An increased capacity for adrenal DHEA release is associated with decreased avoidance and negative mood symptoms in women with PTSD

Neuropsychopharmacology

Volumn 29, Issue 8, 2004, Pages 1546-1557

  Rasmusson, Ann M ^a,e   Vasek, Jitka ^b   Lipschitz, Deborah S ^a   Vojvoda, Dolores ^a   Mustone, Mary Ellen ^b   Shi, Quihu ^c   Gudmundsen, Gretchen ^b   Morgan, Charles A ^a   Wolfe, Jessica ^b   Charney, Dennis S ^d  

^a YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b BOSTON UNIVERSITY SCHOOL OF MEDICINE   (United States)

^c NEW YORK MEDICAL COLLEGE   (United States)

^d NATIONAL INSTITUTE OF MENTAL HEALTH   (United States)

^e VA CONNECTICUT HEALTHCARE SYSTEM   (United States)

Author keywords

Cortisol; DHEA; HPA axis; Post traumatic stress disorder; Premenopausal women; PTSD

Indexed keywords

CORTICOTROPIN; GLUCOCORTICOID ANTAGONIST; HYDROCORTISONE; PRASTERONE; PROGESTERONE;

ADRENAL GLAND; ADULT; ARTICLE; AVOIDANCE BEHAVIOR; CLINICAL ARTICLE; CONCENTRATION RESPONSE; CONTROLLED STUDY; CORRELATION ANALYSIS; FEMALE; HORMONE BLOOD LEVEL; HORMONE RELEASE; HUMAN; MOOD DISORDER; POSTTRAUMATIC STRESS DISORDER; PREMENOPAUSE; PRIORITY JOURNAL; RATING SCALE; SCORING SYSTEM; SYMPTOM;

ADRENAL GLANDS; ADULT; AGING; BEHAVIOR; COSYNTROPIN; DEHYDROEPIANDROSTERONE; DEHYDROEPIANDROSTERONE SULFATE; ESTROGENS; FEMALE; HUMANS; HYDROCORTISONE; MENSTRUAL CYCLE; MOOD DISORDERS; PROGESTERONE; PSYCHIATRIC STATUS RATING SCALES; STRESS DISORDERS, POST-TRAUMATIC;

EID: 3242791689     PISSN: 0893133X     EISSN: None     Source Type: Journal    
DOI: 10.1038/sj.npp.1300432     Document Type: Article

References (112)

