HPA Axis Activity under Psychosocial Stress in Patients with Acute and Remitted Panic Disorder.

Petrowski, Katja; Wintermann, Gloria-Beatrice; Joraschky, Peter; Siepmann, Martin

Background: Panic disorder (PD) has been linked to an altered activity of Hypothalamic-pituitary-adrenal (HPA) axis. To understand the elevated risk for future psychiatric episodes in PD it is of interest how remitted patients might differ from healthy controls in the activity of the HPA axis. Methods: Fourteen patients with PD and 14 healthy controls were exposed to the Trier Social Stress Test (TSST) on consecutive days twice before and twice after psychotherapeutic intervention. Salivary cortisol and heart rate variability (HRV) were measured repeatedly. Results: The healthy controls showed normal increase of salivary cortisol. By contrast, in patients with PD cortisol responses were absent on all testing days. In respect to RMSSD, the TSST exposure led to a decrease in both groups. Conclusion: The findings suggest that in patients with remitted PD, a hypo-response pattern of the HPA axis after significant symptom reduction might be a risk for future psychiatric episodes (German J Psychiatry 2011; 14(2): 72- 79).

PANIC disorders; HYPOTHALAMIC-pituitary-adrenal axis; PSYCHOLOGICAL stress testing; PSYCHOLOGICAL tests; HYDROCORTISONE; HEART beat

German Journal of Psychiatry, 2011, Vol 14, Issue 2, p72

1433-1055

Academic Journal