Kathol R G, Noyes R, Lopez A L, Reich J H
Dept. of Psychiatry, University of Iowa, Iowa City 52242.
Psychiatry Res. 1988 May;24(2):211-21. doi: 10.1016/0165-1781(88)90064-9.
Sixty-five patients with panic disorder and 37 matched controls collected 24-hour urine specimens for measurement of urinary free cortisol. Although patients with panic disorder had significantly higher urinary free cortisol levels than control subjects, this difference was accounted for by panic disorder patients with concomitant depression, agoraphobia, or both. Urinary free cortisol excretion was not related to the age of onset of panic disorder, the number of spontaneous panic attacks, or the degree of impairment associated with the disorder. They were related, however, to the level of symptoms on both the Hamilton Rating Scale for Depression and the Hamilton Rating Scale for Anxiety in the entire group of panic patients, but this relationship disappeared when those patients with the complications of agoraphobia and depression were excluded. These data suggest that, as with primary depression, depression secondary to panic disorder, as well as to agoraphobia in panic disorder patients, is associated with hyperactivity of the hypothalamic-pituitary-adrenal axis.
65名惊恐障碍患者和37名匹配的对照者收集了24小时尿液样本以测量尿游离皮质醇。尽管惊恐障碍患者的尿游离皮质醇水平显著高于对照者，但这种差异是由伴有抑郁、广场恐惧症或两者皆有的惊恐障碍患者导致的。尿游离皮质醇排泄与惊恐障碍的起病年龄、自发性惊恐发作次数或与该障碍相关的损害程度无关。然而，它们与整个惊恐障碍患者组中汉密尔顿抑郁评定量表和汉密尔顿焦虑评定量表上的症状水平相关，但当排除那些伴有广场恐惧症和抑郁并发症的患者时，这种关系就消失了。这些数据表明，与原发性抑郁一样，惊恐障碍继发的抑郁以及惊恐障碍患者中的广场恐惧症与下丘脑-垂体-肾上腺轴的功能亢进有关。
