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Diurnal Cortisol Levels and Cortisol Response in Youths with Obsessive-Compulsive Disorder
Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
Department of Child and Adolescent Psychiatry, Göteborg University, Göteborg, Sweden; The Regional Center for Child and Adolescent Psychiatry (R. BUP), Oslo, Norway.
Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
2008 (English)In: Neuropsychobiology, ISSN 0302-282X, E-ISSN 1423-0224, Vol. 57, no 1-2, 14-21 p.Article in journal (Refereed) Published
Abstract [en]

Background/Aims: Recent results indicate a role of the hypothalamic-pituitary-adrenal (HPA) axis in the pathophysiology of obsessive-compulsive disorder (OCD). Although childhood onset is common, the HPA axis has scarcely been studied in young OCD subjects. Therefore, the present study aimed at examining basal and response levels of salivary cortisol in a sample of young OCD subjects.

Methods: Twenty-three children and adolescents with DSM-IV OCD were compared to a reference group of school children (n = 240-336). The basal cortisol rhythm was measured through saliva samples 3 times/day. The cortisol response to a psychological stressor (exposure therapy in the OCD group and a fire alarm in the reference group) was also examined.

Results: Compared to the reference group, OCD subjects displayed higher early-morning cortisol values (p = 0.005) with no difference between the late-morning and evening values. The cortisol levels in the OCD group diminished in response to the psychological stressor, compared to a positive response in the reference group (p < 0.001). No relation was found between cortisol and clinical parameters.

Conclusion: These results support the idea that HPA hyperactivity, commonly found in adult OCD patients, is also present at an earlier stage of development, with specificity for the early-morning peak.

Place, publisher, year, edition, pages
S. Karger, 2008. Vol. 57, no 1-2, 14-21 p.
Keyword [en]
Cortisol, Stress response, Obsessive-compulsive disorder, children
National Category
Neurosciences
Identifiers
URN: urn:nbn:se:liu:diva-15681DOI: 10.1159/000123117ISI: 000257134900005OAI: oai:DiVA.org:liu-15681DiVA: diva2:126934
Available from: 2008-11-26 Created: 2008-11-26 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Psychosocial Stress, Mental Health and Salivary Cortisol in Children and Adolescents
Open this publication in new window or tab >>Psychosocial Stress, Mental Health and Salivary Cortisol in Children and Adolescents
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Stressful experiences and conditions in childhood influence the health and well-being of the growing individual, and can also confer a long-lasting impact into adult life. Delineating the social, mental and biological aspects of stress in children and adolescents is therefore of great concern for human beings. Despite these notions, much knowledge is lacking regarding stress in childhood.

This thesis aimed at examining diverse aspects of stress in children and adolescents: associations between social conditions, traumatic life events, mental health, and salivary cortisol as a measure of the activity of a major physiological stress system. Cross-sectional samples included two non-clinical samples of school-aged children (N=240-336) and adolescents (N =400), and two clinical samples of children with obsessive-compulsive disorder (OCD) (N =23) and adolescents who had experienced childhood abuse (N =15). Main measures were salivary cortisol sampled three times a day, and questionnaires to teachers, parents and children with questions about each child’s mental health, traumatic life events and about the socioeconomic situation of the parents.

The main findings include observation of 1) higher cortisol levels in children with a moderate level of psychosocial burden (low socioeconomic status, immigrant family, social impairment of mental health problems), 2) higher cortisol levels in children with OCD who also displayed a tendency to decreasing cortisol in the face of an acute stressor, and 3) cortisol was positively related to mental health problems in abused adolescents. Furthermore, the deleterious effect of 4) traumatic events involving a social dimension, interpersonal traumas, and 5) cumulative traumatic events, polytraumatization, on the mental health of children and adolescents was indicated.

The findings are discussed with respect to the complex interactions between social, mental and biological aspects of children and adolescents. The consequences of adverse experiences in childhood may represent pathways to future health problems. Consideration of the social circumstances in childhood might in the future guide public health policies and the identification of target groups for preventive interventions as well as leading to improvements in treatment for children exposed to severe stress.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2008. 138 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1084
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-15686 (URN)978-91-7393-776-4 (ISBN)
Public defence
2008-12-03, Berzeliussalen, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2008-11-26 Created: 2008-11-26 Last updated: 2009-08-21Bibliographically approved

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Gustafsson, Per E.Gustafsson, Per A.Nelson, Nina

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