Psychological, autonomic and neuroendocrine responses to acute stressors in the combined dexamethasone/CRH test: a study in healthy subjects

The combined dexamethasone/CRH test (DEX/CRH test) is reported to produce a ugmented ACTH and cortisol responses in various psychiatric disorders as we ll as in some non-psychiatric conditions. To examine whether stress affects the outcome of DEX/CRH test, two stress groups in a repeated measures desi gn were compared to an age-matched control group with regard to the psychol ogical. autonomic and neuroendocrine responses after the combined dexametha sone and CRH challenge. Cold presser (4 degreesC, total 10 min) produced st ronger subjective distress than mental arithmetic (15 min). Cold exposure, but not the mental test, elevated systolic and diastolic blood pressure, wh ereas the mental test increased pulse rate and skin conductance level more markedly than cold exposure. Neither stressor produced a significantly enha nced response of ACTH and cortisol in DEX/CRH test, and there was no correl ation between psychological and neuroendocrine responses. These findings su ggest that different stressors induce different patterns of sympathetic act ivation and that acute stress is unlikely to affect the results of DEX/CRH test. (C) 2001 Elsevier Science Ltd. All rights reserved.