Depression and Anxiety Correlate Differently with Salivary Free Cortisol in the Morning in Patients with Functional Somatic Syndrome |
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Authors: | Hiromi Mutsuura Kenji Kanbara Mikihiko Fukunaga Kazumi Yamamoto Ikumi Ban Kana Kitamura Yoshihide Nakai |
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Institution: | (1) Department of Psychosomatic Medicine, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi-shi, Osaka 570-8507, Japan |
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Abstract: | Patients presenting with functional somatic syndrome (FSS) are common, and the symptoms are persistent and difficult to treat
for doctors and costly for society. The aim of this study was to clarify the common pathophysiology of FSS, especially the
relationship between hypothalamic-pituitary-adrenal (HPA) axis function and psychological characteristics of patients with
FSS. The subjects were 45 patients with FSS and 29 healthy controls. Salivary free cortisol was measured in the morning, and
psychological tests examining depression, anxiety and quality of life (QOL) were performed on the same day. In patients with
FSS, depressive scores showed a significant negative correlation with salivary free cortisol in the morning, although in healthy
controls, cortisol showed a significant positive correlation with depressive scores. In addition, the correlation between
other psychological test scores and cortisol secretion in patients with FSS contrasted with that of controls. The relationship
between cortisol and depression, anxiety or QOL, suggests that the HPA axis of patients with FSS is dysfunctional and does
not function properly when patients with FSS are under stress. This dysfunction may explain the pathology of medically unexplained
persistent symptoms of patients with FSS. |
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