Hostname: page-component-848d4c4894-mwx4w Total loading time: 0 Render date: 2024-06-16T19:57:52.086Z Has data issue: false hasContentIssue false

Posttraumatic stress disorder and incidence of thyroid dysfunction in women

Published online by Cambridge University Press:  29 November 2018

Sun Jae Jung*
Affiliation:
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
Jae H. Kang
Affiliation:
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
Andrea L. Roberts
Affiliation:
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Kristen Nishimi
Affiliation:
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Qixuan Chen
Affiliation:
Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
Jennifer A. Sumner
Affiliation:
Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY, USA
Laura Kubzansky
Affiliation:
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Karestan C. Koenen
Affiliation:
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
*
Author for correspondence: Sun Jae Jung, E-mail: sunjaejung@yuhs.ac

Abstract

Background

Abnormal thyroid function is prevalent among women and has been linked to increased risk of chronic disease. Posttraumatic stress disorder (PTSD) has been linked to thyroid dysfunction in some studies; however, the results have been inconsistent. Thus, we evaluated trauma exposure and PTSD symptoms in relation to incident thyroid dysfunction in a large longitudinal cohort of civilian women.

Methods

We used data from 45 992 women from the ongoing Nurses’ Health Study II, a longitudinal US cohort study that began in 1989. In 2008, history of trauma and PTSD were assessed with the Short Screening Scale for Diagnostic and Statistical Manual of Mental Disorders, fourth edition, PTSD, and incident thyroid dysfunction was determined by participants’ self-report in biennial questionnaires of physician-diagnosed hypothyroidism and Graves’ hyperthyroidism. The study period was from 1989 to 2013. Proportional hazard models were used to estimate multivariable-adjusted hazard ratios and 95% confidence intervals (CIs) for incident hypothyroidism and Graves’ hyperthyroidism.

Results

In multivariable-adjusted models, we found significant associations for PTSD only with hypothyroidism [p-trend <0.001; trauma with no PTSD symptoms, 1.08 (95% CI 1.02–1.15); 1–3 PTSD symptoms, 1.12 (95% CI 1.04–1.21); 4–5 PTSD symptoms, 1.23 (95% CI 1.13–1.34); and 6–7 PTSD symptoms, 1.26 (95% CI 1.14–1.40)]. PTSD was not associated with risk of Graves’ hyperthyroidism (p-trend = 0.34). Associations were similar in sensitivity analyses restricted to outcomes with onset after 2008, when PTSD was assessed.

Conclusions

PTSD was associated with higher risk of hypothyroidism in a dose-dependent fashion. Highlighted awareness for thyroid dysfunction may be especially important in women with PTSD.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2018 

