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Urinary free-cortisol levels in posttraumatic stress disorder patients
The Journal of Nervous and Mental Disease
|March 1, 1986
Summary
Patients with posttraumatic stress disorder (PTSD) exhibit lower urinary free-cortisol levels compared to other psychiatric conditions. This finding in PTSD may inform diagnostic approaches and understanding of stress responses.
Area of Science:
- Neuroendocrinology
- Psychiatry
- Clinical Psychology
Background:
- Urinary free-cortisol levels are a biomarker for hypothalamic-pituitary-adrenal (HPA) axis activity.
- Previous research indicates altered HPA axis function in various psychiatric disorders.
- PTSD is often associated with symptoms of anxiety and depression, typically linked to elevated cortisol.
Purpose of the Study:
- To compare urinary free-cortisol levels across different psychiatric patient groups.
- To investigate the relationship between cortisol levels and the presence of PTSD.
- To explore potential diagnostic utility of hormonal markers in PTSD.
Main Methods:
- Radioimmunoassay measurement of urinary free-cortisol levels.
- Sampling at 2-week intervals during hospitalization.
- Comparison of mean cortisol levels between PTSD, major depressive disorder, bipolar I (manic), paranoid schizophrenia, and undifferentiated schizophrenia groups.
Main Results:
- Mean urinary free-cortisol levels were significantly lower in PTSD patients (33.3 +/- 3.2 microg/day) compared to major depressive disorder, bipolar I (manic), and undifferentiated schizophrenia.
- Cortisol levels in PTSD were similar to those in paranoid schizophrenia (37.5 +/- 3.9 microg/day).
- These differences were consistent in initial samples post-admission.
Conclusions:
- PTSD patients exhibit characteristically low and stable urinary free-cortisol levels, contrasting with typical expectations for anxiety and depression.
- This finding is notable given the concurrent sympathetic nervous system hyperactivity observed in PTSD.
- Low cortisol levels in PTSD and paranoid schizophrenia may relate to defensive organizational processes, suggesting hormonal criteria could aid PTSD diagnosis.