1. Altemus M, Redwine L, Leong Y-M, Yoshikawa T, Yehuda R, Detera-Wadleigh S et al (1997). Reduced sensitivity to glucocorticoid feedback and reduced glucocorticoid receptor mRNA expression in the luteal phase of the menstrual cycle. Neuropsychopharmacology 17: 100-109.
2. Altemus M, Roca C, Galliven E, Romanos C, Deuster P (2001). Increased vasopressin and adrenocorticotropin responses to stress in the midluteal phase of the menstrual cycle. J Clin Endocrin Metab 86: 2525-2530.
3. American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders 4th edn. American Psychiatric Association: Washington, DC.
4. Araneo BA, Shelby J, Li G-Z, Ku W, Daynes RA (1993). Administration of dehydroepiandrosterone to burned mice preserves normal immunologic competence. Arch Surg 128: 318-325.
5. Arlt W, Callies F, vanVlumen JC, Koehler I, Reincke M, Bidlingmaier M et al (1999). Dehydroepiandrosterone replacement in women with adrenal insufficiency. N Engl J Med 341: 1013-1020.
6. Baker DG, West SA, Nicholson WE, Ekhator NN, Kasckow JW, Hill KK et al (1999). Serial CSF corticotropin-releasing hormone levels and adrenocortical activity in combat veterans with posttraumatic stress disorder. Am J Psychiatry 156: 585-588.
7. Barbaccia ML, Serra M, Purdy RH, Biggio G (2001). Stress and neuroactive steroids. Int Rev Neurobiol 46: 243-272.
8. Bastianetto S, Ramassamy C, Poirier J, Quirion R (1999). Dehydroepiandrosterone (DHEA) protects hippocampal cells from oxidative stress-induced damage. Mol Brain Res 66: 35-41.
9. Baulieu E-E, Robel P (1998). Dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) as neuroactive neurosteroids. Proc Natl Acad Sci USA 95: 4089-4091.
10. Bernton E, Hoover D, Galloway R, Popp K (1995). Adaptation to chronic stress in military trainees. Ann NY Acad Sci 774: 217-231.
11. Bertagna X, Escourolle H, Pinier JL, Coste J, Raux-Demay MC, Perles P et al (1994). Administration of RU 486 for 8 days in normal volunteers: antiglucocorticoid effect with no evidence of peripheral cortisol deprivation. J Clin Endocrinol Metab 78: 375-380.
12. Blake DD, Weathers FW, Nagy LM (1993). A clinician rating scale for assessing current and lifetime PTSD: the CAPS-I. Behav Ther 18: 187-188.
13. Blauer KL, Poth M, Rogers W, Bernton E (1991). DHEA antagonizes the suppressive effects of dexamethasone on lymphocyte proliferation. Endocrinology 129: 3174-3179.
14. Bohus B, DeKloet ER (1981). Adrenal steroids and extinction behavior: antagonism by progesterone, deoxycorticosterone and dexamethasone of a specific effect of corticosterone. Life Sci 28: 433-440.
15. Bremner JD, Vermetten E, Mazure CM (2000). Development and preliminary psychometric properties of an instrument for the measurement of childhood trauma: the Early Trauma Inventory. Depress Anxiety 12: 1-12.
16. Breslau N, Davis GC, Peterson EL, Schultz LR (2000). A second look at comorbidity in victims of trauma: the posttraumatic stress disorder-major depression connection. Biol Psychiatry 48: 902-909.
17. Browne ES, Wright BE, Porter JR, Svec F (1992). Dehydroepiandrosterone: antiglucocorticoid action in mice. Am J Med Sci 303: 366-371.
18. Chader GJ, Reif-Leher L (1972). Hormonal effects on the neural retina: corticoid uptake, specific binding and structural requirement for the induction of glutamine synthetase. Biochim Biophys Acta 264: 186-196.
19. Chou Y-C, Luttge WG (1998). Activated type II receptors in brain cannot rebind glucocorticoids: relationship to progesterone's antiglucocorticoid actions. Brain Res 440: 67-78.
20. Compagnone NA, Mellon SH (2000). Neurosteroids: biosynthesis and function of these novel neuromodulators. Front Neuroendocrinol 21: 1-56.
