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Persistence of anxiety disorders and concomitant changes in cortisol
Bram Dierckx1, Gwen Dieleman, Joke H M Tulen
1Department of Child and Adolescent Psychiatry, Erasmus MC, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands.
Journal of Anxiety Disorders
|May 22, 2012
Summary
Anxiety disorders in children and adolescents can alter stress hormone (cortisol) levels. Persistent anxiety is linked to abnormal cortisol patterns, highlighting the need for effective treatment.
Area of Science:
- Endocrinology
- Child and Adolescent Psychiatry
- Neuroscience
Background:
- Anxiety disorders are prevalent in children and adolescents.
- The hypothalamic-pituitary-adrenal (HPA) axis, which regulates cortisol, may be affected by anxiety.
- Understanding the relationship between anxiety disorder course and cortisol levels is crucial for treatment.
Purpose of the Study:
- To investigate the association between the treatment course of anxiety disorders in youth and concurrent changes in cortisol levels.
- To examine how cortisol production and rhythm differ based on treatment outcomes (remission vs. persistence) over one year.
Main Methods:
- A clinical sample of 116 children and adolescents with anxiety disorders was assessed.
- Assessments included the Anxiety Disorders Interview Schedule at baseline, 3 months, and 1-year follow-up.
- Cortisol levels were measured to analyze daytime production and morning rise patterns.
Main Results:
- Persistence of anxiety disorder correlated with increased daytime cortisol production and a trend towards a decreased cortisol morning rise.
- At 1-year follow-up, non-remitters exhibited the highest daytime cortisol levels, while early remitters had the lowest.
- Early remitters showed the highest cortisol morning rise, whereas non-remitters had the lowest, indicating altered HPA-axis function.
Conclusions:
- The persistence of anxiety disorders in children and adolescents is associated with significant alterations in HPA-axis functioning, specifically in cortisol patterns.
- These findings underscore the importance of timely and adequate treatment for anxiety disorders to potentially normalize HPA-axis regulation.
- Changes in cortisol dynamics serve as potential biomarkers for treatment response and disorder persistence.
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