Premenstrual Syndrome, Inflammatory Status, and Mood States in Soccer Players.

OBJECTIVE: To evaluate the relationship between the inflammatory profile and mood states in the different phases of the menstrual cycle in soccer players with and without premenstrual syndrome (PMS). METHODS: Data on the menstrual cycle and mood states were collected using the Daily Symptom Report and the Brunel Mood Scale. Cytokine and stress hormone concentrations were measured in urine by flow cytometry before and after a game in the luteal phase and in the follicular phase of one menstrual cycle. RESULTS: In all, 59.6% of the athletes had PMS. The PMS group showed higher concentrations of interleukin (IL)-1ß, IL-6, and IL-8 than the athletes without PMS. After the game, IL-6 decreased in the follicular phase and the luteal phase. The tumor necrosis factor-α levels were higher in the group without PMS during the post-game follicular phase than before the game. In the PMS group, tension was higher in the follicular phase before the game and depression was higher in the pre-game luteal phase than in the group without PMS. The PMS group also presented a negative correlation between depression and IL-10 levels in the pre-game follicular phase. Finally, in the pre-game luteal phase were found positive correlations between growth hormone and IL-10. CONCLUSION: PMS influences the inflammatory condition related to mood states and stress hormones in female soccer players.

Active ghrelin and the postpartum.

Postpartum depression (PPD) occurs in 10-15 % of women. The appetite hormone ghrelin, which fluctuates during pregnancy, is associated with depression in nonpregnant samples. Here, we examine the association between PPD and active ghrelin from pregnancy to postpartum. We additionally examine whether ghrelin changes from pregnancy to postpartum and differs between breastfeeding and non-breastfeeding women. Sixty women who participated in a survey examining PPD and had information in regard to ghrelin concentrations were included in the study. The Edinburgh Postnatal Depression Scale was used to assess symptoms of PPD. Raw ghrelin levels and ghrelin levels adjusted for creatinine were included as outcomes. Women screening positive for PPD at 12 weeks postpartum had higher pregnancy ghrelin concentrations. Ghrelin concentrations significantly decreased from pregnancy to 6 weeks postpartum and this change differed based on pregnancy depression status. Finally, ghrelin levels were lower in women who breastfed compared with women who were bottle-feeding. No significant findings remained once ghrelin levels were adjusted for creatinine. Although results do not suggest an association between PPD and ghrelin after adjusting for creatinine, future research should continue to explore this possibility extending further across the postpartum period with larger sample sizes.

Gastrointestinal Symptoms and Altered Intestinal Permeability Induced by Combat Training Are Associated with Distinct Metabotypic Changes.

Physical and psychological stress have been shown to modulate multiple aspects of gastrointestinal (GI) physiology, but its molecular basis remains elusive. We therefore characterized the stress-induced metabolic phenotype (metabotype) in soldiers during high-intensity combat training and correlated the metabotype with changes in GI symptoms and permeability. In a prospective, longitudinal study, urinary metabotyping was conducted on 38 male healthy soldiers during combat training and a rest period using gas chromatography-mass spectrometry. The urinary metabotype during combat training was clearly distinct from the rest period (partial least-squares discriminant analysis (PLSDA) Q(2) = 0.581), confirming the presence of a unique stress-induced metabotype. Differential metabolites related to combat stress were further uncovered, including elevated pyroglutamate and fructose, and reduced gut microbial metabolites, namely, hippurate and m-hydroxyphenylacetate (p < 0.05). The extent of pyroglutamate upregulation exhibited a positive correlation with an increase in IBS-SSS in soldiers during combat training (r = 0.5, p < 0.05). Additionally, the rise in fructose levels was positively correlated with an increase in intestinal permeability (r = 0.6, p < 0.005). In summary, protracted and mixed psychological and physical combat-training stress yielded unique metabolic changes that corresponded with the incidence and severity of GI symptoms and alteration in intestinal permeability. Our study provided novel molecular insights into stress-induced GI perturbations, which could be exploited for future biomarker research or development of therapeutic strategies.

Association of depressive and anxiety symptoms with 24-hour urinary catecholamines in individuals with untreated high blood pressure.

