Childhood stressful events, HPA axis and anxiety disorders

Table 1 Hypothalamic pituitary adrenal axis functioning and its relationship with childhood traumata and psychopathology in post-traumatic stress disordered patients

Author	Control group	Sample	Cortisol levels	ACTH levels	Suppression (DST)	Stress test	Correlations with childhood traumata and psychopathology
Lemieux et al[46], 1995	9 non abused women; 8 abused women w/o PTSD	11 abused women with PTSD	↑ Basal urinary levels	-	-	-	↑ Scores on Impact Event Scale related to cortisol levels in PTSD sample
De Bellis et al[48], 1999	10 non-traumatized children; 24 healthy controls	18 children with PTSD due to childhood maltreatment	↑ Basal urinary levels	-	-	-	↑ Psychopathology
Bremner et al[66], 2003	18 HC	23 patients with abuse-related PTSD	Salivary cortisol: 61% higher	-	-	Cognitive challenge	Neurohormonal response to stress in PTSD subjects is not impaired
			Waiting for test; 46% higher during test
Luecken[52], 1998	31 HC	30 students who lost one parent before age 16	↑ Salivary levels post task	-	-	Video clip depicting the death of a parent + speech task	Altered neurohormonal responses to stress in those who lost one parent
Elzinga et al[53], 2003	12 abused women without PTSD	12 abused women with PTSD	Salivary cortisol: 60% higher waiting for test; 122% higher during test; 69% higher during recovery	-	-	Personalized trauma scripts	Altered neurohormonal responses to stress in PTSD abused women
Rasmusson et al[56], 2001	11 HC	12 outpatients with PTSD	= Plasma basal levels; ↑ plasma and urinary post tests levels	= Basal levels; ↑ post CRF levels	-	CRF and ACTH stimulation tests	Altered neurohormonal responses to stress in PTSD subjects
Santa Ana et al[57], 2006	31 HC	58 subjects with PTSD (25 with childhood trauma)	↓ Plasma basal and post	↓ Post task	-	Cold Pressor Task	-
			Task, if childhood trauma
De Bellis et al[58], 1994	13 HC girls	13 sexually abused girls	= Plasma and salivary basal and post CRH	↓ Basal and post CRH	-	CRH stimulation test	↑ Adult psychopathology and altered hormonal responses to stress
Stein et al[61], 1997	21 non abused women	19 children and/or adolescent with sexual abuse	-	-	↑	Low dose DST (0.5 mg)	↑ Adult psychopathology
Yehuda et al[31], 2004	10 non traumatized subjects	52 traumatized subjects	-	-	↑	Low dose DST (0.5 mg)	-
Jovanovic et al[59], 2010	61 traumatized non PTSD subjects	29 traumatized PTSD subjects	= Basal plasma levels; ↓ post Dex plasma levels	↓ Post Dex	↑	Low dose DST (0.5 mg)	Abnormalities of HPA feedback and ↑ psychopathology
Altemus et al[62], 2003	15 HC	16 women with PTSD due to childhood abuse	= Basal plasma and salivary levels	-	-	-	-
Lindley et al[47], 2004	17 HC	17 subjects with PTSD (88% due to childhood trauma)	↑ Basal salivary levels	-	=	Low dose DST (0.5 mg)	No correlations between cortisol, childhood abuse and psychopathology

HC: Healthy controls; DST: Dexamethasone suppression test; PTSD: Posttraumatic stress disorder; ACTH: Adrenocorticotropin hormone; CRH: Corticotropin releasing hormone; CRF: Corticotropin releasing factor.