Anxiety and salivary cortisol in symptomatic and nonsymptomatic panic patients and healthy volunteers performing simulated public speaking

• Published in: Psychiatry research Vol. 133; no. 2; pp. 239 - 252
• Main Authors: Garcia-Leal, Cybele, Parente, Alexandre C.B.V., Del-Ben, Cristina M., Guimarães, Francisco S., Moreira, Ayrton Custódio, Elias, Lucila Leico Kagohara, Graeff, Frederico G.
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 28.02.2005; Elsevier
• Subjects: Adult; Adult and adolescent clinical studies; Antidepressive Agents, Tricyclic - therapeutic use; Anxiety; Anxiety - diagnosis; Anxiety - drug therapy; Anxiety - metabolism; Anxiety disorders. Neuroses; Biological and medical sciences; Circadian Rhythm; Clomipramine - therapeutic use; Daily rhythm; Female; Healthy Volunteers; Humans; Hydrocortisone - analysis; Hypothalamo-Hypophyseal System - metabolism; Male; Medical sciences; Panic disorder; Panic Disorder - diagnosis; Panic Disorder - drug therapy; Panic Disorder - metabolism; Pituitary-Adrenal System - metabolism; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Saliva - chemistry; Salivary cortisol; Severity of Illness Index; Simulated public speaking; Speech; Simulated public speaking; Anxiety; Daily rhythm; Salivary cortisol; Panic disorder; Human; Affect affectivity; Panic; Anxiety disorder; Patient; Hydrocortisone; Glucocorticoid; Verbal communication; Observer presence; Adrenal hormone
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2004.04.010

Anxiety and salivary cortisol were measured in subjects performing simulated public speaking (SPS), a procedure that has been neurobiologically related to panic disorder. The subjects were divided into three groups: 18 symptomatic panic patients, 16 nonsymptomatic, drug-treated panic patients, and 17 healthy controls. In the experimental session, subjective anxiety (Visual Analogue Mood Scale) and the total score of the Bodily Symptom Scale (BSS) were higher in symptomatic patients than in controls, with nonsymptomatic patients in between. Measures of cortisol taken at home showed that the level was higher at 9:00 h than at 23:00 h in every group, indicating a normal circadian regulation of the hypothalamic–pituitary–adrenal (HPA) axis in panic patients. Also in every group, the level of cortisol was high at the beginning of the experimental session and decreased after 70 min. This fall parallels the decrease in anxiety and BSS ratings, and appears to reflect habituation of initial, anticipatory anxiety. Preparation and performance of speech raised anxiety and BSS scores to the initial levels, but failed to increase cortisol measured over 60 min, starting at the end of the speech. Therefore, SPS does not seem to activate the HPA axis, as reported in panic attacks.