OBJECTIVE: Depression and anxiety are considered risk factors for cardiovascular disease (CVD). The explanatory mechanisms, however, are still to be characterized. One proposed pathophysiological pathway is dysregulation of the autonomic nervous system, including heightened sympathetic nervous system activity. This study examined the relationship between symptoms of depression, anxiety, and sympathetic nervous system activity in individuals with untreated high blood pressure. METHODS: A total of 140 participants with untreated high blood pressure (55% white, 38.5% female, mean [standard deviation] age = 45.5 [8.55] years) collected urine over a 24-hour period on 3 separate occasions. Urine samples were assayed for mean 24-hour epinephrine (EPI24) and norepinephrine excretion. Depressive symptoms were assessed using the Beck Depression Inventory, with anxiety symptoms assessed using the Spielberger State-Trait Anxiety Inventory. RESULTS: Depression and anxiety scores were intercorrelated (r = 0.76, p < .001). EPI24 was positively correlated with anxiety (r = 0.20, p = .02) but not depression (r = 0.02, p = .77), whereas 24-hour urinary norepinephrine excretion was not correlated with anxiety (r = 0.10, p = .21) or with depression (r = 0.07, p = .39). Regression models, accounting for sex, age, body mass index, race, mean systolic ambulatory blood pressure, tobacco use, alcohol use, physical activity, and sleep efficiency confirmed that anxiety was associated with EPI24 excretion (p = .023) and that depressive symptoms were not (p = .54). CONCLUSIONS: Anxiety was associated with heightened sympathoadrenal activity, suggesting a biological pathway through which anxiety could increase CVD risk. Anxiety and depression may confer increased CVD risk via different mechanisms.

Adrenal activity and anxiety-like behavior in fur-chewing chinchillas (Chinchilla lanigera).

Due to its complexity, in combination with a lack of scientific reports, fur-chewing became one of the most challenging behavioral problems common to captive chinchillas. In the last years, the hypothesis that fur-chewing is an abnormal repetitive behavior and that stress plays a role in its development and performance has arisen. Here, we investigated whether a relationship existed between the expression and intensity of fur-chewing behavior, elevated urinary cortisol excretion and anxiety-related behaviors. Specifically, we evaluated the following parameters in behaviorally normal and fur-chewing animals of both sexes: (1) mean concentrations of urinary cortisol metabolites and (2) anxiety-like behavior in an elevated plus-maze test. Urinary cortisol metabolites were higher only in females that expressed the most severe form of the fur-chewing behavior (P≤0.05). Likewise, only fur-chewing females exhibited increased (P≤0.05) anxiety-like behaviors associated with the elevated plus-maze test. Overall, these data provided additional evidence to support the concept that fur-chewing is a manifestation of physiological stress in chinchilla, and that a female sex bias exists in the development of this abnormal behavior.

Maternal and paternal plasma, salivary, and urinary oxytocin and parent-infant synchrony: considering stress and affiliation components of human bonding.

Studies in mammals have implicated the neuropeptide oxytocin (OT) in processes of bond formation and stress modulation, yet the involvement of OT in human bonding throughout life remains poorly understood. We assessed OT in the plasma, saliva, and urine of 112 mothers and fathers interacting with their 4-6-month-old infants. Parent-infant interactions were micro-coded for parent and child's social behaviors and for the temporal coordination of their socio-affective cues. Parents were interviewed regarding their attachment to the infant and reported on bonding to own parents, romantic attachment, and parenting stress. Results indicated that OT in plasma (pOT) and saliva (sOT) were inter-related and were unrelated to OT in urine (uOT). pOT and sOT in mothers and fathers were associated with parent and child's social engagement, affect synchrony, and positive communicative sequences between parent and child. uOT was related to moments of interactive stress among mothers only, indexed by the co-occurrence of infant negative engagement and mother re-engagement attempts. pOT and sOT were associated with mothers' and fathers' attachment relationships throughout life: to own parents, partner, and infant, whereas uOT correlated with relationship anxiety and parenting stress among mothers only. Similar to other mammals, OT is involved in human attachment and contingent parenting. The dual role of OT in stress and affiliation underscores its complex involvement in processes of social bonding throughout life.

