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Stress: a risk factor for serious illness.

Theodore B Vanitallie1

  • 1Columbia University College of Physicians & Surgeons, USA.

Metabolism: Clinical and Experimental
|June 1, 2002
PubMed
Summary

The body

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Area of Science:

  • Neuroendocrinology
  • Stress Physiology
  • Psychotraumatology

Background:

  • The human stress response involves the hypothalamic-pituitary-adrenocortical (HPA) axis and sympathoadrenal system (SAS).
  • Chronic stress (allostatic load) can lead to illnesses like hypertension, atherosclerosis, and immune dysfunction.
  • The limbic system, including the hippocampus and amygdala, plays a key role in stress and memory.

Purpose of the Study:

  • To review the neuroendocrine mechanisms underlying stress responses and their dysregulation.
  • To examine the role of stress in the development of stress-related disorders, particularly PTSD.
  • To highlight the neuroendocrine characteristics of post-traumatic stress disorder (PTSD) in adults and children.

Main Methods:

  • Review of existing literature on stress physiology, neuroendocrinology, and psychotraumatology.
  • Analysis of studies investigating the HPA axis, SAS, and limbic system in response to stress.
  • Examination of neuroendocrine profiles in adult and child populations with PTSD.

Main Results:

  • Dysregulation of the stress system contributes to various chronic illnesses.
  • Chronic stress can impair hippocampal function, leading to memory and cognitive deficits.
  • Adult PTSD is often associated with enhanced glucocorticoid receptor feedback sensitivity and lower cortisol, alongside exaggerated catecholamine responses.
  • Severely maltreated children with PTSD may show elevated urinary cortisol, catecholamines, and dopamine years post-abuse.

Conclusions:

  • The intricate stress system is crucial for adaptation but its dysregulation underlies significant pathology.
  • Post-traumatic stress disorder (PTSD) exemplifies stress-induced illness, with distinct neuroendocrine signatures in adults and children.
  • Understanding these neuroendocrine differences is vital for targeted therapeutic interventions in PTSD.

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