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Childhood traumata, Dexamethasone Suppression Test and psychiatric symptoms: a trans-diagnostic approach

Published online by Cambridge University Press:  05 February 2010

C. Faravelli ,
S. Gorini Amedei ,
F. Rotella ,
L. Faravelli ,
A. Palla ,
G. Consoli ,
V. Ricca ,
S. Batini ,
C. Lo Sauro  and
A. Spiti
...Show all authors
C. Faravelli*
Affiliation:
Department of Neurology and Psychiatry, Florence University, Viale Morgagni 85, 50134 Firenze, Italy
S. Gorini Amedei
Affiliation:
Department of Neurology and Psychiatry, Florence University, Viale Morgagni 85, 50134 Firenze, Italy
F. Rotella
Affiliation:
Department of Neurology and Psychiatry, Florence University, Viale Morgagni 85, 50134 Firenze, Italy
L. Faravelli
Affiliation:
Department of Neurology and Psychiatry, Florence University, Viale Morgagni 85, 50134 Firenze, Italy
A. Palla
Affiliation:
Department of Neurology and Psychiatry, Florence University, Viale Morgagni 85, 50134 Firenze, Italy
G. Consoli
Affiliation:
Department of Neurology and Psychiatry, Florence University, Viale Morgagni 85, 50134 Firenze, Italy
V. Ricca
Affiliation:
Department of Neurology and Psychiatry, Florence University, Viale Morgagni 85, 50134 Firenze, Italy
S. Batini
Affiliation:
Department of Neurology and Psychiatry, Florence University, Viale Morgagni 85, 50134 Firenze, Italy
C. Lo Sauro
Affiliation:
Department of Neurology and Psychiatry, Florence University, Viale Morgagni 85, 50134 Firenze, Italy
A. Spiti
Affiliation:
Department of Neurology and Psychiatry, Florence University, Viale Morgagni 85, 50134 Firenze, Italy
M. Catena dell'Osso
Affiliation:
Department of Neurology and Psychiatry, Florence University, Viale Morgagni 85, 50134 Firenze, Italy
*
*Address for correspondence: Professor C. Faravelli, Studio DeA, Via P.F. Calvi 10, 50100, Florence, Italy. (Email: [email protected])
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Abstract

Background

Childhood traumatic events and functional abnormalities of the hypothalamus–pituitary–adrenal (HPA) axis have been widely reported in psychiatric patients, although neither is specific for any diagnosis. Among the limited number of studies that have evaluated these topics, none has adopted a trans-diagnostic approach. The aim of the present research is to explore the relationship between childhood stressors, HPA axis function and psychiatric symptoms, independent of the diagnosis.

Method

A total of 93 moderate to severely ill psychiatric out-patients of Florence and Pisa University Psychiatric Units and 33 healthy control subjects were recruited. The assessment consisted of salivary cortisol pre- and post-low dose (0.5 mg) Dexamethasone, early and recent life events, 121 psychiatric symptoms independent of diagnosis, SCID, BPRS.

Results

In total, 33.5% of patients were Dexamethasone Suppression Test (DST) non-suppressors, compared with 6.1% of controls (p=0.001). Among patients, non-suppression was associated with particular symptoms (i.e. depressive and psychotic), but not to any specific diagnosis. Early stressful life events were significantly associated with higher salivary cortisol levels, with DST non-suppression and with approximately the same subset of symptoms. A recent stressful event seemed to be associated to the HPA response only in those subjects who were exposed to early traumata.

Conclusions

Our report suggests a relationship between life stress, HPA axis and psychopathology. A cluster of specific psychiatric symptoms seems to be stress related. Moreover, it seems that an abnormal HPA response is possibly triggered by an excessive pressure in vulnerable individuals.

Keywords

HPA axislife eventpsychopathologytransdiagnosticvulnerability
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 12 , December 2010 , pp. 2037 - 2048
Copyright
Copyright © Cambridge University Press 2010

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