Urinary volatilome analysis in a mouse model of anxiety and depression.

Psychiatric disorders including depression and anxiety comprise a broad range of conditions with different symptoms. We have developed a mouse model of depression/anxiety in mice deficient in the St3gal4 gene. In this study, we performed a comparative analysis of urinary volatile organic compounds (VOCs) in St3gal4-deficient (St3gal4-KO) and wild-type mice using gas chromatography-mass spectrometry, and we screened 18 putative VOCs. Principal component analysis (PCA) based on these VOCs identified a major group of 11 VOCs, from which two groups were clarified by hierarchical clustering analysis. One group including six VOCs (pentanoic acid, 4-methyl-, ethyl ester; 3-heptanone, 6-methyl; benzaldehyde; 5,9-undecadien-2-ol, 6,10-dimethyl; and unknown compounds RI1291 and RI1237) was correlated with the startle response (r = 0.620), which is related to an unconscious defensive response. The other group including two VOCs (beta-farnesene and alpha-farnesene) comprised pheromones which increased in KO mice. Next, male mice underwent a social behavior test with female mice in the estrus stage, showing reduced access of KO male mice to female mice. Comparative analysis of urinary VOCs before and after encounters revealed that the six VOCs were not changed by these encounters. However, in WT mice, the two farnesenes increased after the encounters, reaching the level observed in KO mice, which was not altered following the encounter. Taken together, these results indicated that St3gal4 was involved in modulating urinary VOCs. Moreover, VOC clusters discovered by comparison of St3gal4-KO mice with WT mice were correlated with differential emotional behaviors.

The relationship between diurnal cortisol secretion and climacteric-related symptoms.

OBJECTIVES: Chronic stress, also associated with climacteric-related symptoms, may influence cortisol secretion. We studied cortisol metabolism in peri- and postmenopausal women with diverse climacteric-related symptoms. STUDY DESIGN AND MAIN OUTCOME MEASURES: The study population was 35 women, aged 45-70 years. Plasma cortisol levels were measured from blood samples collected every 20 min over 24 h. Urinary cortisol was analysed from 24-hour urine collections. Climacteric-related symptoms (vasomotor, sleep, depressive, anxiety, cognitive, sexual, menstrual, and somatic) were evaluated with the Women's Health Questionnaire (WHQ). Associations between cortisol variables (24-hour, night, day, maximum, minimum, morning baseline, cortisol awakening response (CAR), area under the curve, slope, and 24-hour urinary cortisol) and the symptoms were first examined with a correlation analysis. Then, the women were divided into two groups according to their climacteric symptomatology, and differences in cortisol variables between the groups were investigated. Diurnal cortisol curves by symptomatology were also analyzed visually. RESULTS: In the correlation analysis, more frequent vasomotor symptoms were associated with a higher CAR (rs = 0.37, p = 0.039) and lower 24-hour urinary cortisol excretion (rs= -0.45, p = 0.012), and more frequent depressive symptoms were associated with a higher minimum cortisol level (rs = 0.33, p = 0.0498). When the women were divided into two groups, women with more frequent vasomotor (p = 0.012) or somatic symptoms (p = 0.021) had a lower 24-hour urinary cortisol excretion than less symptomatic women. CONCLUSIONS: Although previous studies have reported associations between climacteric-related symptoms and cortisol secretion, these two factors were not substantially interrelated in our study.

Relationship between Anxiety and Interleukin 10 in Female Soccer Players with and Without Premenstrual Syndrome (PMS).

