HPA axis reactivity in chronic pelvic pain: association with depression

Journal of Psychosomatic Obstetrics and Gynaecology
Katja WingenfeldChristine Heim

Abstract

Chronic pelvic pain (CPP) is a frequent gynecological complaint. The pathophysiology of CPP is not fully understood. The aim of this study was to determine whether the presence of depressive symptoms is associated with hypothalamic-pituitary-adrenal (HPA) axis dysfunction in CPP. We measured neuroendocrine responses to a standardized social stress test and to a standard adrenocorticotropin (ACTH)(1-24) stimulation test in 18 patients with CPP, stratified based on the presence of high versus low self-reported depressive symptoms, compared with 24 controls. Women with CPP and low depression exhibited enhanced ACTH responses to psychosocial stress compared with women with CPP and high depression, whereas there were no differences in cortisol responses. In the ACTH(1-24) stimulation test, CPP patients with high depression demonstrated enhanced cortisol responses. These results suggest a relationship between self-reported depression and reactivity of the HPA axis in patients with CPP.

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Citations

Nov 10, 2012·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Christoph MuhtzChristian Otte
Apr 8, 2016·The Journal of Pain : Official Journal of the American Pain Society·Mark P JensenMelissa A Day
Aug 15, 2015·Der Schmerz·S ElsenbruchW Jänig
Nov 8, 2014·European Journal of Pain : EJP·K WingenfeldS Lautenbacher
Jan 12, 2017·Drugs·Erin T CareySawsan As-Sanie
Aug 11, 2017·Chronic Stress·Chadi G Abdallah, Paul Geha

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