HPA axis regulation in posttraumatic stress disorder: A meta-analysis focusing on potential moderators

Schumacher S, Niemeyer H, Engel S, Cwik JC, Laufer S, Klusmann H, Knaevelsrud C (2019)

Publication Type: Journal article

Publication year: 2019

Journal

Neuroscience and Biobehavioral Reviews Elsevier

Book Volume: 100

Pages Range: 35-57

DOI: 10.1016/j.neubiorev.2019.02.005

Abstract

Posttraumatic stress disorder (PTSD) is often associated with alterations in the hypothalamic–pituitary–adrenal (HPA) axis. Previous findings are inconsistent, possibly due to trauma exposure of controls or different hormone measurement methods. We investigated cortisol, dehydroepiandrosterone (DHEA) and its sulfate (DHEA-S) in adults with clinical PTSD under basal or challenged conditions (Prospero registration no. CRD42016041690). A search of PubMed, Scopus, Medline, PsycINFO, Pilots/ProQuest, and Web of Science resulted in 108 included studies (N = 6484). Morning and 24 h cortisol were significantly lower in PTSD than in controls (g = −0.21; 95% CI: −0.42–(−0.01); g = −0.31; CI: −0.60–(−0.03)). Significant cortisol increases occurred after awakening in PTSD (g = 0.40; CI: 0.13–0.67) and in non-exposed controls (g = 0.96; CI: 0.59–1.33). Evening DHEA was significantly higher in PTSD than in non-exposed controls (g = 0.58; CI: 0.17–0.99). All groups showed large cortisol suppression effects after dexamethasone administration. Overall, the potential moderators investigated did not reveal a consistent pattern of HPA alterations.

Authors with CRIS profile

Sinha Engel

Involved external institutions

Freie Universität Berlin DE Germany (DE) Universität zu Köln DE Germany (DE)

How to cite

APA:

Schumacher, S., Niemeyer, H., Engel, S., Cwik, J.C., Laufer, S., Klusmann, H., & Knaevelsrud, C. (2019). HPA axis regulation in posttraumatic stress disorder: A meta-analysis focusing on potential moderators. Neuroscience and Biobehavioral Reviews, 100, 35-57. https://doi.org/10.1016/j.neubiorev.2019.02.005

MLA:

Schumacher, Sarah, et al. "HPA axis regulation in posttraumatic stress disorder: A meta-analysis focusing on potential moderators." Neuroscience and Biobehavioral Reviews 100 (2019): 35-57.

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