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Cortisol awakening response in drug-naïve panic disorder

Authors Katarzyna Jakuszkowiak-Wojten, Landowski J, Wiglusz M, Cubala W

Received 1 March 2016

Accepted for publication 19 April 2016

Published 27 June 2016 Volume 2016:12 Pages 1581—1585

DOI https://doi.org/10.2147/NDT.S107547

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Chin-Pang Lee

Peer reviewer comments 3

Editor who approved publication: Dr Roger Pinder


Katarzyna Jakuszkowiak-Wojten, Jerzy Landowski, Mariusz S Wiglusz, Wiesław Jerzy Cubała

Department of Psychiatry, Medical University of Gdansk, Gdansk, Poland

Background: It is unclear whether hypothalamic–pituitary–adrenal axis is involved in the pathophysiology of panic disorder (PD). The findings remain inconsistent. Cortisol awakening response (CAR) is a noninvasive biomarker of stress system activity. We designed the study to assess CAR in drug-naïve PD patients.  
Materials and methods: We assessed CAR in 14 psychotropic drug-naïve outpatients with PD and 14 healthy controls. The severity of PD was assessed with Panic and Agoraphobia Scale. The severity of anxiety and depression was screened with Hospital Anxiety and Depression Scale.  
Results: No significant difference in CAR between PD patients and control group was found. No correlations were observed between CAR and anxiety severity measures in PD patients and controls.  
Limitations: The number of participating subjects was relatively small, and the study results apply to nonsuicidal drug-naïve PD patients without agoraphobia and with short-illness duration. There was a lack of control on subjects’ compliance with the sampling instructions. 
Conclusion: The study provides no support for elevated CAR levels in drug-naïve PD patients without agoraphobia.

Keywords: panic disorder, PD, CAR, cortisol awakening response, HPA axis, hypothalamic–pituitary–adrenal axis

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