alexa The Effect of Comorbid Depression and Sexual Abuse during Childhood on Glucocorticoid and Mineralocorticoid Receptor Sensitivity of Patients with Post-Traumatic Stress Disorder
ISSN: 2167-1044

Journal of Depression and Anxiety
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Research Article

The Effect of Comorbid Depression and Sexual Abuse during Childhood on Glucocorticoid and Mineralocorticoid Receptor Sensitivity of Patients with Post-Traumatic Stress Disorder

Marcelo F. Mello1*, Andrea F. Mello1, Juliana E. Ruiz1, Jose Paulo Fiks1, Sergio B. Andreoli1, Rodrigo A. Bressan1, Mariana C. P. Costa1, Jair J. Mari1, Deborah Suchecki2 and Mario Juruena3
1Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP)
2Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP)
3Department of Psychiatry, Universidade de São Paulo-Ribeirão Preto (USP-RP)
*Corresponding Author : Marcelo F Mello
Associate Professor, Department of Psychiatry
Federal University of São Paulo (UNIFESP)
Rua Borges Lagoa, 570 Sao Paulo-SP Brazil
Tel: 55 11 30786829
Fax: 55 11 30786829
E-mail: [email protected]
Received July 20, 2013; Accepted September 05, 2013; Published September 10, 2013
Citation: Mello MF (2013) The Effect of Comorbid Depression and Sexual Abuse during Childhood on Glucocorticoid and Mineralocorticoid Receptor Sensitivity of Patients with Post-Traumatic Stress Disorder. J Depress Anxiety S4:004. doi:10.4172/2167-1044.S4-004
Copyright: © 2013 Mello MF. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Evidence shows that Posttraumatic Stress Disorder (PTSD) patients have low basal cortisol levels and
Glucocorticoid-Receptor (GR) super sensitivity following a pharmacological challenge. These findings, however, are controversial, partially due to the presence of confounding factors such as comorbidity with Major Depressive Disorder (MDD) and childhood trauma. In the present study, salivary cortisol levels of victims of violence with and without PTSD were assessed following a Prednisolone Suppression Test (PST), controlling for the presence of MDD and sexual abuse during childhood. The sample was nested in an epidemiological study performed in the city of São Paulo. Subjects with a diagnosis of PTSD  (PTSD+) and a matched control group (PTSD-) were submitted to the Structured Clinical Interview for DSM-IV, after which the Early Trauma Inventory (ETI), Clinician-Administered PTSD Scale (CAPS), Beck
Depression (BDI) and Anxiety Inventory (BAI) and Peri-traumatic Dissociative Experiences Questionnaire (PDEQ) were used. A saliva sample was collected before and after 5 mg of prednisolone was  administered at 10 PM. Of the 34 PTSD+ patients, 19 had MDD comorbidity (PTSD+MDD). The cortisol curve of PTSD+MDD patients was similar to that of controls, and both were higher than that of PTSD patients. Cortisol levels after awakening after prednisolone administration were negatively correlated with the CAPS, BAI, and sexual abuse score on the ETI. These findings not only reinforce the idea that PTSD patients have GR super sensitivity, they also reveal that factors such as sexual abuse during childhood and comorbid MDD should be considered when studying HPA-axis reactivity, given their significant impact on the stress response.

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