Munro Cynthia A, Oswald Lynn M, Weerts Elise M, McCaul Mary E, Wand Gary S
Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
Alcohol Clin Exp Res. 2005 Jul;29(7):1133-8. doi: 10.1097/01.alc.0000172459.71517.05.
Previous studies have described blunted stress hormone responses after pharmacological activation of the hypothalamic-pituitary-adrenal (HPA) axis in sober alcoholics. The aim of the present study was to compare ACTH, cortisol, and prolactin responses to a psychological stressor in abstinent alcohol-dependent subjects matched to healthy control subjects.
Individuals who met DSM-IV diagnostic criteria for a history of alcohol dependence but not for other axis I disorders were included in the study (n = 18; mean duration of abstinence +/- SEM, 3.5 +/- 5.7 years). Social drinkers (n = 23) served as control subjects. The sober alcohol-dependent and control subjects were matched for demographic measures including levels of stress symptoms. All subjects underwent the Trier Social Stress Test (TSST), a laboratory-based psychological stressor. Prestress and poststress plasma ACTH, cortisol, and prolactin levels, as well as a self-report measure of anxiety (State-Trait Anxiety Inventory), were obtained.
Nondepressed, abstinent alcoholics and control subjects did not differ with regard to age, racial composition, or baseline or poststress ratings of anxiety. Whereas ACTH and cortisol levels increased in response to the TSST, prolactin levels did not. Stress hormone response curves for the three hormones did not differ between the alcoholics and control subjects.
When matched for levels of stress, a laboratory-based psychological stress test did not induce differential hormone response curves for abstinent alcoholics and control subjects.
先前的研究描述了清醒的酗酒者下丘脑 - 垂体 - 肾上腺(HPA)轴经药物激活后应激激素反应减弱的情况。本研究的目的是比较戒酒的酒精依赖者与健康对照者对心理应激源的促肾上腺皮质激素(ACTH)、皮质醇和催乳素反应。
符合DSM - IV酒精依赖史诊断标准但不符合其他轴I障碍诊断标准的个体纳入研究(n = 18;平均戒酒时长±标准误,3.5±5.7年)。社交饮酒者(n = 23)作为对照。戒酒的酒精依赖者和对照者在包括应激症状水平等人口统计学指标上进行匹配。所有受试者均接受基于实验室的心理应激源——特里尔社会应激测试(TSST)。获取应激前和应激后血浆ACTH、皮质醇和催乳素水平,以及焦虑的自我报告测量值(状态 - 特质焦虑量表)。
未患抑郁症的戒酒酗酒者和对照者在年龄、种族构成或焦虑的基线或应激后评分方面没有差异。虽然ACTH和皮质醇水平在TSST刺激下升高,但催乳素水平未升高。酗酒者和对照者三种激素的应激激素反应曲线没有差异。
当在应激水平上进行匹配时,基于实验室的心理应激测试并未在戒酒酗酒者和对照者中诱导出不同的激素反应曲线。