Labad Javier, Melia Cristian Sebastian, Segalàs Cinto, Alonso Pino, Salvat-Pujol Neus, Real Eva, Ferrer Álex, Jiménez-Murcia Susana, Soriano-Mas Carles, Soria Virginia, Menchón José Manuel
Consorci Sanitari del Maresme, Mataró, Spain; Institut d'Investigació Sanitària Parc Taulí (I3PT), Sabadell, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group-Psychiatry and Mental Health, Barcelona, Spain; Department of Clinical Sciences, Universitat de Barcelona, Spain.
J Psychiatr Res. 2021 Jan;133:191-196. doi: 10.1016/j.jpsychires.2020.12.017. Epub 2020 Dec 14.
Previous studies in non-clinical populations suggest that obsessive-compulsive symptoms are associated with hypothalamic-pituitary-adrenal (HPA) axis measures and that there are sex differences in these associations. We aimed to replicate these findings in a sample of 57 patients with obsessive-compulsive disorder (OCD) and 98 healthy subjects. Current and lifetime OCD symptom dimensions were assessed with the Dimensional Yale-Brown Obsessive Compulsive Scale (DY-BOCS). Depressive symptoms and state and trait anxiety were also assessed. The following HPA axis measures were analysed in saliva: the diurnal cortisol slope (calculated using two formulas: [1] awakening to 11 p.m. [AWE diurnal slope] and [2] considering fixed time points [FTP diurnal slope] from 10 a.m. to 11 p.m.) and the dexamethasone suppression test ratio (DSTR) after 0.25 mg of dexamethasone. Multiple linear regression analyses were conducted to explore the contribution of OCD symptom dimensions to each HPA axis measure while adjusting for age, sex, BMI, smoking, trait anxiety and depressive symptoms. A sex-specific association between current ordering/symmetry symptoms and AWE diurnal cortisol slope (positive association [flattened slope] in men, inverse association [stepper slope] in women) was found. Two similar sex by OCD dimensions interactions were found for lifetime aggressive and ordering/symmetry symptoms and both (FTP, AWE) diurnal cortisol slopes. Current and lifetime hoarding symptoms were associated to a more flattened FTP diurnal cortisol slope in women. The DSTR was not associated with OCD symptoms. The lifetime interference in functionality was associated with a more flattened AWE diurnal cortisol slope. In conclusion, our study suggests that there are sex differences in the association between OCD subtypes and specific HPA axis measures.
先前针对非临床人群的研究表明，强迫症状与下丘脑-垂体-肾上腺（HPA）轴指标相关，且这些关联存在性别差异。我们旨在对57名强迫症（OCD）患者和98名健康受试者组成的样本进行这些研究结果的重复验证。使用维度耶鲁-布朗强迫量表（DY-BOCS）评估当前和终生的OCD症状维度。还评估了抑郁症状以及状态焦虑和特质焦虑。分析唾液中的以下HPA轴指标：昼夜皮质醇斜率（使用两个公式计算：[1]从觉醒到晚上11点[AWE昼夜斜率]，以及[2]考虑从上午10点到晚上11点的固定时间点[FTP昼夜斜率]）和0.25毫克地塞米松后的地塞米松抑制试验比率（DSTR）。进行多元线性回归分析，以探讨OCD症状维度对每个HPA轴指标的贡献，同时对年龄、性别、BMI、吸烟、特质焦虑和抑郁症状进行校正。发现当前的排序/对称症状与AWE昼夜皮质醇斜率之间存在性别特异性关联（男性为正相关[斜率变平]，女性为负相关[斜率上升]）。对于终生的攻击性和排序/对称症状以及两个（FTP、AWE）昼夜皮质醇斜率，发现了两个类似的性别与OCD维度的相互作用。当前和终生的囤积症状与女性中更平坦的FTP昼夜皮质醇斜率相关。DSTR与OCD症状无关。终生的功能干扰与更平坦的AWE昼夜皮质醇斜率相关。总之，我们的研究表明，OCD亚型与特定HPA轴指标之间的关联存在性别差异。
