Neuroendocrine responses to psychological stress in adolescents with anxiety disorder

Neurotransmitter-neuroendocrine and cardiovascular responses to the adminis tration of a psychologically stressful mixed-model test (Mental Arithmetic, Stroop Color Word Interference Task, Trier Social Stress Test) were examin ed in 20 male peripubertal subjects affected by anxiety disorder (group A: 14 with generalized anxiety disorder, 6 with generalized anxiety disorder a nd separation anxiety disorder) and 20 junior school adolescents, matched f or age, without overt psychological disorders (group B). Plasma levels of n orepinephrine (NE), epinephrine (EPI), adrenocorticotropic hormone (ACTH), beta-endorphin (beta-EP), cortisol (CORT), growth hormone (GH), prolactin ( PRL) and testosterone (Te) were measured immediately before the beginning o f the tests and 30 min later at their end. Mean prestress values of GH, PRL , beta-EP and ACTH were significantly higher in anxious subjects than in co ntrols. There was no difference in NE, EPI, cardiovascular CORT and Te pres tress levels in the two groups. After the psychological stress session NE, GH and Te concentrations increased significantly in anxious subjects (A), b ut not in controls. In contrast, beta-EP and PRL decreased significantly du ring the psychological stress session in anxious subjects, and were unaffec ted by stress in the subjects without anxiety. No significant changes were found in ACTH, CORT and EPI during the challenge either in anxious subjects or in controls, which may be attributed to the late time of poststress blo od sampling. In contrast to controls, heart rate and systolic blood pressur e increased significantly in anxious subjects after psychological stress te sting. Our data support the hypothesis that the hyperactivity of the noradr energic system in response to stress is associated with anxiety disorders i n adolescents and might influence the responses of GH and Te. High prestres s basal values of stress hormones seem to be induced in anxious subjects by the anticipation of the task or by a persistent hyperactivity of the norad renergic system. Further studies are needed to investigate in more detail t he involvement of the HPA axis in anxious adolescents by a more refined res olution of time points of blood sampling. Copyright (C) 2000 S. Karger AG, Basel.