Childhood traumata, Dexamethasone Suppression Test and psychiatric symptoms: a trans-diagnostic approach
Abstract
BACKGROUND: Childhood traumatic events and functional abnormalities of the hypothalamus-pituitary-adrenal (HPA) axis have been widely reported in psychiatric patients, although neither is specific for any diagnosis. Among the limited number of studies that have evaluated these topics, none has adopted a trans-diagnostic approach. The aim of the present research is to explore the relationship between childhood stressors, HPA axis function and psychiatric symptoms, independent of the diagnosis. METHOD: A total of 93 moderate to severely ill psychiatric out-patients of Florence and Pisa University Psychiatric Units and 33 healthy control subjects were recruited. The assessment consisted of salivary cortisol pre- and post-low dose (0.5 mg) Dexamethasone, early and recent life events, 121 psychiatric symptoms independent of diagnosis, SCID, BPRS. RESULTS: In total, 33.5% of patients were Dexamethasone Suppression Test (DST) non-suppressors, compared with 6.1% of controls (p=0.001). Among patients, non-suppression was associated with particular symptoms (i.e. depressive and psychotic), but not to any specific diagnosis. Early stressful life events were significantly associated with higher salivary cortisol levels, with DST non-suppression and with approximately the same subset of symptoms. A recent stressful event seemed to be associated to the HPA response only in those subjects who were exposed to early traumata. CONCLUSIONS: Our report suggests a relationship between life stress, HPA axis and psychopathology. A cluster of specific psychiatric symptoms seems to be stress related. Moreover, it seems that an abnormal HPA response is possibly triggered by an excessive pressure in vulnerable individuals.
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The review's findings on children and young people align with conclusions from childhood stressful events research about the lasting impact of early stressful life events or adverse experiences.
“This aligns with conclusions drawn from childhood stressful events research, highlighting the lasting impact of early stressful life events or adverse experiences [35].”
From Understanding Eco-anxiety: A Systematic Scoping Review of Current Literature and Identified Knowledge Gaps (2021) · cites this paper as [35]
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- Authors
- Faravelli, C., Amedei, S. G., Rotella, F., Faravelli, L., Palla, A., Consoli, G., Ricca, V., Batini, S., Sauro, C. L., Spiti, A., & dell'Osso, M. C.
- Affiliations
- University of Florence (IT)
- Corresponding author
- Faravelli, C.
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2010-02-05
- Volume
- 40
- Issue
- 12
- Pages
- 2037-2048
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2330294330
- Cited by
- 43
- References
- 108
- Citations by year
- 2026: 1 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 3 · 2018: 7 · 2017: 2 · 2016: 6 · 2014: 3 · 2013: 2 · 2012: 6
- FWCI
- 1.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Florence Research (University of Florence) (submittedVersion)
- Funders
- Department of Science and Technology, Ministry of Science and Technology, India
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- childhood trauma, childhood stress, hypothalamic-pituitary-adrenal axis, dexamethasone suppression test, salivary cortisol, psychiatric symptoms, depressive symptoms, psychotic symptoms, early life events, psychopathology
- MeSH terms
- Adolescent, Adult, Aged, Mental Disorders, Child Abuse, Dexamethasone, Female, Glucocorticoids, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Male, Middle Aged, Pituitary-Adrenal System, Saliva, Stress, Psychological, Case-Control Studies, Young Adult
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