Basal activity of the hypothalamic-pituitary-adrenal axis in patients withdepersonalization disorder

Depersonalisation disorder may occur during severe anxiety or following a t raumatic event, suggesting a possible role of stress hormones. This study i nvestigated basal activity of the hypothalamic-pituitary-adrenal (HPA) axis in patients with depersonalisation disorder. Salivary cortisol levels were measured at four time points over 12 h in patients with depersonalisation disorder (N = 13), major depressive disorder (MDD, N = 14) and healthy cont rols (N = 13). Beck Depression Inventory scores were significantly higher i n depersonalised subjects than controls, while MDD subjects demonstrated hi gher scores than both groups. Basal cortisol levels of depersonalised subje cts were significantly lower than those of MDD subjects but not healthy con trols. These results point to reduced basal activity of the HPA axis in dep ersonalisation disorder. This pilot study supports the distinction between depersonalisation disorder and major depressive disorder which should be ex amined in a larger sample. (C) 2001 Elsevier Science Ireland Ltd. All right s reserved.