The Stress-Induced Hyperprolactinemia Might Not Be that Stress-Induced as Argued: Observational Case-Control Study.

Abstract

Objective: The mechanism behind prolactin (PRL) elevation in stress-induced hyperprolactinemia (si-HP) in humans is unclear. This study aimed to investigate the effect of psychological stress and venous puncture (VP) pain on si-HP.

Methods: The study included 91 individuals (9 males, 82 females) referred for HP. Anxiety levels were assessed using the Anxiety Sensitivity Index-3 (ASI-3) and the State-Trait Anxiety Inventory (STAI-1 and STAI-2), and visual scales were used to evaluate trypanophobia, nosocomephobia, and scanxiety. Serial PRL measurements were performed with venous cannula (VC) at 0 minute (min), 30 min, and 60 min for the first 32 patients and with the VP method at the same intervals for the following 59 patients. si-HP was defined as PRL levels at 60 min (PRL 60min) decreasing to normal limits according to gender.

Results: There were 23 HP (-), 25 HP (+), and 19 si-HP individuals, as well as 24 with macroprolactinaemia. The frequency of si-HP in the VC group (n = 7/32) was similar to that in the VP group (12/59, P = .9). The prolactin levels at 0 minute (PRL0min) and prolactin levels at 60 minutes (PRL60min) levels of the VC group were similar to those of the VP group. Trypanophobia, nosocomephobia, scanxiety, ASI-3, STAI-1, and STAI-2 scale scores were similar between the si-HP group and other groups. Trypanophobia, nosocomephobia, scanxiety, ASI-3, STAI-1, and STAI-2 scales scores were not correlated with PRL0min or PRL60min levels.

Conclusion: Si-HP is independent of states momentary or trait anxiety, and phobias trypanophobia, nosocomephobia and scanxiety. In this context, the relevance of the nomenclature of si-HP is controversial.