Abuse-related posttraumatic stress disorder and alterations of the hypothalamic-pituitary-adrenal axis in women with chronic pelvic pain.
Identifieur interne : 000911 ( PubMed/Corpus ); précédent : 000910; suivant : 000912Abuse-related posttraumatic stress disorder and alterations of the hypothalamic-pituitary-adrenal axis in women with chronic pelvic pain.
Auteurs : C. Heim ; U. Ehlert ; J P Hanker ; D H HellhammerSource :
- Psychosomatic medicine [ 0033-3174 ]
English descriptors
- KwdEn :
- Adrenocorticotropic Hormone (blood), Adult, Arousal (physiology), Child, Child Abuse (psychology), Child Abuse, Sexual (psychology), Corticotropin-Releasing Hormone, Dexamethasone, Diagnosis, Differential, Female, Humans, Hydrocortisone (metabolism), Hypothalamo-Hypophyseal System (physiopathology), Life Change Events, Pelvic Pain (physiopathology), Pelvic Pain (psychology), Pituitary-Adrenal System (physiopathology), Psychophysiologic Disorders (physiopathology), Psychophysiologic Disorders (psychology), Risk Factors, Saliva (metabolism), Somatoform Disorders (physiopathology), Somatoform Disorders (psychology), Stress Disorders, Post-Traumatic (diagnosis), Stress Disorders, Post-Traumatic (physiopathology), Stress Disorders, Post-Traumatic (psychology).
- MESH :
- chemical , blood : Adrenocorticotropic Hormone.
- chemical , metabolism : Hydrocortisone.
- diagnosis : Stress Disorders, Post-Traumatic.
- metabolism : Saliva.
- physiology : Arousal.
- physiopathology : Hypothalamo-Hypophyseal System, Pelvic Pain, Pituitary-Adrenal System, Psychophysiologic Disorders, Somatoform Disorders, Stress Disorders, Post-Traumatic.
- psychology : Child Abuse, Child Abuse, Sexual, Pelvic Pain, Psychophysiologic Disorders, Somatoform Disorders, Stress Disorders, Post-Traumatic.
- Adult, Child, Corticotropin-Releasing Hormone, Dexamethasone, Diagnosis, Differential, Female, Humans, Life Change Events, Risk Factors.
Abstract
Although numerous organic conditions may cause chronic pelvic pain (CPP), diagnostic laparoscopy reveals a normal pelvis in many patients with CPP. However, psychological studies yield a high frequency of psychopathology and increased prevalences of chronic stress and traumatic life events, ie, sexual and physical abuse, in women with CPP, suggesting a relationship between posttraumatic stress disorder (PTSD) and CPP. As chronic stress and PTSD have been associated with specific alterations of the hypothalamic-pituitary-adrenal (HPA) axis, we explored stress history, psychopathology and HPA axis alterations in women with CPP.
PubMed: 9625218
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Abuse-related posttraumatic stress disorder and alterations of the hypothalamic-pituitary-adrenal axis in women with chronic pelvic pain.</title><author><name sortKey="Heim, C" sort="Heim, C" uniqKey="Heim C" first="C" last="Heim">C. Heim</name><affiliation><nlm:affiliation>Center for Psychobiological and Psychosomatic Research, University of Trier, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Ehlert, U" sort="Ehlert, U" uniqKey="Ehlert U" first="U" last="Ehlert">U. Ehlert</name></author><author><name sortKey="Hanker, J P" sort="Hanker, J P" uniqKey="Hanker J" first="J P" last="Hanker">J P Hanker</name></author><author><name sortKey="Hellhammer, D H" sort="Hellhammer, D H" uniqKey="Hellhammer D" first="D H" last="Hellhammer">D H Hellhammer</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="????"><PubDate><MedlineDate>1998 May-Jun</MedlineDate></PubDate></date><idno type="RBID">pubmed:9625218</idno><idno type="pmid">9625218</idno><idno type="wicri:Area/PubMed/Corpus">000911</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000911</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Abuse-related posttraumatic stress disorder and alterations of the hypothalamic-pituitary-adrenal axis in women with chronic pelvic pain.</title><author><name sortKey="Heim, C" sort="Heim, C" uniqKey="Heim C" first="C" last="Heim">C. Heim</name><affiliation><nlm:affiliation>Center for Psychobiological and Psychosomatic Research, University of Trier, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Ehlert, U" sort="Ehlert, U" uniqKey="Ehlert U" first="U" last="Ehlert">U. Ehlert</name></author><author><name sortKey="Hanker, J P" sort="Hanker, J P" uniqKey="Hanker J" first="J P" last="Hanker">J P Hanker</name></author><author><name sortKey="Hellhammer, D H" sort="Hellhammer, D H" uniqKey="Hellhammer D" first="D H" last="Hellhammer">D H Hellhammer</name></author></analytic><series><title level="j">Psychosomatic medicine</title><idno type="ISSN">0033-3174</idno></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adrenocorticotropic