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Salivary cortisol concentrations before and after carbon-dioxide inhalations in children

Coplan, Jeremy D; Moreau, Donna; Chaput, France; Martinez, Jose M; Hoven, Christina W; Mandell, Donald J; Gorman, Jack M; Pine, Daniel S
BACKGROUND: Considerable research implicates over-activity of the hypothalamic-pituitary adrenal axis in the pathophysiology of adult mood and anxiety disorders. The current study evaluates the association between salivary cortisol concentrations and response to carbon-dioxide inhalation in children and adolescents with anxiety disorders, mood disorders, or no psychiatric illness. The central question was whether response to carbon-dioxide inhalation is associated with levels of hypothalamic-pituitary adrenal axis activation. If confirmed, this would relate hypothalamic-pituitary adrenal axis activation in juveniles, as in adults, and response to a well-studied respiratory procedure. METHODS: Serial salivary cortisol samples were examined in 98 subjects (ages 9-17 years), including 62 subjects with an anxiety and/or mood disorder and 36 nonpsychiatrically ill comparisons. Samples were obtained upon arrival at the laboratory, following a tilt test, then before and immediately after a standard 5% carbon dioxide inhalation procedure. RESULTS: Salivary cortisol levels pre-carbon-dioxide inhalation were significantly higher in patients sensitive to the anxiogenic effects of carbon dioxide (n = 20) than in patients who did not respond to carbon dioxide (n = 42) and in healthy subjects, none of whom were sensitive to carbon dioxide (n = 36); cortisol concentrations in the latter two groups were indistinguishable. Salivary cortisol did not increase during carbon-dioxide inhalation, irrespective of diagnostic group or degree of reactivity to the procedure. CONCLUSIONS: The current data resemble data from studies of laboratory-induced panic among adult patients. In both groups, activation of the hypothalamic-pituitary adrenal axis is associated with the response to a standardized stressor. Similarly, as in adults, carbon-dioxide inhalation in juveniles does not produce a significant change in hypothalamic-pituitary adrenal axis activation.
PMID: 11958784
ISSN: 0006-3223
CID: 161770

General medical problems among the offspring of depressed parents: a 10-year follow-up

Kramer, R A; Warner, V; Olfson, M; Ebanks, C M; Chaput, F; Weissman, M M
OBJECTIVE: To examine the association between both parental and offspring depression and the general medical problems of a sample of offspring at high and low risk for depression. METHOD: Offspring (n = 222) from families with either depressed or nondepressed parents were followed up for a period of 10 years. Data collected included psychiatric diagnoses derived from direct semistructured interviews and history of general medical problems and hospital visits. Rates of medical problems and hospitalizations were calculated, and offspring were stratified by depression status of both parent and offspring. RESULTS: In analyses controlled for sociodemographic factors, offspring depression status was associated with a history of genitourinary disorders, headaches, respiratory disorders, other disorders, and hospitalizations in the offspring, and parental depression was associated with a history of unconsciousness and hospitalization in the offspring. After subjects were stratified by parental depression, significant associations between offspring depression and medical problems were found for only those offspring with a depressed parent. CONCLUSIONS: These findings suggest that a history of parental depression increases the risk for medical problems and hospitalization among depressed offspring. The co-occurrence of general medical and psychological problems among offspring of depressed parents may have implications for the treatment of both depression and comorbid medical disorders.
PMID: 9628080
ISSN: 0890-8567
CID: 161785

Soft signs in children of parents with agoraphobia

Kaplan, S L; Busner, J; Gallagher, R; Chaput, F; Acosta, E
OBJECTIVE: To study a proposed relationship between anxiety disorders and neurological soft signs by determining whether children of agoraphobic parents would have an increased prevalence of soft signs compared to children of parents without agoraphobia. METHOD: Family study methodology was used to compare 25 children of agoraphobic adults and 25 age- and sex-matched children of nonagoraphobic adults on a structured soft signs examination and on structured psychiatric interviews. Also, soft signs of 12 agoraphobic adults were compared with soft signs of 16 control adults. RESULTS: Children of agoraphobic adults had significantly more right- and left-side motor slowness on finger tapping and hand patting (p values < .05) than did children of controls. Seventy-six percent of the children of agoraphobic adults had at least one slow motor sign, compared with 28% of the control children (p < .001). There were no significant differences in soft signs between agoraphobic and control adults. CONCLUSIONS: The study provides additional support for a relationship between soft signs and anxiety disorder.
PMID: 8919714
ISSN: 0890-8567
CID: 161786