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Research on Fibromyalgia
Increased 24-hour urinary cortisol excretion in patients
with post- traumatic stress disorder and patients with major depression, but not
in patients with fibromyalgia.
| AUTHORS:
| Maes M; Lin A; Bonaccorso S; van
Hunsel F; Van Gastel A; Delmeire L; Biondi M; Bosmans E; Kenis G; Scharpe
S
| AUTHOR AFFILIATION:
| Clinical Research Center for Mental
Health, Antwerp, Belgium.
| SOURCE:
| Acta Psychiatr Scand 1998
Oct;98(4):328-35
| CITATION IDS:
| PMID: 9821456 UI: 99038897
| ABSTRACT:
| There is now firm evidence that
major depression is accompanied by increased baseline activity of the
hypothalamic-pituitary-adrenal (HPA) axis, as assessed by means of 24-h
urinary cortisol (UC) excretion. Recently, there were some reports that
fibromyalgia and post-traumatic stress disorder (PTSD), two disorders
which show a significant amplitude of depressive symptoms, are associated
with changes in the baseline activity of the HPA axis, such as low 24-h UC
excretion. The aim of the present study was to examine 24-h UC excretion
in fibromyalgia and PTSD patients compared to normal controls and patients
with major depression. In the three patient groups, severity of depressive
symptoms was measured by means of the Hamilton Depression Rating Scale (HDRS)
score. Severity of fibromyalgia was measured using a dolorimetrically
obtained myalgic score, and severity of PTSD was assessed by means of
factor analytical scores computed on the items of the Composite
International Diagnostic Interview (CIDI), PTSD Module. Patients with PTSD
and major depression had significantly higher 24-h UC excretion than
normal controls and fibromyalgia patients. At a threshold value of > or
= 240 micrograms/24 h, 80% of PTSD patients and 80% of depressed patients
had increased 24 h UC excretion with a specificity of 100%. There were no
significant differences in 24-h UC excretion either between fibromyalgia
patients and normal controls, or between patients with major depression
and PTSD patients. In the three patient groups, no significant
correlations were found between 24-h UC excretion and the HDRS score. In
fibromyalgia, no significant correlations were found between 24-h UC
excretion and the myalgic score. In PTSD, no significant correlations were
found between 24-h UC excretion and severity of either
depression-avoidance or anxiety- arousal symptoms. In conclusion, this
study found increased 24-h UC excretion in patients with PTSD comparable
to that in patients with major depression, whereas in fibromyalgia no
significant changes in 24- h UC were found.
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