期刊
INTERNATIONAL JOURNAL OF PSYCHIATRY IN MEDICINE
卷 39, 期 3, 页码 215-226出版社
SAGE PUBLICATIONS INC
DOI: 10.2190/PM.39.3.a
关键词
bereavement; cortisol; PTSD; MDD; September 11
类别
资金
- National Institute of Mental Health [RO1MH-066367]
- NATIONAL INSTITUTE OF MENTAL HEALTH [R01MH066367] Funding Source: NIH RePORTER
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 of posttraumatic 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. (Int'l. J. Psychiatry in Medicine 2009; 39:215-226)
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