persistence of anxiety disorders and concomitant changes in cortisol

Abstract

In a clinical sample of 116 children and adolescents we studied the relation between the course of ananxietydisorder during treatment and theconcomitantchangesincortisollevels. Assessments at baseline, after three months, and at one-year follow-up were performed with theAnxietyDisordersInterview Schedule. When we comparedcortisollevels at baseline and one-year follow-up,persistenceof theanxietydisorder was associated with both increased daytimecortisolproduction (F=3.2, p=0.04) and a trend towards a decreasedcortisolmorning rise (F=2.4, p=0.09). At one-year follow-up daytimecortisolproduction was lowest in the early remitters (109.7±29.2 h mmol/l), higher in the late remitters (121.0±40.0 h mmol/l) and highest in the non-remitters (131.1±48.9 h mmol/l). Early remitters had the highestcortisolmorning rise (1.1±1.5 h mmol/l), followed by the late remitters (0.8±1.8 h mmol/l), the non-remitters had the lowestcortisolmorning rise (0.07±1.7 h mmol/l).Persistenceof ananxietydisorder may thus lead tochangesin HPA-axis functioning, underscoring the importance adequate treatment ofanxietydisorders.