Yehuda R, Kahana B, Binder-Brynes K, Southwick S M, Mason J W, Giller E L
Department of Psychiatry, Mount Sinai School of Medicine, New York, N.Y., USA.
Am J Psychiatry. 1995 Jul;152(7):982-6. doi: 10.1176/ajp.152.7.982.
The authors' objective was to compare the urinary cortisol excretion of Holocaust survivors with posttraumatic stress disorder (PTSD) (N = 22) to that of Holocaust survivors without PTSD (N = 25) and comparison subjects not exposed to the Holocaust (N = 15).
Twenty-four-hour urine samples were collected, and the following day, subjects were evaluated for the presence and severity of past and current PTSD and other psychiatric conditions.
Holocaust survivors with PTSD showed significantly lower mean 24-hour urinary cortisol excretion than the two groups of subjects without PTSD. Multiple correlation analysis revealed a significant relationship between cortisol levels and severity of PTSD that was due to a substantial association with scores on the avoidance subscale.
The present findings replicate the authors' previous observation of low urinary cortisol excretion in combat veterans with PTSD and extend these findings to a non-treatment-seeking civilian group. The results also demonstrate that low cortisol levels are associated with PTSD symptoms of a clinically significant nature, rather than occurring as a result of exposure to trauma per se, and that low cortisol levels may persist for decades following exposure to trauma among individuals with chronic PTSD.
作者的目的是比较患有创伤后应激障碍（PTSD）的大屠杀幸存者（N = 22）、未患PTSD的大屠杀幸存者（N = 25）以及未经历过大屠杀的对照对象（N = 15）的尿皮质醇排泄情况。
收集24小时尿液样本，次日评估受试者过去和当前PTSD及其他精神疾病的存在情况和严重程度。
患有PTSD的大屠杀幸存者24小时尿皮质醇平均排泄量显著低于两组未患PTSD的受试者。多元相关分析显示皮质醇水平与PTSD严重程度之间存在显著关系，这是由于与回避分量表得分有实质性关联。
本研究结果重复了作者之前在患有PTSD的退伍军人中观察到的低尿皮质醇排泄现象，并将这些结果扩展到一个未寻求治疗的平民群体。结果还表明，低皮质醇水平与具有临床显著性质的PTSD症状相关，而非因暴露于创伤本身所致，并且在患有慢性PTSD的个体中，低皮质醇水平可能在暴露于创伤后持续数十年。
