Altered cortisol awakening response in posttraumatic stress disorder

An altered function of the hypothalamic-pituitary-ad renal axis is assumed to be characteristic for Posttraumatic Stress Disorder (PTSD), although there is inconsistent empirical evidence. Only few studies examined the awakening cortisol response and a daytime profile in PTSD. Salivary cortisol Levels were measured at seven intervals from awakening until 8 PM in trauma-exposed subjects with (N=29) and without PTSD (N=19) and in 15 non-exposed controls. White the three groups did not differ with respect to their first cortisol level immediately after awakening, the expected cortisol increase to awakening 15-60 min Later was significantly Lower in PTSD patients compared to non-PTSD subjects and healthy controls. This effect remained stable when trauma-exposed subjects with comorbid major depression were excluded from the analysis. A significant negative correlation between the overall cortisol secretion (AUC(G)) and overall PTSD symptomatology and hyperarousal symptoms was found. The findings are discussed in tight of the hypothesis of a counterregulation of hyperarousal symptoms and chronic stress in PTSD. (c) 2005 Elsevier Ltd. All rights reserved.