Prior research has connected posttraumatic stress disorder (PTSD) to
increased levels of catecholamines. However, studies of cortisol levels have
produced mixed results.
To examine urinary catecholamine and cortisol levels in individuals
with PTSD in a community sample.
A representative cohort of young adult community residents, assessed
periodically during a 10-year period for exposure to trauma and PTSD, was
used to select a subset for urine collection studies conducted in a sleep
laboratory across 2 consecutive nights and the intermediate day.
The sample of young adults was randomly selected from a large health
maintenance organization and is representative of the geographic area except
for the extremes of the socioeconomic status range.
A subsample was selected from the 10-year follow-up cohort (n = 913;
91.1% of the initial sample). Eligibility criteria were: (1) persons exposed
to trauma during the preceding 5 years, (2) other individuals who met PTSD
criteria, and (3) a random preselected subsample. Of 439 eligible individuals,
292 (66.5%) participated, including 69 with lifetime PTSD.
Main Outcome Measures
Measures of cortisol and catecholamine levels in urine.
The lifetime PTSD group demonstrated significantly higher catecholamine
levels than the group exposed to trauma without PTSD and the nonexposed group.
Individuals exposed to trauma without PTSD demonstrated significantly lower
urine catecholamine levels than the nonexposed and the PTSD groups. Mean cortisol
levels did not differ across groups. When analyzed by comorbidity with major
depressive disorder (MDD), the PTSD-only group did not differ in cortisol
levels from the groups with neither PTSD nor MDD. Women with MDD plus PTSD
demonstrated significantly higher cortisol levels than women with neither
disorder or with either disorder alone.
Trauma per se does not lead to sustained increases in cortisol or catecholamine
levels. Posttraumatic stress disorder is associated with higher catecholamine
levels. In contrast, persons with PTSD had neither an increase nor a decrease
in mean urinary cortisol levels. Women with PTSD and comorbid MDD had higher