Abstract
The purpose of this study was to investigate cortisol levels as a function of the hypothalamic-pituitary-adrenal axis (HPA) in relation
to alexithymia in patients with somatoform disorders (SFD). Diurnal
salivary cortisol was sampled in 32 patients with SFD who also
underwent a psychiatric examination and filled in questionnaires
(Toronto Alexithymia Scale, TAS scale; Screening for Somatoform
Symptoms, SOMS scale; Hamilton Depression Scale, HAMD). The mean TAS
total score in the sample was 55.69.6, 32% of patients being
classified as alexithymic on the basis of their TAS scores. Depression
scores were moderate (HAMD=13.2, Beck Depression Inventory, BDI=16.5).
The patients' alexithymia scores (TAS scale Difficulty identifying
feelings) correlated significantly positively with their somatization
scale scores (Symptom Checklist-90 Revised, SCL-90-R); r=0.3438 (P0.05)
and their scores on the Global Severity Index (GSI) on the SCL-90-R;
r=0.781 (P0.01). Regression analysis was performed with cortisol
variables as the dependent variables. Cortisol levels [measured by
the area under the curve-ground (AUC-G), area under the curve-increase
(AUC-I) and morning cortisol (MCS)] were best predicted in a multiple
linear regression model by lower depressive scores (HAMD) and more
psychopathological symptoms (SCL-90-R). No significant correlations
were found between the patients' alexithymia scores (TAS) and cortisol
levels. The healthy control group (n=25) demonstrated significantly
higher cortisol levels than did the patients with SFD; in both tests
P0.001 for AUC-G and AUC-I. However, the two groups did not differ in
terms of their mean morning cortisol levels (P0.05). The results
suggest that pre-existing hypocortisolism might possibly be associated
with SFD.
Original language | English |
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Pages (from-to) | 366-373 |
Number of pages | 8 |
Journal | Nordic Journal of Psychiatry |
Volume | 62 |
Issue number | 5 |
DOIs | |
Publication status | Published - 2008 |
Keywords
- alexithymia
- cortisol
- Somatoform disorders