Neuroendocrine Response to Traumatic Dissociation in Patients with Unipolar Depression

Abstract

Background:

Dissociation is traditionally attributed to trauma and other psychological stress that are linked to dissociated traumatic memories. Although recent studies regarding neuroendocrinology of traumatic dissociation are rare, they suggest possible dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis. The aim of the present study is to perform examination of HPA axis functioning indexed by basal prolactin and cortisol and test their relationship to psychic and somatoform dissociative symptoms.

Design:

Clinical and laboratory study of consecutive inpatients.

Setting:

Patients treated at the university hospital, Psychiatry department of Charles University in Prague.

Participants:

40 consecutive inpatients with diagnosis of unipolar depression mean age 43.37 (SD=12.21).

Main outcome measures:

Assessment of psychic and somatoform dissociation (DES, SDQ-20), depressive symptoms (BDI-II) and basal serum prolactin and cortisol.

Results:

Data show that prolactin and cortisol as indices of HPA axis functioning manifest significant relationship to dissociative symptoms. Main results represent highly significant correlations between psychic dissociative symptoms (DES) and serum prolactin (r=0.55, p=0.0001), and relationship between somatoform dissociation (SDQ-20) and serum cortisol (r=-0.38, p=0.008).

Conclusions:

These results indicate relationship between HPA-axis reactivity and psychosocial stress as a function of dissociative symptoms in unipolar depressive patients that could reflect passive coping behavior and disengagement.