Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-28T00:11:17.342Z Has data issue: false hasContentIssue false
  • English
  • Français

Asymmetry of salivary cortisol and α-amylase responses to psychosocial stress in anorexia nervosa but not in bulimia nervosa

Published online by Cambridge University Press:  02 February 2011

P. Monteleone ,
P. Scognamiglio ,
B. Canestrelli ,
I. Serino ,
A. M. Monteleone  and
M. Maj
P. Monteleone*
Affiliation:
Department of Psychiatry, University of Naples SUN, Italy
P. Scognamiglio
Affiliation:
Department of Psychiatry, University of Naples SUN, Italy
B. Canestrelli
Affiliation:
Department of Psychiatry, University of Naples SUN, Italy
I. Serino
Affiliation:
Department of Experimental Medicine, University of Naples SUN, Italy
A. M. Monteleone
Affiliation:
Department of Psychiatry, University of Naples SUN, Italy
M. Maj
Affiliation:
Department of Psychiatry, University of Naples SUN, Italy
*
*Address for correspondence: P. Monteleone, M.D., Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, 80138, Naples, Italy. (Email: monteri@tin.it)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The stress response involves the activation of the hypothalamic–pituitary–adrenal (HPA) axis and the sympathetic nervous system (SNS). As a role for stress in determining of the onset and the natural course of eating disorders (EDs) has been proposed, the study of the psychobiology of the stress response in patients with anorexia nervosa (AN) and bulimia nervosa (BN) should be helpful in understanding the pathophysiology of these disorders. The two neurobiological components of the stress response can be easily explored in humans by the measurement of salivary cortisol and α-amylase response to a stressor. Therefore, we assessed salivary cortisol and α-amylase responses to the Trier Social Stress Test (TSST) in symptomatic patients with AN and BN compared to healthy controls.

Method

Seven AN women, eight BN women and eight age-matched healthy females underwent the TSST between 1530 and 1700 h. Salivary cortisol and α-amylase levels were measured by an enzyme-linked immunosorbent assay (ELISA).

Results

Compared to healthy women, AN patients showed a normal cortisol response to the TSST, although this occurred at significantly increased hormone levels, and an almost complete absence of response of α-amylase. BN women, however, exhibited enhanced pre-stress levels of salivary α-amylase but a normal response of the enzyme and cortisol to the TSST.

Conclusions

These findings demonstrate, for the first time, the occurrence of an asymmetry between the HPA axis and SNS components of the stress response in the acute phase of AN but not in BN. The pathophysiological significance of this asymmetry remains to be determined.

