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Cited by 80Stress Responses and CortisolEating Disorders and BehaviorsRegulation of Appetite and Obesity

An investigation of hypothalamic-pituitary-adrenal axis hyperactivity in anorexia nervosa: the role of CRH and AVP

CONNAN, F, LIGHTMAN, S, LANDAU, S, WHEELER, M, TREASURE, J, CAMPBELL, I·2007·Journal of Psychiatric Research
DOI 10.1016/j.jpsychires.2005.12.005
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Abstract

We hypothesised that hypothalamic-pituitary-adrenal (HPA) axis hyperactivity in anorexia nervosa (AN) is associated with (a) elevated arginine vasopressin (AVP) activity and (b) enhanced pituitary sensitivity to AVP, as it is in depressive illness. 16 Healthy women and 18 women with active AN participated in a combined dexamethasone (DXM)/corticotrophin releasing hormone (CRH) challenge test and an AVP challenge test. This combination of tests is designed to assess the functional contribution of AVP to HPA axis activity. 10 of the active AN group repeated participation after weight gain. The cortisol response to AVP was reduced by 138% in the active AN group, suggesting an impairment of pituitary sensitivity to AVP, which began to normalise with weight gain. The cortisol and adreno-corticotrophin (ACTH) responses to the DXM/CRH test were not significantly enhanced in the active AN group, suggesting that there was no elevated endogenous AVP activity augmenting the response to CRH in AN. Weight gain was associated with blunting of the endocrine response to the DXM/CRH test, which may have been related to rising oestrogen levels. Thus, contrary to the hypotheses, we did not find (a) evidence of upregulated AVP activity or (b) enhanced pituitary sensitivity to AVP in AN. These findings suggest that the mechanism of HPA axis hyperactivity differs in depression and AN, with greater involvement of AVP in depressive disorder and perhaps more reliance on CRH to drive the axis in AN. The powerful anorexigenic effect of CRH could contribute to the severity of weight loss associated with AN.

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  • Many psychiatric disorders, including ED, PTSD, and anxiety disorders, are characterised by dysregulation of the HPA axis.

    “Since many psychiatric disorders, including ED, PTSD, and anxiety disorders, are characterised by dysregulation of the HPA axis (Connan et al., 2007;Ehlert et al., 2001;Lo Sauro et al., 2008), there has been increasing interest in further exploration of the potential anti-stress and anxiolytic effects of intranasal oxytocin in psychiatric disorders characterised by elevated threat sensitivity.”

    From Meta-analytic review of the effects of a single dose of intranasal oxytocin on threat processing in humans (2018) · cites this paper as Connan et al., 2007

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Authors
CONNAN, F., LIGHTMAN, S., LANDAU, S., WHEELER, M., TREASURE, J., & CAMPBELL, I.
Affiliations
  • King's College London (GB)
  • Bristol Royal Infirmary (GB)
  • St Thomas' Hospital (GB)
Corresponding author
CONNAN, F
ORCID
Venue
Journal of Psychiatric Research
Publisher
Elsevier BV
Published
2007-01
Volume
41
Issue
1-2
Pages
131-143
ISSN
0022-3956 (ISSN-L)
DOI
10.1016/j.jpsychires.2005.12.005
OpenAlex
W2026003300
Semantic Scholar
8c3761abe015455f20da8c380e71f52be3f99c79
Cited by
80
References
66
Citations by year
2026: 2 · 2025: 7 · 2024: 4 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 4 · 2019: 2 · 2018: 3 · 2017: 4 · 2016: 3 · 2015: 1 · 2014: 3 · 2013: 4 · 2012: 8
FWCI
2.33
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Psychiatric Research (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion)
  • Explore Bristol Research (submittedVersion)
Funders
  • European Commission
  • Medical Research Council
Topics
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
Keywords
anorexia nervosa, vasopressin, corticotropin-releasing factor, cortisol response, ACTH response, weight gain, estrogen, depression
MeSH terms
Adolescent, Adrenocorticotropic Hormone, Adult, Anorexia Nervosa, Anxiety, Arginine Vasopressin, Corticotropin-Releasing Hormone, Demography, Depressive Disorder, Dexamethasone, Drug Combinations, Drug Hypersensitivity, Female, Glucocorticoids, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Middle Aged, Pituitary-Adrenal System, Surveys and Questionnaires, Severity of Illness Index, Weight Loss

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