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Salivary cortisol levels in persons with and without different anxiety disorders.
Psychosom Med. 2010 May; 72(4):340-7.PM

Abstract

OBJECTIVE

To examine the association between several subtypes of anxiety disorders and various cortisol indicators in a large cohort study. Anxiety disorders have been suggested to be linked to hypothalamic-pituitary-adrenal (HPA) axis activity, although results are scarce and inconsistent. No earlier studies have examined consistency of HPA axis findings across several anxiety subtypes and whether associations are state or trait dependent.

METHODS

Data are derived from 1427 participants of the Netherlands Study of Depression and Anxiety. Three groups were compared: 342 control participants without psychiatric disorders; 311 persons with a remitted (no current) anxiety disorder (social phobia, generalized anxiety disorder, panic disorder); and 774 persons with a current anxiety disorder, as diagnosed using the Composite International Diagnostic Interview psychiatric interview. Cortisol levels were measured in seven saliva samples, determining the 1-hour cortisol awakening response, evening cortisol, and cortisol response after 0.5 mg of dexamethasone ingestion.

RESULTS

Current anxiety disorder was associated with higher awakening cortisol levels (p = .002). These findings were mainly present for patients with panic disorder with agoraphobia and anxious patients with comorbid depressive disorder. Remitted anxiety only showed a trend toward higher morning cortisol (p = .08). No associations were observed for anxiety status and evening cortisol level or cortisol suppression after dexamethasone.

CONCLUSIONS

This study showed a modest but significantly higher 1-hour cortisol awakening response among anxiety patients, which was driven by those with panic disorder with agoraphobia and those with comorbid depression.

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Authors+Show Affiliations

Vreeburg SA
Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands. s.vreeburg@ggzingeest.nl
Zitman FG
No affiliation info available
van Pelt J
No affiliation info available
Derijk RH
No affiliation info available
Verhagen JC
No affiliation info available
van Dyck R
No affiliation info available
Hoogendijk WJ
No affiliation info available
Smit JH
No affiliation info available
Penninx BW
No affiliation info available

MeSH

AdultAgoraphobiaAnxiety DisordersCircadian RhythmDepressive Disorder, MajorFemaleHumansHydrocortisoneHypothalamo-Hypophyseal SystemMaleMiddle AgedPanic DisorderPersonality InventoryPhobic DisordersPituitary-Adrenal SystemSalivaSeasons

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20190128

Clinical Trial Links

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Citation

Vreeburg, Sophie A., et al. "Salivary Cortisol Levels in Persons With and Without Different Anxiety Disorders." Psychosomatic Medicine, vol. 72, no. 4, 2010, pp. 340-7.
Vreeburg SA, Zitman FG, van Pelt J, et al. Salivary cortisol levels in persons with and without different anxiety disorders. Psychosom Med. 2010;72(4):340-7.
Vreeburg, S. A., Zitman, F. G., van Pelt, J., Derijk, R. H., Verhagen, J. C., van Dyck, R., Hoogendijk, W. J., Smit, J. H., & Penninx, B. W. (2010). Salivary cortisol levels in persons with and without different anxiety disorders. Psychosomatic Medicine, 72(4), 340-7. https://doi.org/10.1097/PSY.0b013e3181d2f0c8
Vreeburg SA, et al. Salivary Cortisol Levels in Persons With and Without Different Anxiety Disorders. Psychosom Med. 2010;72(4):340-7. PubMed PMID: 20190128.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Salivary cortisol levels in persons with and without different anxiety disorders. AU - Vreeburg,Sophie A, AU - Zitman,Frans G, AU - van Pelt,Johannes, AU - Derijk,Roel H, AU - Verhagen,Jolanda C M, AU - van Dyck,Richard, AU - Hoogendijk,Witte J G, AU - Smit,Johannes H, AU - Penninx,Brenda W J H, Y1 - 2010/02/26/ PY - 2010/3/2/entrez PY - 2010/3/2/pubmed PY - 2010/7/16/medline SP - 340 EP - 7 JF - Psychosomatic medicine JO - Psychosom Med VL - 72 IS - 4 N2 - OBJECTIVE: To examine the association between several subtypes of anxiety disorders and various cortisol indicators in a large cohort study. Anxiety disorders have been suggested to be linked to hypothalamic-pituitary-adrenal (HPA) axis activity, although results are scarce and inconsistent. No earlier studies have examined consistency of HPA axis findings across several anxiety subtypes and whether associations are state or trait dependent. METHODS: Data are derived from 1427 participants of the Netherlands Study of Depression and Anxiety. Three groups were compared: 342 control participants without psychiatric disorders; 311 persons with a remitted (no current) anxiety disorder (social phobia, generalized anxiety disorder, panic disorder); and 774 persons with a current anxiety disorder, as diagnosed using the Composite International Diagnostic Interview psychiatric interview. Cortisol levels were measured in seven saliva samples, determining the 1-hour cortisol awakening response, evening cortisol, and cortisol response after 0.5 mg of dexamethasone ingestion. RESULTS: Current anxiety disorder was associated with higher awakening cortisol levels (p = .002). These findings were mainly present for patients with panic disorder with agoraphobia and anxious patients with comorbid depressive disorder. Remitted anxiety only showed a trend toward higher morning cortisol (p = .08). No associations were observed for anxiety status and evening cortisol level or cortisol suppression after dexamethasone. CONCLUSIONS: This study showed a modest but significantly higher 1-hour cortisol awakening response among anxiety patients, which was driven by those with panic disorder with agoraphobia and those with comorbid depression. SN - 1534-7796 UR - https://www.unboundmedicine.com/medline/citation/20190128/Salivary_cortisol_levels_in_persons_with_and_without_different_anxiety_disorders_ L2 - https://doi.org/10.1097/PSY.0b013e3181d2f0c8 DB - PRIME DP - Unbound Medicine ER -