The relationship between alexithymia and salivary cortisol levels in somatoform disorders |
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Authors: | Francisco Pedrosa Gil Martin Bidlingmaier Nathan Ridout Carl Eduard Scheidt Samantha Caton Claudia Schoechlin |
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Affiliation: | 1. Psychosomatic Out-patient-Clinic, Department of Internal Medicine, Ludwig-Maximilians-University, , Pettenkoferstr. 10, 80336, Munich, GermanyFrancisco.Pedrosa.Gil@med.uni-muenchen.de;3. Neuroendocrinology, Department of Internal Medicine, Ludwig-Maximilians-University, Ziemssenstr.1, 80036, Munich, Germany;4. Psychology Group, School of Life &5. Health Sciences, Aston University, Aston Triangle, Birmingham, B4 7ET, UK;6. United Kingdom;7. Department of Psychosomatic and Psychotherapeutic Medicine, University Hospital, Hauptstrasse 8, 79104, Freiburg, Germany;8. Department of Clinical Psychology and Psychophysiology, Psychiatric and Psychotherapeutic Hospital, Nu?baumstr. 7, 80336, Munich, Germany |
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Abstract: | The purpose of this study was to investigate cortisol levels as a function of the hypothalamic–pituitary–adrenal axis (HPA) in relation to alexithymia in patients with somatoform disorders (SFD). Diurnal salivary cortisol was sampled in 32 patients with SFD who also underwent a psychiatric examination and filled in questionnaires (Toronto Alexithymia Scale, TAS scale; Screening for Somatoform Symptoms, SOMS scale; Hamilton Depression Scale, HAMD). The mean TAS total score in the sample was 55.6±9.6, 32% of patients being classified as alexithymic on the basis of their TAS scores. Depression scores were moderate (HAMD=13.2, Beck Depression Inventory, BDI=16.5). The patients’ alexithymia scores (TAS scale “Difficulty identifying feelings”) correlated significantly positively with their somatization scale scores (Symptom Checklist-90 Revised, SCL-90-R); r=0.3438 (P<0.05) and their scores on the Global Severity Index (GSI) on the SCL-90-R; r=0.781 (P<0.01). Regression analysis was performed with cortisol variables as the dependent variables. Cortisol levels [measured by the area under the curve–ground (AUC-G), area under the curve–increase (AUC-I) and morning cortisol (MCS)] were best predicted in a multiple linear regression model by lower depressive scores (HAMD) and more psychopathological symptoms (SCL-90-R). No significant correlations were found between the patients’ alexithymia scores (TAS) and cortisol levels. The healthy control group (n=25) demonstrated significantly higher cortisol levels than did the patients with SFD; in both tests P<0.001 for AUC-G and AUC-I. However, the two groups did not differ in terms of their mean morning cortisol levels (P>0.05). The results suggest that pre-existing hypocortisolism might possibly be associated with SFD. |
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Keywords: | Alexithymia Cortisol Somatoform disorders |
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