Salivary cortisol, posttraumatic stress symptoms, and general health in the acute phase and during 9-month follow-up.

BACKGROUND: Because traumatic events are unpredictable, there are few studies of psychobiological states immediately following such events. Our study aimed to determine the relation of salivary cortisol to psychologic distress immediately after a traumatic event and then during follow-up. METHODS: Measurement of morning and evening salivary cortisol and ratings of psychologic distress (using the Impact of Events Scale [IES], the Post Traumatic Symptom Scale, and the General Health Questionnaire) were performed with 31 United Nations soldiers at three time points--5 days and 2 and 9 months--following a mine accident in Lebanon. RESULTS: Five days after the accident, 15 subjects reported substantial posttraumatic distress according to the IES, as well as significantly lower morning and higher evening cortisol levels compared with the low-impact group. Within 9 months, the posttraumatic distress of the high-impact group was reduced, accompanied by an increase in morning and a decrease in evening cortisol levels. There were significant relationships between evening cortisol and all rating scales at the first and third time points. CONCLUSIONS: Subclinical posttraumatic stress following an adverse event can be measured biologically via salivary cortisol levels soon after the event.

Salivary cortisol and serum prolactin in relation to stress rating scales in a group of rescue workers.

BACKGROUND: Rescue service personnel are often exposed to traumatic events as part of their occupation, and higher prevalence rates of psychiatric illness have been found among this group. METHODS: In 65 rescue workers, salivary cortisol at 8 AM and 10 PM and serum prolactin at 8 AM were related to the psychiatric self-rating scale General Health Questionnaire (GHQ-28) measuring psychiatric health, and the Impact of Events Scale (IES) and Post Traumatic Symptom Scale (PTSS) measuring posttraumatic symptoms. RESULTS: Seventeen percent of the study population scored above the GHQ-28 cut-off limit but none scored beyond the cut-off limit in the IES and PTSS questionnaires. Salivary cortisol concentration at 10 PM correlated with statistical significance to anxiety (p < .005) and depressive symptoms (p < .01) measured with GHQ-28, as well as to posttraumatic symptoms, with avoidance behavior measured with IES (p < .01) and PTSS (p < .005). Two of the rescue workers were followed over time with the same sampling procedure after a major rescue commission. CONCLUSIONS: The correlation between evening salivary cortisol and anxiety, depressiveness, and posttraumatic avoidance symptoms indicates that these parameters can be used in screening and follow-up after traumatic stress events.

Effects of amitriptyline on rat plasma and brain content of monoamine precursors and other large neutral amino acids.

Amitriptyline caused decreased concentrations in rat plasma of the amino acids tyrosine and tryptophan, which are precursors to monoaminergic neurotransmitters, and also of those other large neutral amino acids (LNAAs) (valine, phenylalanine, leucine and isoleucine) with which tyrosine and tryptophan compete for the carrier-mediated transport from plasma into the brain. The various LNAAs were, however, not decreased to the same extent. Thus, the relative concentrations, calculated as the ratio of each one of them to the total concentration of LNAAs, were also influenced by amitriptyline. The relative concentrations of tryptophan were decreased while the relative concentrations of phenylalanine and leucine were increased. Those of tyrosine, valine and isoleucine were not influenced by amitriptyline. The relative concentrations of the LNAAs in plasma are considered to be of importance to how much of each of them that will be transported into the brain. Based on this assumption one would have expected that the amitriptyline-induced changes in the relationships between different LNAAs would have caused changes in their brain concentrations in accordance with their relative concentrations in plasma. However, amitriptyline caused decreased concentrations of all LNAAs in rat whole brain. This finding cannot be explained by altered relationships between the LNAAs but must be explained by other mechanisms. Nevertheless, this effect of amitriptyline on brain LNAA concentrations might be of importance to monoamine function.

Diurnal rhythm in absolute and relative concentrations of large neutral amino acids in human plasma.

In order to obtain detailed information on the diurnal plasma rhythmicity in those large neutral amino acids (LNAA) which compete with each other for carrier-mediated transport from plasma into the brain, blood samples were collected every hour for 24h from six healthy men, aged 25-50 yr. The well-known diurnal rhythm in the concentration of plasma amino acids was confirmed and is described in greater detail in this paper. These data might be helpful in clinical situations where LNAAs (e.g. L-dopa, alpha-methyldopa and tryptophan) are used as therapeutic agents, since these amino acids compete with endogenous LNAAs for carrier-mediated transport from plasma into the brain. Furthermore, it was found that the amplitude of variation differed between the individual LNAAs. In addition the relationships between them, expressed as ratios of the concentrations of each single LNAA to total LNAA concentration also possess diurnal rhythms, different from those observed in absolute LNAA concentrations. This rhythmicity in relative LNAA concentrations might be of importance for brain function, since altered relationships between LNAAs in plasma might bring about altered concentrations of LNAAs in the brain and consequently, in monoamine synthesis.