The role of acute cortisol and DHEAS in predicting acute and chronic PTSD symptoms

Abstract

SummaryBackground: Decreased activation of the hypothalamus-pituitary-adrenal (HPA) axis in response to stress is suspected to be a vulnerability factor for posttraumatic stress disorder (PTSD). Previous studies showed inconsistent findings regarding the role of cortisol in predicting PTSD. In addition, no prospective studies have examined the role of dehydroepiandrosterone (DHEA), or its sulfate form DHEAS, and the cortisol-to-DHEA(S) ratio in predicting PTSD. In this study, we tested whether acute plasma cortisol, DHEAS and the cortisol-to-DHEAS ratio predicted PTSD symptoms at 6 weeks and 6 months post-trauma. Methods: Blood samples of 397 adult level-1 trauma center patients, taken at the trauma resuscitation room within hours after the injury, were analyzed for cortisol and DHEAS levels. PTSD symptoms were assessed at 6 weeks and 6 months post-trauma with the Clinician Administered PTSD Scale. Results: Multivariate linear regression analyses showed that lower cortisol predicted PTSD symptoms at both 6 weeks and 6 months, controlling for age, gender, time of blood sampling, injury, trauma history, and admission to intensive care. Higher DHEAS and a smaller cortisol-to-DHEAS ratio predicted PTSD symptoms at 6 weeks, but not after controlling for the same variables, and not at 6 months. Conclusions: Our study provides important new evidence on the crucial role of the HPA-axis in response to trauma by showing that acute cortisol and DHEAS levels predict PTSD symptoms in survivors of recent trauma. #

The Association of 5-HTTLPR XLL Genotype with Higher Cortisol Levels in African Americans

“…Similar diurnal patterns have also been reported for dehydroepiandrosterone sulfate (DHEAS) [14,15]. Moreover, abnormal concentrations of cortisol and DHEAS have been linked to HPA axis dysfunction [16][17][18][19].…”

DHEAS and cortisol/DHEAS-ratio in recurrent depression: State, or trait predicting 10-year recurrence?

“…This could be caused by enhancing effects of DHEAS on memory and cognition, which make patients with a relatively lower cortisol/DHEAS-ratio more receptive for CT's recurrence preventing effects (Maninger et al, 2009;Sripada et al, 2013). Analogically, lower cortisol (and higher DHEAS) prospectively predicted post-traumatic stress disorder (PTSD)-symptoms in trauma center patients (Mouthaan et al, 2014).…”

Travma Sonrası Stres Bozukluğunda HPA Ekseninin Disregülasyonu

“…Sağlıklı insanlarda, DHEA/kortizol oranlarının stres ile başa çıkma becerileriyle ilişkili olabileceği 77 ve askeri personelde yüksek kortizol/DHEA kısalmış toplam yaşam süresi ile ilişkili olduğu bildirilmiştir 78 . Adölesanlarda yapılan çalışmalarda, cinsel istismar mağdurlarında düşük DHEA düzeylerinin görüldüğü 79 ve düşük DHEA düzeylerin ileride oluşabilecek TSSB semptomların şiddetini öngörebileceği bildirilmiştir 80 . DHEA-S'nin anabolizan ve nöroprotektif etkileri ile oksidatif stres ve inflamasyonu azalttığı insan deneklerde gösterilmiştir 81 ve askeri eğitim sırasında DHEA takviyesinin koruyucu etkileri olabileceği bildirilmiştir 82 .…”