Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, University of Pisa, Pisa, Italy.
CNS Spectr. 2012 Dec;17(4):214-20. doi: 10.1017/S1092852912000685.
Alterations of the hypothalamic-pituitary-adrenal (HPA) axis and of its peripheral indices have been reported in both normal and pathological anxiety with controversial findings. The aim of the present study was to investigate the possible correlations between serum cortisol and dehydroepiandrosterone-sulfate (DHEA-S) levels and DHEA-S/cortisol ratio, and panic-agoraphobic spectrum dimensions in a sample of healthy subjects.
Forty-two healthy subjects of both sexes, with no current or lifetime psychiatric disorders, were assessed by means of the Structured Clinical Interview for DSM-IV (SCID-I/P) and the so-called Panic Agoraphobic Spectrum-Self Report lifetime version (PAS-SR).
Significant, negative correlations were found between cortisol levels and the total score of the separation sensitivity, panic-like symptoms, and medication/substance sensitivity PAS-SR domains. The PAS-SR total and the panic-like symptoms domain scores were positively related to the DHEAS/cortisol ratio. When the sample was divided in women and men, these correlations were present in women only.
These findings, while indicating the presence of significant relationships between panic-agoraphobic traits and some indices of HPA axis functioning in healthy women, would suggest this as one of the factors explaining the greater vulnerability of women to cross the line between normal and pathological anxiety.
Further studies are needed to explore gender differences in the relationships between HPA axis alterations and the panic-agoraphobic spectrum dimensions.
下丘脑-垂体-肾上腺（HPA）轴及其外周指标的改变在正常和病理性焦虑中均有报道，但结果存在争议。本研究旨在探讨健康受试者血清皮质醇和硫酸脱氢表雄酮（DHEA-S）水平及其比值与惊恐-广场恐怖症谱维度之间的可能相关性。
本研究纳入了 42 名无当前或终生精神障碍的健康受试者，通过DSM-IV 结构临床访谈（SCID-I/P）和所谓的惊恐-广场恐怖症谱-自我报告终生版本（PAS-SR）进行评估。
研究发现，皮质醇水平与分离敏感、类似惊恐症状和药物/物质敏感 PAS-SR 域的总分呈显著负相关。PAS-SR 总分和类似惊恐症状域评分与 DHEAS/皮质醇比值呈正相关。当样本分为女性和男性时，这些相关性仅存在于女性中。
这些发现表明，在健康女性中，惊恐-广场恐怖症特征与 HPA 轴功能的某些指标之间存在显著关系，这可能是女性更容易跨越正常和病理性焦虑之间界限的因素之一。
需要进一步研究以探讨 HPA 轴改变与惊恐-广场恐怖症谱维度之间的性别差异。
