Hypothalamic-pituitary-adrenal and autonomic response to psychological stress in abstinent alcohol use disorder individuals with and without depressive symptomatology

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Human Psychopharmacology: Clinical and Experimental Pub Date : 2023-05-10 DOI:10.1002/hup.2867

Shariful A. Syed, Rajita Sinha, Verica Milivojevic, Alicia MacDougall, Heather LaValle, Gustavo A. Angarita, Helen C. Fox

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引用次数: 1

Abstract

Background

Stress and depression have each been associated with relapse risk. In clinical practice, chronic alcohol use is often accompanied by poor emotional and self-regulatory processes. Tonic and phasic changes in stress responsivity impact an individual's relapse risk to alcohol. A further complicating factor is the pervasive coexistence of depressive symptoms in those with Alcohol Use Disorder (AUD), where the contribution of depressive symptomatology to these processes is not well understood. Individuals with AUD (AD) (21 with and 12 without sub-clinical depressive symptoms) and 37 social drinking controls (16 with and 21 without sub-clinical depressive symptoms) as part of a more extensive study (Fox et al., 2019). All participants were exposed to two 5-min personalized guided imagery conditions (stress and neutral) in a randomized and counterbalanced order across consecutive days. Alcohol craving, negative mood, Stroop performance, and plasma measures (cortisol, adrenocorticotrophic hormone, and salivary alpha-amylase) were collected before and after imagery exposure.

Results

Elevations in autonomic response (heart rate) to imagery (stress and neutral) were observed as a function of drinking (in both depressed and non-depressed individuals with alcohol use disorder compared with depressed and non-depressed social drinkers). Conversely, suppressed cortisol following stress was observed as a function of depressive symptomatology across both drinking groups. Individuals with comorbid AD and depressive symptoms demonstrated attenuated Adrenocorticotropic Hormone and poor Stroop performance compared with the other groups, indicating an interactive effect between drinking and depression on pituitary and inhibitory systems.

Conclusion

Sub-clinical depressive pathophysiology may be distinct from drinking severity and may alter relapse-related stress adaptations during protracted abstinence from alcohol.

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有或无抑郁症状的戒断性酒精使用障碍个体的下丘脑-垂体-肾上腺和自主神经对心理应激的反应

背景:压力和抑郁都与复发风险有关。在临床实践中，慢性酒精使用通常伴随着不良的情绪和自我调节过程。应激反应的补益性和阶段性变化影响个体对酒精的复发风险。进一步的复杂因素是酒精使用障碍(AUD)患者普遍存在抑郁症状，其中抑郁症状学对这些过程的贡献尚不清楚。作为更广泛研究的一部分，AUD (AD)患者(21人有亚临床抑郁症状，12人没有亚临床抑郁症状)和37名社交饮酒对照(16人有亚临床抑郁症状，21人没有亚临床抑郁症状)(Fox et al.， 2019)。所有参与者在连续几天内以随机和平衡的顺序暴露于两个5分钟的个性化引导图像条件(压力和中性)。在图像暴露前后收集酒精渴望、消极情绪、Stroop表现和血浆测量(皮质醇、促肾上腺皮质激素和唾液α -淀粉酶)。结果观察到，饮酒对意象(压力和中性)的自主神经反应(心率)升高(在患有酒精使用障碍的抑郁和非抑郁个体中，与抑郁和非抑郁的社交饮酒者相比)。相反，在两个饮酒组中，应激后的皮质醇抑制被观察到是抑郁症状的一个功能。与其他组相比，伴有AD和抑郁症状的个体表现出促肾上腺皮质激素减弱，Stroop表现较差，表明饮酒和抑郁对垂体和抑制系统有相互作用。结论亚临床抑郁的病理生理可能不同于饮酒严重程度，并可能改变长期戒酒期间复发相关的应激适应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Human Psychopharmacology: Clinical and Experimental 医学-精神病学

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Human Psychopharmacology: Clinical and Experimental provides a forum for the evaluation of clinical and experimental research on both new and established psychotropic medicines. Experimental studies of other centrally active drugs, including herbal products, in clinical, social and psychological contexts, as well as clinical/scientific papers on drugs of abuse and drug dependency will also be considered. While the primary purpose of the Journal is to publish the results of clinical research, the results of animal studies relevant to human psychopharmacology are welcome. The following topics are of special interest to the editors and readers of the Journal: -All aspects of clinical psychopharmacology- Efficacy and safety studies of novel and standard psychotropic drugs- Studies of the adverse effects of psychotropic drugs- Effects of psychotropic drugs on normal physiological processes- Geriatric and paediatric psychopharmacology- Ethical and psychosocial aspects of drug use and misuse- Psychopharmacological aspects of sleep and chronobiology- Neuroimaging and psychoactive drugs- Phytopharmacology and psychoactive substances- Drug treatment of neurological disorders- Mechanisms of action of psychotropic drugs- Ethnopsychopharmacology- Pharmacogenetic aspects of mental illness and drug response- Psychometrics: psychopharmacological methods and experimental design