cortisol Excretion in patients with PTSD and patients with major depression, but not in patients with fibromyalgia. Acta Psychiatric Scandinavica 1998; 98(4): 328–35.CrossRefGoogle Scholar
8.Yehuda, R. Psychological trauma. American Psychiatric Press Inc 1998; 95–125.Google Scholar
9.Goenjin, AK, Yehuda, R, Pynoos, RS. Basal Cortisol and dexamethasone suppression in Cortisol among adolescents after the 1998 earthquake in Armenia. American Journal of Psychiatry 1991; 53: 929–34.Google Scholar
10.Browne, PG, Rose, RM, Mason, JW. Urinary hydroxycorticosteroid levels data on seven helicopter ambulance medics in combat. Archives of General Psychiatry, 1967; 17: 104–10.Google Scholar
11.Smith, MA, Davidson, J, Ritchie, JC. The corticotrophin – releasing hormone test in patients with PTSD. Biology Psychiatry 1989 26(4): 349–55.CrossRefGoogle Scholar
12.Darnell, A, Bremner, JD, Licino, J. Increased CSF levels of corticotrophin releasing factor in chronic PTSD. Neuroscience Abstracts 1994; 20: 15A.Google Scholar
13.Gormley, GJ, Lowy, MT, Reden, AT. Glucocorticoid receptors in depression: Relationship to the dexmethasone suppression test. Am J Psychiat 1985; 142: 1278–84.Google Scholar
14.Yehuda, R, Boisoneau, D, Lowy, MT. Dose – Response changes in plasma Cortisol and lymphocyte glucocorticoid receptors following dexmathasone administration in combat veterans with and without post traumatic stress disorder. Archives Gen Psychiat 1995; 52(7): 583–93.CrossRefGoogle Scholar
15.Stein, MB, Yehuda, R, Koverola, C. HPA axis functioning in adult women who report experiencing severe childhood sexual abuse. Biological Psychiatry 1997; 42:680–6.CrossRefGoogle Scholar
16.Carroll, BJ. The dexmethasone suppression test for melancholia. Br J Psychiatry, 1982; 140:292–304.CrossRefGoogle Scholar
17.Kundler, H, Davidson, J, Meador, K. The DST and post traumatic stress disorder. Am J Psychiat 1990; 28: 665–72.Google Scholar
18.Dinan, TG, Barry, S, Yatham, LN. A pilot study on neuroendocrine test battery in post traumatic stress disorder. Biological Psychiatry 1990; 28: 665–672.CrossRefGoogle Scholar
19.Blanchard, EB, Kolb, LC, Prins, A. Changes in plasma norepinephrine to combat related stimuli among vietnam veterans with PTSD. J Nervous Mental disorder 1991; 179(6): 371–3.CrossRefGoogle Scholar
20.Yehuda, R, Southwick, S, Gillen, EL. Catecholamine excretion and severity of PTSD symptoms in Vietnam combat veterans. J Nervous Mental Disorder, 1992; 180(5): 321–5.CrossRefGoogle ScholarPubMed
21.Mellman, TA, Kurnan, A, Kulick-Bell, R. Nocturnal/daytime urine noradrenergic measures and sleep in combat related PTSD, biological psychiatry 1995; 1:38(3): 174–9.CrossRefGoogle Scholar
22.Yehuda, R, Saver, LJ, Teicher, MH. Plasma norepinephrine and 3 – Methoxy – 4 Hydroxy phenyglycol concentrations and severity of depression in combat post traumatic stress disorder and major depressive disorder, biological psychiatry 1998; 44(1): 56–63.CrossRefGoogle Scholar
23.Bremner, JD. Alterations in brain structure and function associated with PSTD. Seminars in clinical neuropsychiatry 1999; 4(4): 249–255.Google Scholar
24.Chambers, RA, Bremner, JD, Moghaddan, B. Glutamate and PSTD: towards a psychobiology of dissociation. Seminars in clinical neuropsychiatry 1999; 4 (4): 274–81.Google Scholar