Objective To investigate the level of anxiety and its relationship with interleukin (IL)-10 (anti inflammatory cytokine that modulates mood swings) in a group of female soccer players. Methods Fifty-two eumenorrheic soccer players were evaluated (age 19.8 ± 4.7 years). The presence of premenstrual syndrome (PMS) and phases of the menstrual cycle were determined by a daily symptom report (DSR) kept for 3 consecutive months. The concentration of cytokine IL-10 was determined from urine samples collected at four moments: at the follicular and luteal phases of the menstrual cycle, and before (pre) and after (post) the simulated game, and it was quantified by flow cytometry (Luminex xMAP - EMD Millipore, Billerica, MA, USA). The level of anxiety was determined through the BAI anxiety questionnaire answered by all athletes at the same time of the urine collection. The Student t-test, analysis of variance (ANOVA) and Pearson correlation with significance level at 5% were used for data analysis. Results We showed that the prevalence of PMS among female soccer players is similar to that reported in the literature. In addition, we showed that the group with PMS has a higher level of anxiety compared with group without PMS (p = 0.002). Interleukin-10 analysis in players without PMS revealed that there was a significant decrease in the level of this cytokine before the game during the luteal phase when compared with the follicular phase (p < 0.05). The correlation analysis between IL-10 and anxiety showed a negative correlation post-game in the luteal phase in the group without PMS (p = 0.02; r = -0.50) and a positive correlation post-game in the luteal phase in PMS group (p = 0.04; r = 0.36). Conclusion Our results suggest that IL-10 may contribute to reduce anxiety in the group without PMS. This could be attributed to the fact that no IL-10 variation was observed in the group with PMS, which presented higher anxiety symptoms when compared with the group without PMS.

Objetivo Investigar o nível de ansiedade e a sua relação com a interleucina 10 (IL-10) em jogadoras de futebol de campo com e sem síndrome pré-menstrual (SPM). A IL-10 é uma citocina anti-inflamatória que modula o humor e a ansiedade. Métodos Foram avaliadas 52 jogadoras de futebol de campo eumenorreicas (idade 19.8 ± 4.7 anos). A síndrome pré-menstrual (SPM) e as fases do ciclo menstrual foram determinadas pelo questionário de sintomas (DSR) por 3 meses consecutivos. A concentração da interleucina (IL)-10 foi obtida das amostras de urina coletadas em 4 momentos: nas fases folicular e lútea do ciclo menstrual e antes e depois do jogo, e foi quantificada por citometria de fluxo (Luminex xMAP - EMD Millipore, Billerica, MA, USA). O nível de ansiedade foi determinado pelo questionário de ansiedade de BAI, respondido por todas as atletas nos mesmos momentos das coletas de urina. O teste t de Student, a análise de variância (ANOVA) e a correlação de Pearson com nível de significância de 5% foram utilizados para a análise dos dados. Resultados Observou-se 59,6% de SPM nas jogadoras de futebol avaliadas, similar aos dados da literatura. O grupo com SPM possui um estado de ansiedade mais elevado quando comparado ao grupo sem SPM (p = 0,002). A IL-10 apresentou diminuição significante na fase lútea antes do jogo em comparação ao mesmo momento na fase folicular nas jogadoras sem SPM (p < 0,05). A correlação entre a IL-10 e a ansiedade revelou correlação negativa na fase lútea após o jogo no grupo sem SPM (p = 0,02; r = -0,50), bem como correlação positiva na fase lútea após o jogo no grupo com SPM (p = 0,04; r = 0,36). Conclusão Os resultados no grupo sem SPM evidenciam provável controle da ansiedade com a contribuição da IL-10. O grupo com SPM; com ansiedade maior que o grupo sem SPM; não teve variação significativa na IL-10, sugerindo dificuldade maior no controle da ansiedade nessas atletas.

Urine ethanol concentration and alcohol hangover severity.

BACKGROUND: The aim of this study was to examine the relationship between urine ethanol concentration and alcohol hangover severity. METHODS: N = 36 healthy social drinkers participated in a naturalistic study, comprising a hangover day and a control day. N = 18 of them have regular hangovers (the hangover group), while the other N = 18 claim to be hangover immune (hangover-immune group). On each test day at 9.30 am, urine samples were collected. Participants rated their overall hangover severity on a scale from 0 (absent) to 10 (extreme), as well as 18 individual hangover symptoms. RESULTS: Urine ethanol concentration was significantly higher on the hangover day when compared to the control day (p = 0.006). On the hangover day, urine ethanol concentration was significantly lower in the hangover-immune group when compared to the hangover group (p = 0.027). In the hangover-immune group, none of the correlations of urine ethanol concentration with individual hangover symptoms was significant. In contrast, in the hangover group, significant correlations were found with a variety of hangover symptoms, including nausea, concentration problems, sleepiness, weakness, apathy, sweating, stomach pain, thirst, heart racing, anxiety, and sleep problems. CONCLUSION: Urine ethanol levels are significantly associated with the presence and severity of several hangover symptoms.

