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Cortisol levels in children with attention-deficit/hyperactivity disorder
Johan Isaksson1, Kent W Nilsson, Fred Nyberg
1Department of Neuroscience, Child and Adolescent Psychiatry Unit, Uppsala University, 751 85 Uppsala, Sweden. johan.isaksson@neuro.uu.se
Children with Attention-Deficit/Hyperactivity Disorder (ADHD) exhibit lower cortisol levels, suggesting Hypothalamus-Pituitary-Adrenal (HPA) axis dysregulation. These findings may link to under-arousal in ADHD core symptoms.
Area of Science:
- Neuroendocrinology
- Child Psychiatry
Background:
- Hypothalamus-Pituitary-Adrenal (HPA) axis regulation and cortisol secretion patterns vary in psychiatric disorders.
- Previous research on Attention-Deficit/Hyperactivity Disorder (ADHD) and HPA-axis activity remains inconclusive.
Purpose of the Study:
- To investigate diurnal salivary cortisol patterns in children diagnosed with ADHD compared to non-affected controls.
- To explore potential correlations between cortisol levels, ADHD subtypes, symptom severity, and age.
Main Methods:
- Collected four daily saliva samples from 201 children with ADHD and 221 controls (aged 6-17).
- Measured salivary cortisol using radioimmunoassay.
- Assessed ADHD diagnosis, subtypes, and symptom severity via clinical data and parental rating scales.
Main Results:
- Children with ADHD showed significantly lower cortisol levels at waking, 30 minutes post-waking, and before bedtime compared to controls.
- No significant differences were observed in afternoon cortisol levels.
- Lower cortisol levels were more pronounced in children with ADHD over 10 years of age.
- Cortisol levels were not significantly affected by ADHD subtype or co-occurring symptoms, with a weak negative correlation noted between afternoon cortisol and hyperactivity.
Conclusions:
- Findings suggest potential HPA-axis dysregulation, possibly manifesting as down-regulation or a phase delay in the diurnal cortisol curve, in children with ADHD.
- The observed low cortisol levels may be associated with the under-arousal hypothesis relevant to ADHD core symptoms.
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