Yehuda R, Teicher M H, Trestman R L, Levengood R A, Siever L J
Post-Traumatic Stress Disorder Program, Mount Sinai School of Medicine, New York, New York, USA.
Biol Psychiatry. 1996 Jul 15;40(2):79-88. doi: 10.1016/0006-3223(95)00451-3.
The aim of the present study was to evaluate the pattern of basal cortisol release in PTSD and major depression using a chronobiological analysis. Plasma for cortisol determination was obtained from 15 combat veterans with PTSD, 14 subjects with major depression, and 15 normal men every 30 min during a 24-hour period of bed rest. Raw cortisol data were modeled using standard and multioscillator cosinor models to determine the best fitting functions for circadian, hemicircadian, and ultradian components of cortisol release. PTSD subjects had substantially lower cortisol levels, and displayed a pattern of cortisol release that was better modeled by circadian rhythm. PTSD subjects also showed a greater circadian signal-to-noise ratio than the other groups. In contrast, depressed patients displayed a less-rhythmic, more chaotic pattern of cortisol release. The pattern of cortisol secretion and regulation observed in the PTSD group under baseline conditions may reflect an exaggerated sensitization, whereas the chronobiological alterations in depression may reflect dysregulation, of the hypothalamic-pituitary-adrenal (HPA) axis.
本研究的目的是通过时间生物学分析评估创伤后应激障碍（PTSD）和重度抑郁症患者基础皮质醇释放模式。在24小时卧床休息期间，每30分钟从15名患有PTSD的退伍军人、14名重度抑郁症患者和15名正常男性中采集用于测定皮质醇的血浆。使用标准和多振荡器余弦模型对原始皮质醇数据进行建模，以确定皮质醇释放的昼夜节律、半日节律和超日节律成分的最佳拟合函数。PTSD患者的皮质醇水平显著较低，其皮质醇释放模式用昼夜节律模型能更好地模拟。PTSD患者的昼夜信号噪声比也高于其他组。相比之下，抑郁症患者的皮质醇释放模式节律性较差，更紊乱。在基线条件下，PTSD组观察到的皮质醇分泌和调节模式可能反映了一种过度敏感，而抑郁症患者的时间生物学改变可能反映了下丘脑-垂体-肾上腺（HPA）轴的调节失调。