Maternal psychological distress, prenatal cortisol, and fetal weight.

OBJECTIVE: The objective of this study was to examine the effects of maternal psychological distress on estimated fetal weight during midgestation and explore the maternal hypothalamic-pituitary axis and sympathoadrenal dysregulation as potential risk factors for these effects. METHODS: Fetal ultrasound biometry measurements and maternal sociodemographic characteristics, emotional distress symptoms, and first morning urine samples were collected during a clinical ultrasound examination for a cross-sectional sample of 98 women who were between 16 and 29 weeks pregnant. Fetal weight was estimated from ultrasound biometry measurements; maternal emotional distress was assessed using the daily hassles (stress), Center for Epidemiologic Studies-Depression (depression), and State-Trait Anxiety Inventory (anxiety) scales; and urine samples were assayed for cortisol and norepinephrine levels. RESULTS: Correlation analyses revealed that both maternal psychological (daily hassles, depression, and anxiety) and biochemical (cortisol and norepinephrine) variables were negatively related to fetal biometry measurements and estimated fetal weight. A structural equation model further revealed that when the independent variance of maternal sociodemographic, psychological distress, and biochemistry measures were accounted for, prenatal cortisol was the only significant predictor of fetal weight. CONCLUSIONS: Women exhibiting psychological distress during pregnancy exhibit elevated cortisol levels during midgestation that are in turn related to lower fetal weight.

A single session of emotional stress produces anxiety in Wistar rats.

The sensorial stimulation arising from a physically stressed (PS) subject may produce emotional stress in a witnessing partner (WP). Both members of the pair develop functional changes. We tested changes in locomotor activity (crossing) and in the defensive burying test in WP, and PS adult male Wistar rats having been submitted to a single 10 min session in a two-compartment cage. During this session, the WP rats received auditory and olfactory stimulation coming from a PS pair submitted to unavoidable electric footshocks (1 mA, dc, 0.5s, 0.5c/s, 10 min). This experiment was replicated in other groups pre-treated with vehicle or diazepam, and their urine was collected and analyzed by the static Head-Space and Gas Chromatography-Mass Spectrometry (HS-GC/MS) techniques. The WP group displayed a significantly higher crossing [F((2,45))=4.31, P<0.01] and more cumulative burying time [F((2,22))=4.73, P<0.01] than the control or PS groups. Diazepam (1mg/kg) reverted these changes. Our results indicate that the conspecific sensorial communication coming from the PS group produces anxiety probably mediated by 2-heptanone, since the HS-GC/MS analyses showed the highest amount of 2-heptanone in the urine from the PS group [F((2,42))=5.17, P<0.009].

Buprenorphine treatment outcome in dually diagnosed heroin dependent patients: A retrospective study.

The present study compared retrospectively in a clinical non-experimental setting the efficacy of buprenorphine (BUP) in different subgroups of dually diagnosed and non-dually diagnosed opioid-dependent patients: all the subjects included in the study showed severe long-lasting heroin addiction and 68.4% were affected by psychiatric comorbidity. Participants (206) (mean age 32.2+/-8.9, 177 males-29 females) were applicants to a long-term buprenorphine treatment program (mean doses 7.9+/-0.42 mg). Aim of the study was to evaluate dual diagnosis variables possibly influencing retention rate and abstinence from illicit drugs. The patients were divided into 5 subgroups on the basis of dual diagnosis: group 1: major depression (MD) 29.61%; group 2: generalized anxiety (GAD) (11.2%); group 3: personality disorders (PD), antisocial-borderline (21.84%); group 4: schizophrenia (SC)(6.3%); group 5: substance use disorder without overt psychiatric comorbidity (SUD) (31.1%). Group 1 patients affected by MD showed the highest retention rate at 12 months (72.1%) in comparison with the other groups of patients: group 2 GAD (39.1%), group 3 PD (17.8%), group 4 SC (7.7%) and group 5 SUD, without comorbidity (45.3%) (p=0.006, p<0.001, p<0.001, p=0.002). Similarly, at 12 months, the patients affected by MD showed less risk of illicit opioid use (16.4%) than those affected by GAD (34.8%), PD (42.2%), SC (53.8%) and SUD without comorbidity (34.4%) (p=0.06, p=0.003, p=0.008, p=0.017). When evaluated on the whole sample, retention rate was not influenced by dose. In contrast, the higher BUP doses were associated with less risk of illicit opioid use, than lower doses (p<0.001). Multivariate analysis and factor analysis showed a greater association of outcome measures (retention rate and negative urines rate) with comorbid diagnosis (depression) (respectively 0.64) than with buprenorphine doses (respectively 0.54). Our data need to be interpreted with caution because of the retrospective methodology applied to a clinical non-experimental setting. BUP seems to be more effective in opioid-dependent patients affected by depression, probably due to the kappa opioid-receptors antagonist action, counteracting dysphoria, negativism and anxiety. High doses of BUP appear to predict a better outcome, in terms of negative urines, but not in terms of retention.

