Regulation of hypothalamic-pituitary-adrenal activity in response to cognitive therapy in patients with generalized anxiety disorder

Tafet, Gustavo E.; Feder, Diego Javier; Abulafia, Denise P.; Roffman, Silvia S.

doi:10.3758/cabn.5.1.37

Cited by 44 publications

(38 citation statements)

References 19 publications

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“…The lack of an association between GAD and cortisol in the present study was surprising. Previous studies have found higher cortisol levels in GAD patients (Tafet et al, 2005), although in some cases this was in an older adult sample (Mantella et al, 2008), unlike the present study.…”

Section: Sensitivity Analysiscontrasting

confidence: 56%

Major depressive disorder, generalised anxiety disorder, and their comorbidity: Associations with cortisol in the Vietnam Experience Study

Phillips¹,

Batty²,

Gale³

et al. 2011

Psychoneuroendocrinology

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SummaryObjectives: The aim of these analyses was to examine the association of cortisol, dehydroepiandrosterone sulphate (DHEAS), and the cortisol:DHEAS ratio with the diagnoses of major depressive disorder (MDD), generalised anxiety disorder (GAD), and their comorbidity.Design: This was a cross-sectional study.Methods: Participants were 4256 Vietnam era US army veterans. From military service files, telephone interviews, and a medical examination, occupational, socio-demographic, and health data were collected. One-year prevalence of MDD and GAD was determined through a diagnostic interview schedule based on the DSM-IV criteria. Contemporary morning fasted cortisol and DHEAS concentrations were determined. Analyses of covariance were run, first with adjustment for age and then additionally adjusting for a range of candidate confounders.Results: In fully adjusted analyses, there was evidence of lower basal cortisol levels in individuals with MDD and co-morbid MDD and GAD than those with GAD alone or no diagnosis.Conclusion: This suggests that MDD and its comorbidity can also be characterised by low as well as high cortisol levels. A profitable line of future research might be to examine cortisol and DHEAS levels in more representative samples including older participants and women with and without MDD, GAD, and other psychiatric diagnoses.

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Section: Sensitivity Analysiscontrasting

confidence: 56%

Major depressive disorder, generalised anxiety disorder, and their comorbidity: Associations with cortisol in the Vietnam Experience Study

Phillips¹,

Batty²,

Gale³

et al. 2011

Psychoneuroendocrinology

View full text Add to dashboard Cite

show abstract

“…Thus, our findings also suggest that elevated cortisol levels reflect an anxious state and are not dependent upon the duration of the anxiety disorder. As reported by Tafet et al (2005) and Pomara et al (2005) we expect that with successful treatment of GAD, cortisol levels will normalize and GAD-associated symptoms will attenuate.…”

Section: Discussionmentioning

confidence: 77%

“…For instance, GAD patients who underwent cognitive behavioral therapy showed reductions in anxiety symptoms and cortisol levels after 24 weeks compared with GAD patients who did not receive treatment (Tafet et al, 2005), and elderly adults with GAD also showed reductions in anxiety symptoms and plasma cortisol levels following acute and chronic diazepam treatment (Pomara et al, 2005). These studies suggest that elevated cortisol levels may reflect an anxious state and can be attenuated with treatment.…”

Section: Discussionmentioning

confidence: 99%

Salivary cortisol is associated with diagnosis and severity of late-life generalized anxiety disorder

Mantella

Butters

Amico

et al. 2008

Psychoneuroendocrinology

186

151

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SummaryAge-associated alterations in hypothalamic-pituitary-adrenal (HPA) axis functioning may make individuals more susceptible to HPA dysregulation in the context of mood and anxiety disorders. Little to no research has been done to examine HPA axis function in generalized anxiety disorder (GAD), particularly in late-life GAD, the most prevalent anxiety disorder in the elderly. The study sample consisted of 71 GAD subjects and 40 nonanxious comparison subjects over 60 years of age. We examined the hypotheses that elderly individuals with GAD will have elevated salivary cortisol levels compared to nonanxious subjects, and that elevated cortisol levels in GAD will be associated with measures of symptom severity. We report that late-life GAD is characterized by elevated basal salivary cortisol levels, with higher peak cortisol levels and larger areas under the curve, compared to nonanxious subjects. Additionally, severity of GAD as measured by the GAD Severity Scale and the Penn State Worry Questionnaire are positively correlated with cortisol levels. These data demonstrate HPA axis dysfunction in late-life GAD and suggest the need for additional research on the influence of aging on HPA axis function in mood and anxiety disorders.

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“…Additionally, severity of GAD, as measured by psychometric instruments, was positively correlated with cortisol levels [114] . Also Tafet et al [115] and Pomara et al [116] observed that patients with GAD presented increased levels of circulating cortisol (Table 5). Tafet et al [115] reported that cognitive therapy (CT) was effective in improving distressful clinical symptoms of GAD and in recovering psychoneuroendocrinological functions of these subjects.…”

Section: Childhood Stressful Events Hpa Axis and Gadmentioning

confidence: 92%

“…Also Tafet et al [115] and Pomara et al [116] observed that patients with GAD presented increased levels of circulating cortisol (Table 5). Tafet et al [115] reported that cognitive therapy (CT) was effective in improving distressful clinical symptoms of GAD and in recovering psychoneuroendocrinological functions of these subjects. In fact, after a maximum of 24 sessions of CT, a significant decrease in the Hamilton Anxiety Rating Scale and a significant decrease in previously increased levels of circulating cortisol were observed [115] .…”

Section: Childhood Stressful Events Hpa Axis and Gadmentioning

confidence: 92%

Childhood stressful events, HPA axis and anxiety disorders

Faravelli

Sauro²,

Godini³

et al. 2012

WJP

130

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Anxiety disorders are among the most common of all mental disorders and their pathogenesis is a major topic in psychiatry, both for prevention and treatment. Early stressful life events and alterations of hypothalamic pituitary adrenal (HPA) axis function seem to have a significant role in the onset of anxiety. Existing data appear to support the mediating effect of the HPA axis between childhood traumata and posttraumatic stress disorder. Findings on the HPA axis activity at baseline and after stimuli in panic disordered patients are inconclusive, even if stressful life events may have a triggering function in the development of this disorder. Data on the relationship between stress, HPA axis functioning and obsessive-compulsive disorder (OCD) are scarce and discordant, but an increased activity of the HPA axis is reported in OCD patients. Moreover, normal basal cortisol levels and hyperresponsiveness of the adrenal cortex during a psychosocial stressor are observed in social phobics. Finally, abnormal HPA axis activity has also been observed in generalized anxiety disordered patients. While several hypothesis have attempted to explain these findings over time, currently the most widely accepted theory is that early stressful life events may provoke alterations of the stress response and thus of the HPA axis, that can endure during adulthood, predisposing individuals to develop psychopathology. All theories are reviewed and the authors conclude that childhood life events and HPA abnormalities may be specifically and transnosographically related to all anxiety disorders, as well as, more broadly, to all psychiatric disorders.

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Regulation of hypothalamic-pituitary-adrenal activity in response to cognitive therapy in patients with generalized anxiety disorder

Cited by 44 publications

References 19 publications

Major depressive disorder, generalised anxiety disorder, and their comorbidity: Associations with cortisol in the Vietnam Experience Study

Major depressive disorder, generalised anxiety disorder, and their comorbidity: Associations with cortisol in the Vietnam Experience Study

Salivary cortisol is associated with diagnosis and severity of late-life generalized anxiety disorder

Childhood stressful events, HPA axis and anxiety disorders

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