Keywords

Alpha-amylaseanorexia nervosabulimia nervosacortisolstress
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 9 , September 2011 , pp. 1963 - 1969
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adam, TC, Epel, ES (2007). Stress, eating and the reward system. Physiology and Behaviour 91, 449–458.CrossRefGoogle ScholarPubMed
Bauer, AM, Quas, JA, Boyce, WT (2002). Associations between physiological reactivity and children's behavior: advantages of a multisystem approach. Journal of Developmental and Behavioral Pediatrics 23, 102–113.CrossRefGoogle ScholarPubMed
Blinder, BJ, Hagman, J (1986). Serum salivary isoamylase levels in patients with anorexia nervosa, bulimia or bulimia nervosa. Hillside Journal of Clinical Psychiatry 8, 152–163.Google ScholarPubMed
Britton, KT, Segal, DS, Kuczenski, R, Hauger, R (1992). Dissociation between in vivo hippocampal norepinephrine response and behavioral neuroendocrine responses to noise stress in rats. Brain Research 574, 125–130.CrossRefGoogle ScholarPubMed
Cannon, WB (1914). The interrelations of emotions as suggested by recent physiological researches. American Journal of Psychology 25, 256–282.CrossRefGoogle Scholar
Chatterton, Jr. RT, Vogelsong, KM, Lu, YC, Ellman, AB, Hudgens, GA (1996). Salivary alpha-amylase as a measure of endogenous adrenergic activity. Clinical Physiology 16, 433–448.CrossRefGoogle ScholarPubMed
Chatterton, Jr. RT, Vogelsong, KM, Lu, YC, Hudgens, GA (1997). Hormonal responses to psychological stress in men preparing for skydiving. Journal of Clinical Endocrinology and Metabolism 82, 2503–2509.Google ScholarPubMed
Chrousos, GP, Gold, PW (1992). The concepts of stress and stress system disorders: overview of physical and behavioral homeostasis. Journal of the American Medical Association 267, 1244–1252.CrossRefGoogle ScholarPubMed
Corstorphine, E, Mountford, V, Tomlinson, S, Waller, G, Meyer, C (2007). Distress tolerance in the eating disorders. Eating Behavior 8, 91–97.CrossRefGoogle ScholarPubMed
Dixon, J (1985). BMDP Statistical Software. University of California Press: Berkeley, CA.Google Scholar
Ehlert, U, Erni, K, Hebisch, G, Nater, U (2006). Salivary alpha-amylase levels after yohimbine challenge in healthy men. Journal of Clinical Endocrinology and Metabolism 91, 5130–5133.CrossRefGoogle ScholarPubMed
El-Sheikh, M, Erath, SA, Buckhalt, JA, Granger, DA, Mize, J (2008). Cortisol and children's adjustment: the moderating role of sympathetic nervous system activity. Journal of Abnormal Child Psychology 36, 601–611.CrossRefGoogle ScholarPubMed
Fairburn, CG, Bohn, K (2005). Eating disorder NOS (EDNOS): an example of the troublesome ‘not otherwise specified’ (NOS) category in DSM-IV. Behavioral Research and Therapeutics 43, 691–701.CrossRefGoogle ScholarPubMed
Fairburn, CG, Harrison, PJ (2003). Eating disorders. Lancet 361, 407–416.CrossRefGoogle ScholarPubMed
First, MB, Gibbon, M, Spitzer, RL, Williams, JBW (1996). Structured Clinical Interview for Axis I DSM-IV Disorders – Non-Patient Edition (SCID-I/NP, Version 2.0). New York State Psychiatric Institute, Biometrics Research Department: New York.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JB (1995). Structured Clinical Interview for DSM-IV Axis I Disorders – Patient Edition (SCID-I/P, Version 2). New York State Psychiatric Institute, Biometrics Research Department: New York.Google Scholar
Gwirtsman, HE, Kaye, WH, George, DT, Carosella, NW, Greene, RC, Jimerson, DC (1989). Hyperamylasemia and its relationship to binge-purge episodes: development of a clinically relevant laboratory test. Journal of Clinical Psychiatry 50, 196–204.Google ScholarPubMed
Habib, KE, Gold, PW, Chrousos, GP (2001). Neuroendocrinology of stress. Neuroendocrinology 30, 695–728.Google ScholarPubMed
Hagan, MM, Shuman, ES, Oswald, KD, Corcoran, KJ, Profitt, JH, Blackburn, K, Schwiebert, MW, Chandler, PC, Birbaum, MC (2002). Incidence of chaotic eating behaviours in binge-eating disorder: contributing factors. Behavioral Medicine 28, 99–105.CrossRefGoogle ScholarPubMed
