Urinary free cortisol levels in obsessive-compulsive disorder.

Area of Science:

• Neuroscience
• Endocrinology
• Psychiatry

Background:

• Obsessive-compulsive disorder (OCD) is a debilitating mental health condition.
• Elevated urinary free cortisol (UFC) has been observed in some OCD patients.
• The HPA axis dysregulation may play a role in OCD pathophysiology.

Purpose of the Study:

• To investigate urinary free cortisol (UFC) levels in patients with obsessive-compulsive disorder (OCD).
• To examine the effect of clomipramine treatment on UFC levels and OCD symptomatology.
• To explore the relationship between UFC levels and depressive symptoms in OCD.

Main Methods:

• 24-hour urine samples were collected from 17 OCD patients and 25 healthy controls for UFC measurement.
• A subset of OCD patients (n=13) underwent a 10-week trial of clomipramine or placebo.
• Symptom severity was assessed using the Yale-Brown Obsessive Compulsive Scale and NIMH Global Obsessive-Compulsive Scale.

Main Results:

• OCD patients exhibited significantly higher baseline UFC levels compared to controls.
• Following 10 weeks of treatment, UFC levels decreased in both clomipramine and placebo groups, becoming comparable to controls.
• Clomipramine treatment led to significant improvement in OCD symptoms, whereas placebo did not.
• A correlation was found between UFC levels and the presence of depressive symptoms.

Conclusions:

• Urinary free cortisol (UFC) levels are elevated in obsessive-compulsive disorder (OCD) at baseline.
• While clomipramine and placebo normalized UFC levels, only clomipramine effectively reduced OCD symptomatology.
• These findings suggest a complex interplay between the HPA axis, OCD, and depressive symptoms, with clomipramine showing therapeutic efficacy.