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

American Thyroid Association (2017) Prevalence and Impact of Thyroid Disease. [cited 2017 07/17/2017] Available from: https://www.thyroid.org/media-main/about-hypothyroidism/Google Scholar
Ascherio, A and Munger, KL (2007) Environmental risk factors for multiple sclerosis. Part II: noninfectious factors. Annals of Neurology 61, 504513.Google Scholar
Bao, Y, Bertoia, ML, Lenart, EB, Stampfer, MJ, Willett, WC, Speizer, FE and Chavarro, JE (2016) Origin, methods, and evolution of the three nurses’ health studies. American Journal of Public Health 106, 15731581.Google Scholar
Bauer, M, Priebe, S, Graf, KJ, Kurten, I and Baumgartner, A (1994) Psychological and endocrine abnormalities in refugees from East Germany: Part II. Serum levels of cortisol, prolactin, luteinizing hormone, follicle stimulating hormone, and testosterone. Psychiatry Research 51, 7585.Google Scholar
Baumeister, D, Akhtar, R, Ciufolini, S, Pariante, CM and Mondelli, V (2016) Childhood trauma and adulthood inflammation: a meta-analysis of peripheral C-reactive protein, interleukin-6 and tumour necrosis factor-alpha. Molecular Psychiatry 21, 642649.Google Scholar
Bernstein, DP, Fink, L, Handelsman, L, Foote, J, Lovejoy, M, Wenzel, K, Sapareto, E and Ruggiero, J (1994) Initial reliability and validity of a new retrospective measure of child abuse and neglect. American Journal of Psychiatry 151, 11321136.Google Scholar
Boscarino, JA (2004) Posttraumatic stress disorder and physical illness: results from clinical and epidemiologic studies. Annals of the New York Academy of Sciences 1032, 141153.Google Scholar
Breslau, N, Peterson, EL, Kessler, RC and Schultz, LR (1999) Short screening scale for DSM-IV posttraumatic stress disorder. American Journal of Psychiatry 156, 908911.Google Scholar
British Thyroid Association (2017) UK guidelines for the use of thyroid function tests. British Thyroid Foundation (1st Ed.). Harrogate: The Association for Clinical Biochemistry, pp. 186.Google Scholar
Bunevicius, A, Leserman, J and Girdler, SS (2012) Hypothalamic-pituitary-thyroid axis function in women with a menstrually related mood disorder: association with histories of sexual abuse. Psychosomatic Medicine 74, 810816.Google Scholar
Ciloglu, F, Peker, I, Pehlivan, A, Karacabey, K, Ilhan, N, Saygin, O and Ozmerdivenli, R (2005) Exercise intensity and its effects on thyroid hormones. Neuroendocrinology Letters 26, 830834.Google Scholar
Cook, RT (1998) Alcohol abuse, alcoholism, and damage to the immune system – a review. Alcoholism: Clinical and Experimental Research 22, 19271942.Google Scholar
Dantzer, R, O'Connor, JC, Freund, GG, Johnson, RW and Kelley, KW (2008) From inflammation to sickness and depression: when the immune system subjugates the brain. Nature Review Neuroscience 9, 4656.Google Scholar
Desborough, JP (2000) The stress response to trauma and surgery. British Journal of Anaesthesia 85, 109117.Google Scholar
Dhanwal, DK (2011) Thyroid disorders and bone mineral metabolism. Indian Journal of Endocrinology and Metabolism 15, S107S112.Google Scholar
Dube, SR, Fairweather, D, Pearson, WS, Felitti, VJ, Anda, RF and Croft, JB (2009) Cumulative childhood stress and autoimmune diseases in adults. Psychosomatic Medicine 71, 243250.Google Scholar
Eker, SS, Akkaya, C, Sarandol, A, Cangur, S, Sarandol, E and Kirli, S (2008) Effects of various antidepressants on serum thyroid hormone levels in patients with major depressive disorder. Progress in Neuropsychopharmacology & Biological Psychiatry 32, 955961.Google Scholar
Fagundes, CP, Glaser, R and Kiecolt-Glaser, JK (2013) Stressful early life experiences and immune dysregulation across the lifespan. Brain, Behavior, and Immunity 27, 812.Google Scholar
Fisher, CL, Mannino, DM, Herman, WH and Frumkin, H (1997) Cigarette smoking and thyroid hormone levels in males. International Journal of Epidemiology 26, 972977.Google Scholar
Friedman, MJ, Wang, S, Jalowiec, JE, McHugo, GJ and McDonagh-Coyle, A (2005) Thyroid hormone alterations among women with posttraumatic stress disorder due to childhood sexual abuse. Biological Psychiatry 57, 11861192.Google Scholar
