Erbay Lale Gonenir, Kartalci Sukru
Department of Psychiatry, State Hospital of Malatya, Malatya, Turkey.
Department of Psychiatry, Faculty of Medicine, Inonu University, Malatya, Turkey.
Psychiatry Investig. 2015 Oct;12(4):538-44. doi: 10.4306/pi.2015.12.4.538. Epub 2015 Sep 30.
Changes in serum neurosteroid levels have been reported in stress-related disorders such as anxiety and depression, but not in patients with obsessive-compulsive disorder (OCD). We thus investigated such changes in patients with OCD.
We compared the serum levels of progesterone, pregnanolone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEA-S), cortisol and testosterone in 30 patients with OCD and 30 healthy controls.
When male and female patients were evaluated together, DHEA and cortisol levels were significantly higher in patients with OCD than the control group. When the genders were evaluated separately, DHEA and cortisol levels were higher in female patients than the female controls. The increase in DHEA levels in female patients is likely an effect of the hypothalamic-pituitary-adrenal (HPA) axis. In contrast, cortisol levels in male patients were higher than the control group, while testosterone levels were lower. The increased cortisol and decreased testosterone levels in male patients likely involves the hypothalamic-pituitary-gonadal (HPG) axis.
These findings suggest that neurosteroid levels in patients with OCD should be investigated together with the HPA and HPG axes in future studies.
已有报道称,在焦虑和抑郁等应激相关障碍患者中血清神经甾体水平会发生变化,但在强迫症(OCD)患者中未见此类变化。因此,我们对OCD患者的此类变化进行了研究。
我们比较了30例OCD患者和30名健康对照者的血清孕酮、孕烷醇酮、脱氢表雄酮(DHEA)、硫酸脱氢表雄酮(DHEA-S)、皮质醇和睾酮水平。
当对男性和女性患者进行综合评估时,OCD患者的DHEA和皮质醇水平显著高于对照组。当分别对性别进行评估时,女性患者的DHEA和皮质醇水平高于女性对照组。女性患者DHEA水平的升高可能是下丘脑-垂体-肾上腺(HPA)轴作用的结果。相比之下,男性患者的皮质醇水平高于对照组,而睾酮水平较低。男性患者皮质醇水平升高和睾酮水平降低可能涉及下丘脑-垂体-性腺(HPG)轴。
这些发现表明,在未来的研究中,应将OCD患者的神经甾体水平与HPA轴和HPG轴一起进行研究。