Anxiety and stress among science students. Study of calcium and magnesium alterations.

Stress and anxiety of university science students (Chemistry) was evaluated in basal conditions and during exams using validated stress and anxiety questionnaires. The relations between the data obtained and various biochemical markers were established. Results showed that the evaluated students did not experience stress increase as a consequence of exams but suffered a significant increase in anxiety. The psychological findings agree with the urinary biomarkers studied. It is known that anxiety is related to partial magnesium reduction associated with a urinary magnesium excretion increase, as observed in the present data. Nevertheless, stress also correlates with a urinary calcium increase which was not detected in the present study.

State anxiety, physical activity, and urinary 3-methoxy-4-hydroxyphenethylene glycol excretion.

Measurement of urinary 3-methoxy-4-hydroxyphenethylene glycol (MHPG) levels has been suggested as possibly being important in elucidating the role of central noradrenergic function in affective illnesses. The influence on urinary MHPG excretion of the state variables of physical activity and stress has not been clearly defined in previous studies. During a baseline medication-free period, 24 hospitalized depressed female patients underwent a five-day protocol including an eight-hour period of either enhanced or restricted activity. Throughout the protocol, independent measurements of telemetered mobility and stale anxiety were obtained. There were no significant effects of physical activity on urinary MHPG levels. Furthermore, baseline urinary MHPG levels and baseline state anxiety did not covary significantly. However, within-individual analyses yielded a highly significant relationship between changes in urinary MHPG levels and changes in state anxiety. The data suggested that those patients with lower baseline MHPG levels were those more prone to experience increased anxiety under environmentally "activating" circumstances.

The role of pre-operative state-anxiety in the determination of intra-operative neuroendocrine responses and recovery.

OBJECTIVES: The psychophysiological model of adjustment to surgery predicts associations between (1) heightened pre-operative state-anxiety and intra-operative neuroendocrine responses, (2) neuroendocrine responses and complications; and (3) heightened pre-operative state-anxiety and post-operative recovery. The present study examined these associations. METHODS: Participants were 39 patients (mean age 71.9+/-6.1 years) undergoing elective carotid endarterectomy surgery under local anaesthesia. In the week prior to surgery, patients completed baseline measures of physical and mental functioning using the MOS 36-item Short-Form Health Survey (SF-36). In addition to this, they undertook a 24-hour urine save to measure cortisol and catecholamines. Measures of state-anxiety were completed on the evening prior to surgery. A second 24-hour urine save was started at the time of anaesthetic induction. Follow-up measures of physical and mental functioning were completed 1 month following surgery. All complications were recorded during hospitalization. RESULTS: There was a significant negative association between pre-operative state-anxiety and intra-operative cortisol (r=-.52, p

Di-(2-ethylhexyl) phthalate exposure is negatively correlated with trait anxiety in girls but not with trait anxiety in boys or anxiety-like behavior in male mice.