21. Cruess DG, Antoni MH, Kumar M, Ironson G, McCabe P, Fernandez JB et al (1999). Cognitive-behavioral stress management buffers decreases in dehydroepiandrosterone sulfate (DHEA-S) and increases in the cortisol/DHEA-S ratio and reduces mood disturbance and perceived stress among HIV-seropositive men. Psychoneuroendocrinology 24: 537-549.
22. Daynes RA, Dudley DJ, Araneo BA (1990). Regulation of murine lymphokine production in vivo, II: Dehydroepiandrosterone is a natural enhancer of IL-2 synthesis by helper T cells. Eur J Immunol 19: 2319-2325.
23. De Bellis MD, Baum AS, Birmaher B, Keshavan MS, Eccard CH, Boring AM et al (1999). A.E. Bennett Research Award - developmental traumatology. Part I: Biological stress systems. Biol Psychiatry 45: 1259-1270.
24. Dickstein G, Shechner C, Nicholson WE, Rosner I, Shen-Orr Z, Adawi F et al (1991). Adrenocorticotropin stimulation test: effects of basal cortisol level, time of day, and suggested new sensitive low dose test. J Clin Endocrinol Metab 72: 773-778.
25. Diggle PJ, Liang K-Y, Zeger SL (1994). Analysis of Longitudinal Data. Oxford Science Publications: Oxford, England.
26. Erosheva EA, Salek FS, Stone RA, Folan MM, Greenhouse J, Kroboth PD (2000). Characterizing the diurnal rhythm of DHEA and effects of an oral dose of alprazolam. Biol Psychiatry 47: 145S.
27. Fabian TJ, Dew MA, Pollock BG, Reynolds III CF, Mulsant BH, Butters MA et al (2001). Endogenous concentrations of DHEA and DHEA-S decrease with remission of depression in older adults. Biol Psychiatry 50: 767-774.
28. First MB, Spitzer RL, Gibbon M, Williams JB (1995a). Structured Clinical Interview for the DSM-IV Axis I Disorders-NonPatient Edition (SCID-I/NP, Version 2.0). Biometrics Research Department, New York State Psychiatric Institute: NewYork, NY.
29. First MB, Spitzer RL, Gibbon M, Williams JB (1995b). Structured Clinical Interview for the DSM-IV Axis I Disorders-Patient Edition (SCID-I/P, Version 2.0). Biometrics Research Department, New York State Psychiatric Institute: NewYork, NY.
30. Friedman MJ, McDonagh-Coyle AS, Jalowiec JE, Wang S, Fournier DA, McHugo GJ (2001). Neurohormonal findings during treatment of women with PTSD due to childhood sexual abuse (CSA) Abstract for the 17th Annual Meeting for the International Society for Traumatic Stress Studies, New Orleans, LA. p 45.
31. Genazzani AR, Petraglia F, Bernardi F, Casarosa E, Salvestroni C, Tonetti A et al (1998). Circulating levels of allopregnanolone in humans: gender, age, and endocrine influences. J Clin Endocrinol Metab 83: 2099-2103.
32. Giesen EM, Beck G (1982). Hormonal deinduction of tyrosine aminotransferase. Horm Metab Res 14: 252-256.
33. Gold PW, Drevets WC, Charney DS (2002). New insights into the role of cortisol and the glucocorticoid receptor in severe depression. Biol Psychiatry 52: 381-385.
34. Gonzalez-Bono E, Rohleder N, Hellhammer DH, Salvador A, Kirschbaum C (2002). Glucose but not protein or fat load amplifies the cortisol response to psychosocial stress. Hormone Behav 41: 328-333.
35. Goodyer IM, Herbert J, Altham PME (1998). Adrenal steroid secretion and major depression in 8- to 16-year-olds, III. Influence of cortisol/DHEA ratio at presentation on subsequent rates of disappointing life events and persistent major depression. Psychol Med 28: 265-273.
36. Grossman R, Yehuda R, New A, Schmeidler J, Silverman J, Mitropoulou V, Maria St N, Golier J, Siever L (2003). Dexamethasone suppression test findings in subjects with personality disorders: associations with posttraumatic stress disorder and major depression. Am J Psychiatry 160: 1291-1297.
37. Grundemann D, Schechinger B, Rappold GA, Schomig E (1998). Molecular identification of the cortisone-sensitive extraneuronal catecholamine transporter. Nat Neurosci 1: 349-351.
