Basal blood DHEA-S/cortisol levels predicts EMDR treatment response in adolescents with PTSD. (3rd April 2018)

• Record Type: Journal Article
• Authors: Usta, Mirac Baris; Gumus, Yusuf Yasin; Say, Gokce Nur; Bozkurt, Abdullah; Şahin, Berkan; Karabekiroğlu, Koray
• Is Part Of: Nordic journal of psychiatry. Volume 72:Number 3(2018)
• Page Start: 164
• Page End: 172
• Publication Date: 2018-04-03
• Subjects: Biomarker -- PTSD -- cortisol -- DHEA -- EMDR -- adolescent; Psychopharmacology -- Periodicals; Psychotherapy -- Periodicals; Psychiatry -- Periodicals; Psychiatry -- Scandinavia -- Periodicals; 616.89
• DOI: 10.1080/08039488.2017.1406984
• Languages: English
• ISSNs: 0803-9488

Abstract

Abstract: Objective : In literature, recent evidence has shown that the hypothalamic–pituitary–adrenal (HPA) axis can be dysregulated in patients with post-traumatic stress disorder (PTSD) and HPA axis hormones may predict the psychotherapy treatment response in patients with PTSD. In this study, it was aimed to investigate changing cortisol and DHEA-S levels post-eye movement desensitization and reprocessing (EMDR) therapy and the relationship between treatment response and basal cortisol, and DHEA-S levels before treatment. Method : The study group comprised 40 adolescents (age, 12–18 years) with PTSD. The PTSD symptoms were assessed using the Child Depression Inventory (CDI) and Child Post-traumatic Stress Reaction Index (CPSRI) and the blood cortisol and DHEA-S were measured with the chemiluminescence method before and after treatment. A maximum of six sessions of EMDR therapy were conducted by an EMDR level-1 trained child psychiatry resident. Treatment response was measured by the pre- to post-treatment decrease in self-reported and clinical PTSD severity. Results : Pre- and post-treatment DHEA-S and cortisol levels did not show any statistically significant difference. Pre-treatment CDI scores were negatively correlated with pre-treatment DHEA-S levels ( r : −0.39). ROC analysis demonstrated that the DHEA-S/cortisol ratio predicts treatment response at a medium level (AUC: 0.703, p : .030, sensitivity: 0.65, specificity: 0.86). Conclusion : The results of this study suggested that the DHEA-S/cortisol ratio may predict treatment response in adolescents with PTSD receiving EMDR therapy. The biochemical parameter of HPA-axis activity appears to be an important predictor of positive clinical response in adolescent PTSD patients, and could be used in clinical practice to predict PTSD treatment in the future.