Jacobi, C, Hayward, C, de Zwaan, M, Kraemer, HC, Agras, WS (2004). Coming to terms with risk factors for eating disorders: application of risk terminology and suggestions for a general taxonomy. Psychological Bulletin 130, 19–65.CrossRefGoogle ScholarPubMed
Kirschbaum, C, Hellhammer, DH (1989). Salivary cortisol in psychobiological research: an overview. Neuropsychobiology 22, 150–169.CrossRefGoogle ScholarPubMed
Kirschbaum, C, Pirke, K, Hellhammer, DH (1993). The ‘Trier Social Stress Test’: a tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology 28, 76–81.CrossRefGoogle Scholar
Kreipe, RE, Goldestein, B, DeKing, DE, Tipton, R, Kempski, MH (1994). Heart rate power spectrum analysis of autonomic dysfunction in adolescents with anorexia nervosa. International Journal of Eating Disorders 16, 159–165.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
Kronvall, P, Fahy, TA, Isaksson, A, Theander, S (1992). The clinical relevance of salivary α-amylase monitoring in bulimia nervosa. Biological Psychiatry 32, 156–163.CrossRefGoogle Scholar
Lo Sauro, C, Ravaldi, C, Cabras, PL, Faravelli, C, Ricca, V (2008). Stress, hypothalamic-pituitary-adrenal axis and eating disorders. Neuropsychobiology 57, 95–115.CrossRefGoogle ScholarPubMed
Murialdo, G, Casu, M, Falchero, M, Brugnolo, A, Patrone, V, Cerro, PF, Ameri, P, Andraghetti, G, Briatore, L, Copello, F, Cordera, R, Rodriguez, G, Ferro, AM (2007). Alterations in the autonomic control of heart rate variability in patients with anorexia or bulimia nervosa: correlations between sympathovagal activity, clinical features, and leptin levels. Journal of Endocrinological Investigation 30, 356–362.CrossRefGoogle ScholarPubMed
Nater, UM, La Marca, R, Florin, L, Moses, A, Langhans, W, Koller, MM, Ehlert, U (2006). Stress-induced change in human salivary alpha-amylase activity – associations with adrenergic activity. Psychoneuroendocrinology 31, 49–58.CrossRefGoogle ScholarPubMed
Petretta, M, Bonaduce, D, Scalfi, L, de Filippo, E, Marciano, F, Migaux, ML, Themistoclakis, S, Ianniciello, A, Contaldo, F (1997). Heart rate variability as a measure of autonomic nervous system function in anorexia nervosa. Clinical Cardiology 20, 219–224.CrossRefGoogle ScholarPubMed
Pike, KM, Wilfley, D, Hilbert, A, Fairburn, C, Dohm, F, Striegel-Moore, R (2006). Antecedent life events of binge-eating disorder. Psychiatric Research 142, 19–29.CrossRefGoogle ScholarPubMed
Rechlin, T, Weis, M, Ott, C, Bleichner, F, Joraschky, P (1998). Alterations of autonomic cardiac control in anorexia nervosa. Biological Psychiatry 43, 358–363.CrossRefGoogle ScholarPubMed
Rohleder, N, Nater, UM, Wolf, JM, Ehlert, U, Kirschbaum, C (2004). Psychosocial stress-induced activation of salivary alpha-amylase: an indicator of sympathetic activity? Annals of the New York Academy of Sciences 1032, 258–263.CrossRefGoogle ScholarPubMed
Rojo, L, Conesa, L, Bermudez, O, Livianos, L (2006). Influence of stress in the onset of eating disorders: data from a two-stage epidemiologic controlled study. Psychosomatic Medicine 68, 628–635.CrossRefGoogle ScholarPubMed
Takai, N, Yamaguchi, M, Aragaki, T, Eto, K, Uchisashi, K, Nishikawa, Y (2004). Effect of psychological stress on the salivary cortisol and amylase levels in healthy young adults. Archives of Oral Biology 49, 963–968.CrossRefGoogle ScholarPubMed
Tsigos, C, Chrousos, GP (2002). Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress. Journal of Psychosomatic Research 53, 865–871.CrossRefGoogle ScholarPubMed
Van Stegeren, A, Rohleder, N, Everaerd, W, Wolf, QT (2006). Salivary alpha amylase as marker for adrenergic activity during stress: effect of betablockade. Psychoneuroendocrinology 31, 137–141.CrossRefGoogle ScholarPubMed
Zonnevylle-Bender, MJS, van Goozen, SHM, Cohen-Kettenis, PT, Jansen, LMC, van Elburg, A, van Engeland, H (2005). Adolescent anorexia nervosa patients have a discrepancy between neurophysiological responses and self-reported emotional arousal to psychosocial stress. Psychiatry Research 135, 45–52.CrossRefGoogle ScholarPubMed