OBJECTIVE: This prospective study aimed to describe the nature and time course of HPA axis dysregulation and psychopathology among terror-bereaved spouses. METHOD: Twenty-three spouses bereaved from September 11, 2001 terror attacks and 22 nonbereaved spouses were compared using a psychiatric diagnostic interview (SCID), 3 days of salivary cortisol collection, and a dexamethasone suppression test. Most subjects had repeated assessments at 6 month intervals during the 2 year study. RESULTS: After September 11, 2001, bereaved compared to nonbereaved had significantly higher rates ofposttraumatic stress disorder (PTSD; 68.1% versus 0%) and major depressive disorder (MDD; 45.5% versus 9.5%). Bereaved had significantly higher morning basal cortisol and less afternoon postdexamethasone cortisol suppression than nonbereaved. Among bereaved, those with PTSD without comorbid MDD had significantly greater afternoon postdexamethasone cortisol suppression than those without psychiatric disorders. CONCLUSIONS: Terror-related spouse death is a severe stressor associated with persistent HPA axis activation, PTSD, and MDD. However, bereaved spouses who developed PTSD and were not depressed had enhanced postdexamethasone cortisol suppression, evidence of heightened glucocorticoid receptor sensitivity.
OBJECTIVE: This prospective study aimed to describe the nature and time course of HPA axis dysregulation and psychopathology among terror-bereaved spouses. METHOD: Twenty-three spouses bereaved from September 11, 2001 terror attacks and 22 nonbereaved spouses were compared using a psychiatric diagnostic interview (SCID), 3 days of salivary cortisol collection, and a dexamethasone suppression test. Most subjects had repeated assessments at 6 month intervals during the 2 year study. RESULTS: After September 11, 2001, bereaved compared to nonbereaved had significantly higher rates ofposttraumatic stress disorder (PTSD; 68.1% versus 0%) and major depressive disorder (MDD; 45.5% versus 9.5%). Bereaved had significantly higher morning basal cortisol and less afternoon postdexamethasonecortisol suppression than nonbereaved. Among bereaved, those with PTSD without comorbid MDD had significantly greater afternoon postdexamethasonecortisol suppression than those without psychiatric disorders. CONCLUSIONS: Terror-related spouse death is a severe stressor associated with persistent HPA axis activation, PTSD, and MDD. However, bereaved spouses who developed PTSD and were not depressed had enhanced postdexamethasonecortisol suppression, evidence of heightened glucocorticoid receptor sensitivity.
Authors: Roger K Pitman; Mark W Gilbertson; Tamara V Gurvits; Flavia S May; Natasha B Lasko; Linda J Metzger; Martha E Shenton; Rachel Yehuda; Scott P Orr Journal: Ann N Y Acad Sci Date: 2006-07 Impact factor: 5.691
Authors: M C Zanarini; A E Skodol; D Bender; R Dolan; C Sanislow; E Schaefer; L C Morey; C M Grilo; M T Shea; T H McGlashan; J G Gunderson Journal: J Pers Disord Date: 2000
Authors: Greg L West; Vanessa Kurdi; Celine Fouquet; Russell Schachar; Michel Boivin; Paul Hastings; Philippe Robaey; Veronique D Bohbot Journal: Compr Psychoneuroendocrinol Date: 2021-03-03
Authors: Pramod N Nehete; Bharti P Nehete; Akash G Patel; Sriram Chitta; Henrieta Scholtzova; Lawrence E Williams Journal: J Immunol Res Date: 2021-11-08 Impact factor: 4.493