Hormone (blood)</term><term>Adult</term><term>Arousal (physiology)</term><term>Child</term><term>Child Abuse (psychology)</term><term>Child Abuse, Sexual (psychology)</term><term>Corticotropin-Releasing Hormone</term><term>Dexamethasone</term><term>Diagnosis, Differential</term><term>Female</term><term>Humans</term><term>Hydrocortisone (metabolism)</term><term>Hypothalamo-Hypophyseal System (physiopathology)</term><term>Life Change Events</term><term>Pelvic Pain (physiopathology)</term><term>Pelvic Pain (psychology)</term><term>Pituitary-Adrenal System (physiopathology)</term><term>Psychophysiologic Disorders (physiopathology)</term><term>Psychophysiologic Disorders (psychology)</term><term>Risk Factors</term><term>Saliva (metabolism)</term><term>Somatoform Disorders (physiopathology)</term><term>Somatoform Disorders (psychology)</term><term>Stress Disorders, Post-Traumatic (diagnosis)</term><term>Stress Disorders, Post-Traumatic (physiopathology)</term><term>Stress Disorders, Post-Traumatic (psychology)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Adrenocorticotropic Hormone</term></keywords><keywords scheme="MESH" type="chemical" qualifier="metabolism" xml:lang="en"><term>Hydrocortisone</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Stress Disorders, Post-Traumatic</term></keywords><keywords scheme="MESH" qualifier="metabolism" xml:lang="en"><term>Saliva</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Arousal</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Hypothalamo-Hypophyseal System</term><term>Pelvic Pain</term><term>Pituitary-Adrenal System</term><term>Psychophysiologic Disorders</term><term>Somatoform Disorders</term><term>Stress Disorders, Post-Traumatic</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Child Abuse</term><term>Child Abuse, Sexual</term><term>Pelvic Pain</term><term>Psychophysiologic Disorders</term><term>Somatoform Disorders</term><term>Stress Disorders, Post-Traumatic</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Child</term><term>Corticotropin-Releasing Hormone</term><term>Dexamethasone</term><term>Diagnosis, Differential</term><term>Female</term><term>Humans</term><term>Life Change Events</term><term>Risk Factors</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Although numerous organic conditions may cause chronic pelvic pain (CPP), diagnostic laparoscopy reveals a normal pelvis in many patients with CPP. However, psychological studies yield a high frequency of psychopathology and increased prevalences of chronic stress and traumatic life events, ie, sexual and physical abuse, in women with CPP, suggesting a relationship between posttraumatic stress disorder (PTSD) and CPP. As chronic stress and PTSD have been associated with specific alterations of the hypothalamic-pituitary-adrenal (HPA) axis, we explored stress history, psychopathology and HPA axis alterations in women with CPP.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">9625218</PMID><DateCreated><Year>1998</Year><Month>08</Month><Day>06</Day></DateCreated><DateCompleted><Year>1998</Year><Month>08</Month><Day>06</Day></DateCompleted><DateRevised><Year>2015</Year><Month>11</Month><Day>19</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0033-3174</ISSN><JournalIssue CitedMedium="Print"><Volume>60</Volume><Issue>3</Issue><PubDate><MedlineDate>1998 May-Jun</MedlineDate></PubDate></JournalIssue><Title>Psychosomatic medicine</Title><ISOAbbreviation>Psychosom Med</ISOAbbreviation></Journal><ArticleTitle>Abuse-related posttraumatic stress disorder and alterations of the hypothalamic-pituitary-adrenal axis in women with chronic pelvic pain.</ArticleTitle><Pagination><MedlinePgn>309-18</MedlinePgn></Pagination><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">Although numerous organic conditions may cause chronic pelvic pain (CPP), diagnostic laparoscopy reveals a normal pelvis in many patients with CPP. However, psychological studies yield a high frequency of psychopathology and increased prevalences of chronic stress and traumatic life events, ie, sexual and physical abuse, in women with CPP, suggesting a relationship between posttraumatic stress disorder (PTSD) and CPP. As chronic stress and PTSD have been associated with specific alterations of the hypothalamic-pituitary-adrenal (HPA) axis, we explored stress history, psychopathology and HPA axis alterations in women with CPP.