38. Heim C, Newport DJ, Heit S, Graham YP, Wilcox M, Bonsall R et al (2000). Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. JAMA 284: 592-597.
39. Heim C, Newport DJ, Wagner D, Wilcox MM, Miller AH, Nemeroff CB (2002). The role of early adverse experience and adulthood stress in the prediction of neuroendocrine stress reactivity in women: a multiple regression analysis. Depress Anx 15: 117-125.
40. Heinz A, Weingartner H, George D, Hommer D, Wolkowitz OM, Linnoila M (1999). Severity of depression in abstinent alcoholics is associated with monoamine metabolites and dehydroepiandrosterone-sulfate concentrations. Psychiatry Res 89: 97-106.
41. Heptulla RA, Tamborlane WV, Ma TYZ, Rife F, Sherwin RS (2001). Oral glucose augments the counterregulatory hormone response during insulin-induced hypoglycemia in humans. J Clin Endocrinol Metab 86: 645-648.
42. Heuser I, Deuschle M, Luppa P, Schweiger U, Standhardt H, Weber B (1998). Increased diurnal plasma concentrations of dehydroepiandrosterone in depressed patients. J Clin Endocrinol Metab 83: 3130-3133.
43. Hornsby PJ (1995). Biosynthesis of DHEAS by the human adrenal cortex and its age-related decline. Ann NY Acad Sci 774: 29-46.
44. Jacobs AR, Edelheit PB, Coleman AE, Herzog AG (1999). Late-onset congenital adrenal hyperplasia: a treatable cause of anxiety. Biol Psychiatry 46: 856-859.
45. Jaycox LH, Foa EB, Morral AR (1998). Influence of emotional engagement and habituation on exposure therapy for PTSD. Ann NY Acad Sci 66: 185-192.
46. Judd AM, Call GB, Barney M, McIlmoil CJ, Balls AG, Adams A et al (2000). Possible function of IL-6 and TNF as intraadrenal factors in the regulation of adrenal steroid secretion. Ann NY Acad Sci 917: 628-637.
47. Kaiser N, Mayer M, Milholland RJ, Rosen F (1979). Studies on the anti-glucocorticoid actions of progesterone in rat thymocytes: early in vitro effects. J Steroid Biochem 10: 379-386.
48. Kaminska M, Harris J, Gilsbers K, Dubrovsky B (2000). Dehydroepiandrosterone sulfate (DHEAS) counteracts decremental effects of corticosterone on dentate gyrus LTP. Implications for depression. Brain Res Bull 52: 229-234.
49. Karishma KK, Herbert J (2002). Dehydroepiandrosterone (DHEA) stimulates neurogenesis in the hippocampus of the rat, promotes survival of newly formed neurons and prevents corticosterone-induced suppression. Eur J Neurosci 16: 445-453.
50. Kaufman J, Birmaher B, Perel J, Dahl RE, Moreci P, Nelson B et al (1997). The corticotropin-releasing hormone challenge in depressed abused, depressed nonabused, and normal control children. Biol Psychiatry 42: 669-679.
51. Kellendonk C, Gass P, Kretz O, Schutz G, Tronche F (2002). Corticosteroid receptors in the brain: gene targeting studies. Brain Res Bull 57: 73-83.
52. Keller-Wood M, Shinsako J, Dallman MF (1984). Interactions between stimulus intensity and corticosteroid feedback in control of ACTH. Am J Physiology 247: E489-E494.
53. Kimonides VG, Khatibi NH, Svendsen CN, Sofroniew MV, Herbert J (1998). Dehydroepiandrosterone (DHEA) and DHEA-sulfate (DHEAS) protect hippocampal neurons against excitatory amino acid-induced neurotoxicity. Proc Natl Acad Sci USA 95: 1852-1857.
54. Kirschbaum C, Kudielka BM, Gaap J, Schommer NC, Hellhammer DH (1999). Impact of gender, menstrual cycle phase, and oral contraceptives on the activity of the hypothalamus-pituitary-adrenal axis. Psychosom Med 61: 154-162.
55. Kosten TR, Wahby VS, Giller E, Mason J (1990). The dexamethasone suppression and TRH stimulation tests in post traumatic stress disorder. Biol Psychiatry 28: 657-664.
56. Kruyt N, Rolland R (1982). Cortisol, 17α-OH-progesterone and androgen responses to a standardized ACTH-stimulation test in different stages of the normal menstrual cycle. Acta Endocrinol 100: 427-433.
