Cortisol, DHEA and DHEA-S during exposure therapy in patients with obsessive-compulsive disorder – secretion patterns and prediction of treatment response
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Cortisol, DHEA and DHEA-S during exposure therapy in patients with obsessive-compulsive disorder – secretion patterns and prediction of treatment response. / Kellner, Michael; Yassouridis, Alexander; Adel, Fred; Muhtz, Christoph; Jelinek, Lena; Wiedemann, Klaus.
In: PSYCHIAT RES, Vol. 291, 2020, p. 113288.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Cortisol, DHEA and DHEA-S during exposure therapy in patients with obsessive-compulsive disorder – secretion patterns and prediction of treatment response
AU - Kellner, Michael
AU - Yassouridis, Alexander
AU - Adel, Fred
AU - Muhtz, Christoph
AU - Jelinek, Lena
AU - Wiedemann, Klaus
PY - 2020
Y1 - 2020
N2 - The cortisol response in patients with obsessive-compulsive disorder (OCD) during exposure with response prevention (ERP), a stressful but very effective psychotherapeutic treatment, has shown contradictory findings in three prior studies with low sample sizes. In a larger cohort of 51 patients with OCD we repeatedly measured subjective units of distress (SUD) and the adrenocortical stress hormones cortisol, dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S) in saliva during the very first session of ERP and on the day before. Expectedly, SUD were increased on the ERP day before the session and further rose during ERP, but salivary cortisol and DHEA were statistically indistinguishable from the comparison condition. Interestingly, DHEA-S was significantly elevated throughout the ERP versus the comparison day, but did not further increase in acute response to ERP. According to an explorative analysis in a subsample, hormone levels on the comparison or the ERP day did not predict anti-OCD treatment response one month later. These results corroborate our prior findings of cortisol non-response despite considerable subjective stress in ERP. The role of DHEA-S in anticipatory anxiety and the effects of augmentative cortisol therapy in ERP need further study.
AB - The cortisol response in patients with obsessive-compulsive disorder (OCD) during exposure with response prevention (ERP), a stressful but very effective psychotherapeutic treatment, has shown contradictory findings in three prior studies with low sample sizes. In a larger cohort of 51 patients with OCD we repeatedly measured subjective units of distress (SUD) and the adrenocortical stress hormones cortisol, dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S) in saliva during the very first session of ERP and on the day before. Expectedly, SUD were increased on the ERP day before the session and further rose during ERP, but salivary cortisol and DHEA were statistically indistinguishable from the comparison condition. Interestingly, DHEA-S was significantly elevated throughout the ERP versus the comparison day, but did not further increase in acute response to ERP. According to an explorative analysis in a subsample, hormone levels on the comparison or the ERP day did not predict anti-OCD treatment response one month later. These results corroborate our prior findings of cortisol non-response despite considerable subjective stress in ERP. The role of DHEA-S in anticipatory anxiety and the effects of augmentative cortisol therapy in ERP need further study.
U2 - 10.1016/j.psychres.2020.113288
DO - 10.1016/j.psychres.2020.113288
M3 - SCORING: Zeitschriftenaufsatz
VL - 291
SP - 113288
JO - PSYCHIAT RES
JF - PSYCHIAT RES
SN - 0165-1781
ER -