The authors aimed to study the effects of postnatal exposure to phthalate on anxiety-like behavior in mice and anxiety proneness in children. Male Imprinting Control Region (ICR) mice aged 4 weeks were administered 20 to 540 mg/kg of di-(2-ethylhexyl) phthalate (DEHP) or vehicle and assessed in the Open Field Test. A group of 277 children aged 8-11 years (150 males) was recruited from South Korea. A cross-sectional examination of urinary DEHP and dibutylphthalate metabolite concentrations was conducted, and the children were scored on the Trait Anxiety Inventory for Children (TAIC). DEHP metabolite concentrations in the urine were significantly and negatively correlated with TAIC scores in the female population but not in the male population. There were no significant group differences in the percentage of distance moved or time spent in the central area in male mice treated with DEHP or vehicle. Our results suggest a sex-dependent effect of DEHP on anxiety proneness in childhood.

Low platelet-poor plasma concentrations of serotonin in patients with combat-related posttraumatic stress disorder.

BACKGROUND: Combat-related posttraumatic stress disorder (CR-PTSD) is associated with a dysregulation of various neurotransmitter systems. METHODS: We assessed levels of platelet-poor plasma (PPP) norepinephrine (NE), and serotonin (5-HT), and 24-hour urinary excretion of NE, dopamine (DA), and homovanillic acid (HVA) in 17 male outpatients with untreated chronic CR-PTSD (age, 33.1 +/- 7.4 years) and 10 normal control subjects (age, 35.8 +/- 2.7 years). RESULTS: Compared with the control subjects, the PTSD patients showed significantly lower PPP 5-HT levels, elevated PPP NE levels, and significantly higher mean 24-hour urinary excretion of all three catecholamines (NE, DA, and HVA). The 24-hour urinary HVA values of the CR-PTSD patients correlated significantly and positively with the total Impact of Event Scale scores and the avoidance symptoms cluster scores, and the PPP 5-HT levels correlated negatively with the Hamilton Anxiety Rating Scale scores. The PPP NE/5-HT ratio was significantly higher in the study group than in the control subjects. CONCLUSIONS: We believe this combined enhanced noradrenergic activity and diminished 5-HT activity may be relevant to the neurobiology of CR-PTSD.

Increased urinary tribulin output in generalised anxiety disorder.

Urinary output of an endogenous monoamine oxidase inhibitor and benzodiazepine receptor binding inhibitor (tribulin) was raised in a group of patients with generalised anxiety disorder compared with controls. Tribulin levels remained relatively constant in individual patients over the 6-week period of observation, mean values remaining high even after reduction of anxiety following non-drug behaviour therapy.

Depression and anxiety symptoms are related to increased 24-hour urinary norepinephrine excretion among healthy middle-aged women.

OBJECTIVE: Depression is a risk factor for morbidity and mortality in a variety of populations, and anxiety has also been associated with risk of mortality among cardiac patients. Dysfunction of the autonomic nervous system may be involved in this risk. The primary goal of this study was to evaluate the relationship between levels of self-reported symptoms of depression and anxiety and 24-hour urinary catecholamine excretion. METHOD: Ninety-one women aged 47-55 years were evaluated. Depression symptoms were assessed with the Beck Depression Inventory (BDI) and state anxiety was assessed with the state anxiety portion (SAI) of the Spielberger State-Trait Anxiety Inventory (STAI). Twenty-four hour urine collections were assayed for epinephrine (EPI), norepinephrine (NE) and cortisol (CORT). EPI, NE and CORT were indexed by body surface area to control for individual differences in body size. RESULTS: Higher levels of depression symptoms were associated with increased 24-hour NE excretion (r=.27, P=.009), with depressed women (n=17, BDI scores >/=10) exhibiting an approximately 25% higher rate of urinary NE excretion than women with BDI scores <10 (n=74), P=.007. Higher levels of state anxiety were also related to greater NE excretion (r=.28, P=.01), and CORT excretion was related to both depression (r=.23, P=.02) and anxiety (r=.22, P=.04). Depression and anxiety symptoms were unrelated to urinary EPI excretion. CONCLUSIONS: The current findings that higher levels of depression and anxiety symptoms are related to increased 24-hour urinary NE and CORT excretion among women suggests that depression and anxiety may be associated with increased sympathetic nervous system (SNS) activity, and are consistent with the possibility that SNS activity may play a role in the increased mortality associated with depression in community-dwelling older adults.