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Plasma cortisol in first episode drug-naïve mania: differential levels in euphoric versus irritable mood.

Abstract：

BACKGROUND:Dysregulation of HPA axis has been widely described in subjects with bipolar disorder (BD), including changes in cortisol levels during mood episodes and euthymia. However, most of the studies were done with medicated BD patients with variable length of illness, which was shown to interfere on peripheral cortisol levels. Therefore, the present study aims to evaluate plasma cortisol levels in drug-naïve BD subjects during the first manic episode, as well as investigate the relationship between plasma cortisol levels and manic symptomatology. METHODS:Twenty-six drug-naïve patients were enrolled meeting criteria for a first manic episode in bipolar I disorder. Severity of mania was assessed using the Young Mania Rating Scale (YMRS). The control group included 27 healthy subjects matched by age and gender. Cortisol was quantified using a direct radioimmunoassay. RESULTS:Plasma cortisol levels were decreased during first manic episode compared to healthy controls. Higher cortisol levels were positively associated with the presence of irritability (dysphoria), while elated mania showed lower cortisol levels compared to controls. LIMITATION:Data including larger samples are lacking. CONCLUSION:Higher cortisol in dysphoric mania compared to predominantly elated/euphoric mania may indicate a clinical and neurobiological polymorphic phenomenon, potentially involving a higher biological sensitivity to stress in the presence of irritable mood. The present findings highlight the importance to add a dimensional approach to the traditional categorical diagnosis for future neurobiological studies in BD.

journal_name

J Affect Disord

journal_title

Journal of affective disorders

authors

Valiengo LL,Soeiro-de-Souza MG,Marques AH,Moreno DH,Juruena MF,Andreazza AC,Gattaz WF,Machado-Vieira R

doi

10.1016/j.jad.2011.11.046

subject

Has Abstract

pub_date

2012-04-01 00:00:00

pages

149-52

issue

1-2

eissn

0165-0327

issn

1573-2517

pii

S0165-0327(11)00789-0

journal_volume

138

pub_type

杂志文章

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