Pituitary-adrenal reactivity in a child psychiatric population: salivary cortisol response to stressors

The aim of this explorative study was to investigate whether physical and p sychological challenges are effective in inducing a cortisol response in ps ychiatric and control children, and if so whether the cortisol response can discriminate between diagnostic groups and is related to psychiatric sympt oms. Fifty-two patients, including children with dysthymia, oppositional de fiant disorder/conduct disorder, pervasive developmental disorder, not othe rwise specified (PDDNOS) and attention deficit hyperactivity disorder, were compared to 15 healthy control children. Symptomatology was scored using t he Child Behaviour Checklist. The response to both psychological and physic al challenges was assessed by measuring salivary cortisol and heart rate. P hysical challenge, but not psychological challenge, resulted in an overall increase in heart rate and saliva cortisol. Dysthymic and PDDNOS patients s howed a diminished cortisol response, in spite of a significant increase in heart rate. These groups scored highest on the symptom factor withdrawal. Withdrawal was negatively correlated with the cortisol response. Thus, phys ical exercise is effective in inducing a salivary cortisol response in chil dren. Dysthymic and PDDNOS patients have a disturbed pituitary-adrenal func tion in relation to physical stress, that may be associated with withdrawal . (C) 1999 Elsevier Science B.V./ECNP. All rights reserved.