PMID: identifier of
Pubmed reference: |
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 (17727959) |
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| title: |
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Abnormal reactions to environmental stress in elderly persons with anxiety disorders: Evidence from a population study of diurnal cortisol changes. |
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| author(s): |
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Isabelle Chaudieu1, Isabelle Beluche1, Joanna Norton1, Jean-Philippe Boulenger1, 2, Karen Ritchie1, Marie Laure Ancelin ( ) 1 |
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| laboratory: |
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| abstract: |
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BACKGROUND: Cortisol secretion in elderly persons with anxiety disorders exposed to common stressful situations has not been evaluated. METHODS: Salivary-free cortisol levels were evaluated at 8, 15, and 22 h, in 201 elderly subjects during stressful and non-stressful days. Psychiatric symptomatology was assessed by a standardized psychiatric examination (MINI). RESULTS: Elderly subjects without psychiatric disorder showed a sustained increase in cortisol secretion several hours after the exposure to a stressful situation. In comparison, subjects with anxiety disorders showed a greater increase in cortisol secretion in the stressful situation, with lowered recuperation capacity. This effect was dose-dependent as a function of anxiety co-morbidity. Persons reporting lifetime major trauma with intrusions exhibited lowered continuous basal cortisol associated with efficient recuperation capacity. Independently of psychopathology, women appeared more reactive to stressful environmental conditions. LIMITATIONS: Exclusion of institutionalized persons and benzodiazepine users may have led to sampling of less severe anxiety symptoms. CONCLUSIONS: Dysregulation of the hypothalamic-pituitary-adrenal axis was observed in elderly persons with anxiety disorders experiencing environmental stress. A common pattern of up-regulated diurnal cortisol secretion was observed in anxious subjects with lifetime and current anxiety disorder irrespective of sub-type (generalized anxiety, phobias) suggesting a stable trait and a common "core" across disorders. Elderly persons who had experienced trauma with subsequent intrusions showed a distinct pattern with down-regulated activity. |
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| subject: |
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| fulltext language: |
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English |
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| ISSN: |
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0165-0327 |
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| publication format: |
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Peer-reviewed article |
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| DOI: |
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10.1016/j.jad.2007.07.025 |
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| journal: |
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| Journal of Affective Disorders (J Affect Disord) |
| Publisher |
Elsevier |
| ISSN |
0165-0327 |
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| Audience: |
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international |
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| publication date: |
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2008-03 |
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| submission date: |
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2007-08-28 |
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| volume: |
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106 |
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| issue: |
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3 |
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| page, identifiant, ...: |
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307-13 |
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| keyword(s) of author: |
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HPA axis – stress – anxiety disorders – traumatism – elderly |
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