Unresponsiveness to psychosocial stress in a subgroup of autistic-like children, Multiple Complex Developmental Disorder

In this study, we tried to replicate the finding of a diminished cortisol r esponse to stress in autistic-like patients in a more homogenous Multiple C omplex Developmental Disorder (MCDD) group. MCDD forms a distinct group wit hin the: autistic-like disorders, characterized by impaired regulation of a nxiety and affective state, impaired social behavior/sensitivity, and thoug ht disorder. A number of MCDD children develop schizophrenia in adult life. Responses to a psychosocial stressor, consisting of speaking in public whil e recorded on video, were measured in 10 MCDD children and 12 healthy contr ol children. The public speaking test was imbedded in a two-hour test sessi on, and compared to a control test session. Hypothalamic-pituitary-adrenal (HPA) responses were measured on salivary cortisol at about 20-minute inter vals, Heart rate was measured continuously. Delta AUC's were computed for b oth heart rate (dAUCHR) and salivary cortisol (dAUCCORT), as a measure of r esponse to the test. The public speaking task resulted in significant responses in heart rate an d salivary cortisol in healthy control children, but not in MCDD children. dAUCHR was 3.28+/-2.37 in healthy control children, but -0.09+/-1.73 in MCD D children (t=3.31, P<0.01). dAUCCORT was 3.22+/-3.16 in healthy control ch ildren, but 0.17+/-1.74 in MCDD children (t=2.72, P<0.05). The impaired responses to psychosocial stress found in MCDD children may be the result of their limited abilities to react adequately to their (social ) environment. The same impairment in stress processing has been found in s chizophrenia, and might he a factor in the vulnerability of these MCDD chil dren to develop schizophrenia. (C) 2000 Elsevier Science Ltd. All rights re served.