Increased nocturnal secretion of ACTH and cortisol in obsessive compulsive disorder

• Published in: Journal of psychiatric research Vol. 41; no. 11; pp. 928 - 933
• Main Authors: Kluge, Michael, Schüssler, Petra, Künzel, Heike E, Dresler, Martin, Yassouridis, Alexander, Steiger, Axel
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.12.2007; Elsevier
• Subjects: ACTH; Adrenocorticotropic Hormone - blood; Adult; Adult and adolescent clinical studies; Anxiety disorders. Neuroses; Arousal - physiology; Biological and medical sciences; Circadian Rhythm - physiology; Cortisol; Female; HPA axis; Humans; Hydrocortisone - blood; Hypothalamo-Hypophyseal System - physiopathology; Male; Medical sciences; Middle Aged; Obsessive compulsive disorder; Obsessive-Compulsive Disorder - blood; Obsessive-compulsive disorders; Pituitary-Adrenal System - physiopathology; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Reference Values; Secretory Rate - physiology; ACTH; Obsessive compulsive disorder; Cortisol; HPA axis; Corticosteroid; Hypothalamohypophysoadrenal axis; Steroid hormone; Secretion; Anxiety disorder; Antiinflammatory agent; Hydrocortisone; Glucocorticoid; Adrenocorticotropic hormone; Adenohypophyseal hormone; Adrenal hormone
• ISSN: 0022-3956; 1879-1379
• DOI: 10.1016/j.jpsychires.2006.08.005

Abstract Information on the function of the hypothalamic-pituitary-adrenal (HPA) axis, the main mammalian system of stress response, in obsessive compulsive disorder (OCD) is inconsistent. In this study, nine inpatients with a DSM-IV diagnosis of OCD without comorbid major depression (Yale-Brown Obsessive Compulsive Scale [Y-BOCS] score >15; HAMD-21 total score ⩽16) and nine healthy matched controls were included. Blood of patients (seven males; 31.8 ± 9.3 years, Y-BOCS: 27.3 ± 4.3, HAMD-21: 13.3 ± 1.9) and controls (seven males, 31.6 ± 9.1 years) was drawn every 20 min between 23:00 and 7:00 h during sleep using a long catheter for later ACTH and cortisol analysis. Secretion patterns of cortisol and ACTH were similar in both groups, in OCD, however, at a higher level. Area under the curve plasma concentrations of both ACTH ( p < 0.05) and cortisol ( p < 0.005) were significantly greater in patients with OCD (ACTH: 674.3 ± 57.4; cortisol: 2148.4 ± 271.7) than in controls (ACTH: 460.2 ± 61.0; cortisol: 1191.2 ± 124.1). In conclusion, our findings suggest that the activity of the HPA axis in patients with OCD is increased compared to healthy controls.