57. Kudielka BM, Hellhammer J, Hellhammer DH, Wolf OT, Pirke K-M, Varadi E et al (1998). Sex differences in endocrine and psychological responses to psychosocial stress in healthy elderly subjects and the impact of a two-week DHEA treatment. J Clin Endocrinol Metab 83: 1756-1761.
58. Legradi G, Holzer D, Kapcala LP, Lechan RM (1997). Glucocorticoids inhibit stress-induced phosphorylation of CREB in corticotropin-releasing hormone neurons of the hypothalamic paraventricular nucleus. Neuroendocrinology 66: 86-97.
59. Leibenluft E, Fiero PL, Rubinow DR (1994). Effects of the menstrual cycle on dependent variables in mood disorder research. Arch Gen Psychiatry 51: 761-781.
60. Lemieux A, Coe C (1995). Abuse-related posttraumatic stress disorder: evidence for chronic neuroendocrine activation in women. Psychsom Med 57: 105-115.
61. Lipschitz DS, Rasmusson AM, Yehuda R, Wang S, Anyan W, Gueoguieva R et al (2003). Salivary cortisol responses to dexamethasone in adolescents with posttraumatic stress disorder. J Am Acad Child Adol Psychiatry 42: 1310-1317.
62. Lupien S, deLeon M, deSanti S, Convit A, Tarshish C, Nair NPV et al (1998). Cortisol levels during human aging predict hippocampal atrophy and memory deficits. Nat Neurosci 1: 69-73.
63. Lupien SG, Gillin CJ, Hauger RL (1999). Working memory is more sensitive than declarative memory to the acute effects of corticosteroids: a dose-response study in humans. Behav Neurosci 113: 420-430.
64. Maes M, Lin A, Bonaccorso S, Van Hunsel F, Van Gastel A, Delmeire L et al (1998). Increased 24-hour urinary cortisol excretion in patients with post-traumatic stress disorder and patients with major depression, but not in patients with fibromyalgia. Acta Psychiatr Scand 98: 328-335.
65. Mason J, Wang S, Yehuda R, Lubin H, Johnson D, Bremner JD et al (2002). Marked lability in urinary free cortisol levels in subgroups of combat veterans with posttraumatic stress disorder during an intensive exposure treatment program. Psychosom Med 6: 234-238.
66. Mason JW, Giller EL, Kosten TR, Ostroff RB, Rodd L (1986). Urinary-free cortisol levels in post-traumatic stress disorder patients. J Nerv Ment Dis 174: 145-159.
67. McEwen B (2002). Estrogen actions throughout the brain. Recent Prog Hormone Res 57: 357-384.
68. McEwen BS (2000). Allostasis and allostatic load: implications for neuropsychopharmacology. Neuropsychopharmacology 22: 108-124.
69. Merke DP, Keil ME, Negro PJ, Gold P, Chrousos GP (1999). 21-hydroxylase deficient carriers reset their hypothalamic-pituitary axis to normalize cortisol production: potential relation to mood changes leading to a selective advantage Endocrine Society Meeting Poster Abstract PI-659.
70. Michael A, Jenaway A, Paykel ES, Herbert J (2000). Altered salivary dehydroepiandrosterone levels in major depression in adults. Biol Psychiatry 48: 989-995.
71. Morfin R, Starka L (2001). Neurosteroid 7-hydroxylation products in the brain. Int Rev Neurobiol 46: 79-95.
72. Morgan III CA, Hazlett G, Southwick S, Rasmusson A, Hoyt G, Zimolo Z et al (2004). Relationships among plasma DHEA(S), cortisol, symptoms of dissociation and objective performance in humans exposed to acute stress. Arch Gen Psychiatry (in press).
73. Morgan III CA, Wang S, Mason J, Southwick SM, Fox P, Hazlett G, Charney DS, Greenfield G (2000). Hormone profiles in humans experiencing military survival training. Biol Psychiatry 47: 891-901.
74. Munck A, Guyre PM, Holbrook NJ (1984). Physiological functions of glucocorticoids in stress and their relation to pharmacological actions. Endocrine Rev 93: 9779-9783.
75. Neslter JE (1996). Advances in understanding the regulation and biologic actions of dehydroepiandrosterone. Curr Opin Endocrinol Diabetes 3: 202-211.