</AbstractText><AbstractText Label="METHOD" NlmCategory="METHODS">We recruited 16 patients with CPP and 14 painfree, infertile controls from a general hospital where diagnostic laparoscopy was performed. Psychological assessment included standardized interviews on clinical symptoms, abuse experiences and major life events as well as psychometric testing for PTSD-like symptoms and depression. Endocrinological evaluation involved determinations of diurnal salivary cortisol levels and hormonal responses to a corticotropin-releasing factor (CRF) stimulation test (100 microg human CRF) and a low-dose dexamethasone suppression test (0.5 mg).</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">We observed increased prevalences of abuse experiences and PTSD in women with CPP as well as a higher total number of major life events, whereas the mean extent of depression was within the normal range. With respect to endocrine measures, women with CPP demonstrated normal to low diurnal salivary cortisol levels, normal plasma-adrenocorticotropin (ACTH), but reduced salivary cortisol levels in the CRF stimulation test, and an enhanced suppression of salivary cortisol by dexamethasone.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Women with CPP demonstrate HPA axis alterations, that partly parallel and partly contrast neuroendocrine correlates of PTSD, but show marked similarity to findings in patients with other stress-related bodily disorders. These findings suggest that a lack of protective properties of cortisol may be of relevance for the development of bodily disorders in chronically stressed or traumatized individuals.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Heim</LastName><ForeName>C</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Center for Psychobiological and Psychosomatic Research, University of Trier, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ehlert</LastName><ForeName>U</ForeName><Initials>U</Initials></Author><Author ValidYN="Y"><LastName>Hanker</LastName><ForeName>J P</ForeName><Initials>JP</Initials></Author><Author ValidYN="Y"><LastName>Hellhammer</LastName><ForeName>D H</ForeName><Initials>DH</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Psychosom Med</MedlineTA><NlmUniqueID>0376505</NlmUniqueID><ISSNLinking>0033-3174</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>7S5I7G3JQL</RegistryNumber><NameOfSubstance UI="D003907">Dexamethasone</NameOfSubstance></Chemical><Chemical><RegistryNumber>9002-60-2</RegistryNumber><NameOfSubstance UI="D000324">Adrenocorticotropic Hormone</NameOfSubstance></Chemical><Chemical><RegistryNumber>9015-71-8</RegistryNumber><NameOfSubstance UI="D003346">Corticotropin-Releasing Hormone</NameOfSubstance></Chemical><Chemical><RegistryNumber>WI4X0X7BPJ</RegistryNumber><NameOfSubstance UI="D006854">Hydrocortisone</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000324" MajorTopicYN="N">Adrenocorticotropic Hormone</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001143" MajorTopicYN="N">Arousal</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="Y">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002649" MajorTopicYN="N">Child Abuse</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002650" MajorTopicYN="N">Child Abuse, Sexual</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003346" MajorTopicYN="N">Corticotropin-Releasing Hormone</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003907" MajorTopicYN="N">Dexamethasone</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003937" MajorTopicYN="N">Diagnosis, Differential</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006854" MajorTopicYN="N">Hydrocortisone</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007030" MajorTopicYN="N">Hypothalamo-Hypophyseal System</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008016" MajorTopicYN="N">Life Change Events</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017699" MajorTopicYN="N">Pelvic Pain</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010913" MajorTopicYN="N">Pituitary-Adrenal System</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011602" MajorTopicYN="N">Psychophysiologic Disorders</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012463" MajorTopicYN="N">Saliva</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013001" MajorTopicYN="N">Somatoform Disorders</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013313" MajorTopicYN="N">Stress Disorders, Post-Traumatic</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1998</Year><Month>6</Month><Day>13</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1998</Year><Month>6</Month><Day>13</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1998</Year><Month>6</Month><Day>13</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId 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