Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Psychosom Obstet Gynaecol. 2009 Dec;30(4):282-6. doi: 10.3109/01674820903254732.
Chronic pelvic pain (CPP) is a frequent gynecological complaint. The pathophysiology of CPP is not fully understood. The aim of this study was to determine whether the presence of depressive symptoms is associated with hypothalamic-pituitary-adrenal (HPA) axis dysfunction in CPP.
We measured neuroendocrine responses to a standardized social stress test and to a standard adrenocorticotropin (ACTH)(1-24) stimulation test in 18 patients with CPP, stratified based on the presence of high versus low self-reported depressive symptoms, compared with 24 controls.
Women with CPP and low depression exhibited enhanced ACTH responses to psychosocial stress compared with women with CPP and high depression, whereas there were no differences in cortisol responses. In the ACTH(1-24) stimulation test, CPP patients with high depression demonstrated enhanced cortisol responses.
These results suggest a relationship between self-reported depression and reactivity of the HPA axis in patients with CPP.
慢性盆腔疼痛（CPP）是一种常见的妇科主诉。CPP 的病理生理学尚未完全阐明。本研究旨在确定抑郁症状的存在是否与 CPP 患者的下丘脑-垂体-肾上腺（HPA）轴功能障碍有关。
我们测量了 18 例 CPP 患者（根据自我报告的抑郁症状高低分层）和 24 例对照者对标准化社会应激测试和标准促肾上腺皮质激素（ACTH）（1-24）刺激测试的神经内分泌反应。
与 CPP 伴高抑郁组相比，CPP 伴低抑郁组的女性对心理社会应激的 ACTH 反应增强，而皮质醇反应无差异。在 ACTH（1-24）刺激试验中，高抑郁组 CPP 患者的皮质醇反应增强。
这些结果表明，在 CPP 患者中，自我报告的抑郁与 HPA 轴的反应性之间存在关系。