76. Newcomer JW, Selke G, Melson AK, Hershey T, Craft S, Richards K et al (1999). Decreased memory performance in healthy humans induced by stress-level cortisol treatment. Arch Gen Psychiatry 56: 527-533.
77. Oberbeck R, Benschop RJ, Jacobs R, Hosch W, Jetschmann JU, Schurmeyer TH et al (1998). Endocrine mechanims of stress-induced DHEA-secretion. J Endocrinol Invest 21: 148-153.
78. Parker L, Eugene J, Farber D, Lifrak E, Lai M, Juler G (1985a). Dissociation of adrenal androgens and cortisol levels in acute stress. Horm Metabol Res 17: 209-212.
79. Parker LN, Levin ER, Lifrak ET (1985b). Evidence for adrenocortical adaptation to severe illness. Endocrinol Metab 60: 947-952.
80. Path G, Bornstein SR, Ehrhart-Bornstein M, Scherbaum WA (1997). Interleukin-6 and the interleukin-6 receptor in the human adrenal gland: expression and effects on steroidogenesis. J Clin Endocrin Metab 82: 2343-2349.
81. Pitman R, Orr S (1990). Twenty-four hour urinary cortisol and catecholamine excretion in combat-related posttraumatic stress disorder. Biol Psychiatry 27: 245-247.
82. Prasad A, Imamura M, Prasad C (1997). Dehydroepiandrosterone decreases behavioral despair in high- but not low-anxiety rats. Physiol Behav 62: 1053-1057.
83. Quinkler M, Meyer B, Oelkers W, Diederich S (2003). Renal inactivation, mineralocorticoid generation, and 11B-hydroxysteroid dehydrogenase inhibition ameliorate the antimineralocorticoid effect of progesterone in vivo. J Clin Endocrinol Metab 88: 3767-3772.
84. Rasmusson AM, Lipschitz DS, Wang S, Hu S, Vojvoda D, Bremner JD et al (2001). Increased pituitary and adrenal reactivity in premenopausal women with PTSD. Biol Psychiatry 50: 965-977.
85. Rinne T, de Kloet ER, Wouters L, Goekoop JG, DeRijk RH, van den Brink W (2002). Hyperresponsiveness of hypothalamic-pituitary-adrenal axis to combined dexamethasone/corticotropin-releasing hormone challenge in female borderline personality disorder subjects with a history of sustained childhood abuse. Biol Psychiatry 52: 1102-1112.
86. Rinne T, deKloet ER, Wouters L, Goekoop JG, de Rijk RH, van den Brink W (2003). Fluvoxamine reduces responsiveness of HPA axis in adult female BPD patients with a history of sustained childhood abuse. Neuropsychopharmacology 28: 126-132.
87. Roca CA, Schmidt PJ, Altemus M, Deuster P, Danaceau MA, Putnam K et al (2003). Differential menstrual cycle regulation of hypothalamic-adrenal axis in women with premenstrual syndrome and controls. J Clin Endocrinol Metab 88: 3057-3063.
88. Rose KA, Stapleton G, Dott K, Kieny MP, Best R, Schwarz M et al (1997). Cyp7b, a novel brain cytochrome P450, catalyzes the synthesis of neurosteroids 7a-hydroxy dehydroepiandrosterone and 7a-hydroxy pregnenolone. Proc Natl Acad Sci USA 94: 4925-4930.
89. Rosenfeld RS, Hellman L, Roffwarg H, Weitzman ED, Fukushima DK, Gallagher TF (1971). Dehydroisoandrosterone is secreted episodically and synchronously with cortisol by normal man. J Clin Endocrinol 33: 87-92.
90. Rupprecht R, Holsboer F (1999). Neuroactive steroids: mechanisms of action and neuropharmacological perspectives. Trends Neurosci 22: 410-416.
91. Sapolsky R (1985). A mechanism for glucocorticoid toxicity in the hippocampus: increased neuronal vulnerability to metabolic insults. J Neurosci 5: 1228-1232.
92. Sapolsky R (1986). Glucocorticoid toxicity in the hippocampus: synergy with an excitotoxin. Neuroendocrinology 43: 440-446.
93. Schmidt PJ, Raju J, Danaceau M, Murphy DL, Berlin RE (2002). The effects of gender and gonadal steroids on the neuroendocrine and temperature response to m-chlorophenylpiperazine in leuprolide-induced hypogonadism in women and men. Neuropsychopharmacology 27: 800-812.
94. Schulkin J, Gold PW, McEwen BS (1998). Induction of corticotropin- releasing hormone gene expression by glucocorticoids: implication for understanding the states of fear and anxiety and allostatis load. Psychoneuroendocrinology 23: 219-243.
95. Sondergaard HP, Hansson L-O, Theorell T (2002). Elevated blood levels of dehydroepiandrosterone sulphate vary with symptom load in posttraumatic stress disorder: findings from a longitudinal study of refugees in Sweden. Psychother Psychosom 71: 298-303.
96. Southwick SM, Bremner JD, Rasmusson A, Morgan CA, Arnsten A, Charney DS (1999). Role of norepinephrine in the pathophysiology and treatment of posttraumatic stress disorder. Biol Psychiatry 46: 1192-1204.
97. A-antagonistic neurosteroids in patients with combat-related post-traumatic stress disorder. Psychol Med 30: 1227-1231.
98. Stein MB, Yehuda R, Koverola C, Hanna C (1997). Enhanced dexamethasone suppression of plasma cortisol in adult women traumatized by childhood sexual abuse. Biol Psychiatry 42: 680-686.
99. Strous R, Maayan R, Lapidus R, Stryjer R, Lustig M, Kotler M et al (2003). Dehydroepiandrosterone augmentation in the management of negative, depressive, and anxiety symptoms in schizophrenia. Arch Gen Psychiatry 60: 133-141.72.
100. Turner BB (1997). Influence of gonadal steroids on brain corticosteroid receptors: minireview. Neurochem Res 22: 1375-1385.
101. Van Haarst AD, Oitzl MS, Workel JO, De Kloet ER (1996). Chronic brain glucocorticoid receptor blockade enhances the rise in circadian and stress-induced pituitary-adrenal activity. Endocrinology 137: 4935-4943.
102. Viau V (2002). Functional cross-talk between the hypothalamic-pituitary- gonadal and -adrenal axes. J Neuroendocrinol 14: 506-513.
103. Walker DL, Davis M (2002). The role of amygdala glutamate receptors in fear learning, fear-potentiated startle, and extinction. Pharm Biochem Behav 71: 379-392.
104. Witchel S, Lee P (1998). Identification of heterozygotic carriers of 21-hydroxylase deficiency: sensitivity of ACTH stimulation tests. Am J Med Genet 76: 337-342.
105. Witchel S, Lee P, Suda-Hartman S, Trucco M, Hoffman E (1997). Evidence for a heterozygote advantage in congenital adrenal hyperplasia due to 21-hydroxylase deficiency. J Clin Endocrinol Metab 82: 2097-2101.
106. Wolkowitz OM, Reus VI, Keebler A, Nelson N, Friedland M, Brizendine L et al (1999). Double-blind treatment of major depression with dehydroepiandrosterone. Am J Psychiatry 156: 646-649.
107. Yaffe K, Ettinger B, Pressman A, Seeley D, Whooley M, Schaefer C et al (1998). Neuropsychiatric function and dehydroepiandrosterone sulfate in elderly women: a prospective study. Biol Psychiatry 43: 694-700.
108. Yehuda R, Boisoneau D, Mason JW, Giller EL (1993). Relationship between lymphocyte glucocorticoid receptor number and urinary-free cortisol excretion in mood, anxiety, and psychotic disorder. Biol Psychiatry 34: 18-25.
109. Yehuda R, Kahana B, Binder-Brynes K, Southwick S, Mason J, Giller E (1995). Low urinary cortisol excretion in holocaust survivors with posttraumatic stress disorder. Am J Psychiatry 152: 982-986.
110. Yehuda R, Southwick SM, Nussbaum G, Wahby V, Giller EL, Mason JW (1990). Low urinary cortisol excretion in patients with posttraumatic stress disorder. J Nerv Ment Dis 178: 366-369.
111. Young AH, Gallagher P, Porter RJ (2002). Elevation of the cortisol-dehydroepiandrosterone ratio in drug-free depressed patients. Am J Psychiatry 159: 1237-1239.
112. Zhang L, Li B, Ma W, Barker JL, Chang YH, Zhao W et al (2002). Dehydroepiandrosterone (DHEA) and its sulfated derivative (DHEAS) regulate apoptosis during neurogenesis by triggering the Akt signaling pathway in opposing ways. Brain Res Mol Brain Res 98: 58-66.