Girdler, SS, Thompson, KS, Light, KC, Leserman, J, Pedersen, CA and Prange, AJ Jr (2004) Historical sexual abuse and current thyroid axis profiles in women with premenstrual dysphoric disorder. Psychosomatic Medicine 66, 403410.Google Scholar
Gold, MS, Pottash, AL and Extein, I (1981) Hypothyroidism and depression. Evidence from complete thyroid function evaluation. Journal of American Medical Association 245, 19191922.Google Scholar
Gomberg-Maitland, M and Frishman, WH (1998) Thyroid hormone and cardiovascular disease. American Heart Journal 135, 187196.Google Scholar
Haviland, MG, Sonne, JL, Anderson, DL, Nelson, JC, Sheridan-Matney, C, Nichols, JG, Carlton, EI and Murdoch, WG (2006) Thyroid hormone levels and psychological symptoms in sexually abused adolescent girls. Child Abuse & Neglect 30, 589598.Google Scholar
Hayes, JP, Vanelzakker, MB and Shin, LM (2012) Emotion and cognition interactions in PTSD: a review of neurocognitive and neuroimaging studies. Frontiers in Integrative Neuroscience 6, 89.Google Scholar
Helmreich, DL and Tylee, D (2011) Thyroid hormone regulation by stress and behavioral differences in adult male rats. Hormones and Behavior 60, 284291.Google Scholar
Hoge, EA, Brandstetter, K, Moshier, S, Pollack, MH, Wong, KK and Simon, NM (2009) Broad spectrum of cytokine abnormalities in panic disorder and posttraumatic stress disorder. Depression and Anxiety 26, 447455.Google Scholar
Holm, IA, Manson, JE, Michels, KB, Alexander, EK, Willett, WC and Utiger, RD (2005) Smoking and other lifestyle factors and the risk of Graves’ hyperthyroidism. Archives of Internal Medicine 165, 16061611.Google Scholar
Hutcheon, JA, Chiolero, A and Hanley, JA (2010) Random measurement error and regression dilution bias. British Medical Journal 340, c2289.Google Scholar
Iacobellis, G, Ribaudo, MC, Zappaterreno, A, Iannucci, CV and Leonetti, F (2005) Relationship of thyroid function with body mass index, leptin, insulin sensitivity and adiponectin in euthyroid obese women. Clinical Endocrinology (Oxf) 62, 487491.Google Scholar
Johnson, RR, Prentice, TW, Bridegam, P, Young, CR, Steelman, AJ, Welsh, TH, Welsh, CJ and Meagher, MW (2006) Social stress alters the severity and onset of the chronic phase of Theiler's virus infection. Journal of Neuroimmunology 175, 3951.Google Scholar
Kang, JH, Kueck, AS, Stevens, R, Curhan, G, De Vivo, I, Rosner, B, Alexander, E and Tworoger, SS (2013) A large cohort study of hypothyroidism and hyperthyroidism in relation to gynecologic cancers. Obstetrics and Gynecology International 2013, 743721.Google Scholar
Karlovic, D, Marusic, S and Martinac, M (2004) Increase of serum triiodothyronine concentration in soldiers with combat-related chronic post-traumatic stress disorder with or without alcohol dependence. Wiener klinische Wochenschrift 116, 385390.Google Scholar
Kessler, RC, Sonnega, A, Bromet, E, Hughes, M and Nelson, CB (1995) Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry 52, 10481060.Google Scholar
Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR and Walters, EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 593602.Google Scholar
Kimerling, R, Ouimette, P and Wolfe, J (2002) Gender and PTSD. New York: Guilford Press.Google Scholar
Kolakowska, T and Swigar, ME (1977) Thyroid function in depression and alcohol abuse: a retrospective study. Archives of General Psychiatry 34, 984988.Google Scholar
Kosten, TR, Wahby, V, Giller, E Jr and Mason, J (1990) The dexamethasone suppression test and thyrotropin-releasing hormone stimulation test in posttraumatic stress disorder. Biological Psychiatry 28, 657664.Google Scholar
Kozaric-Kovacic, D, Karlovic, D and Kocijan-Hercigonja, D (2002) Elevation of serum total triiodothironine and free triiodothironine in Croatian veterans with combat-related post-traumatic stress disorder. Military Medicine 167, 846849.Google Scholar
Kudielka, BM and Wust, S (2010) Human models in acute and chronic stress: assessing determinants of individual hypothalamus-pituitary-adrenal axis activity and reactivity. Stress 13, 114.Google Scholar
Lee, B, Sur, B, Yeom, M, Shim, I, Lee, H and Hahm, DH (2016) Effects of systemic administration of ibuprofen on stress response in a rat model of post-traumatic stress disorder. The Korean Journal of Physiology & Pharmacology 20, 357366.Google Scholar
Li, N, Du, XL, Reitzel, LR, Xu, L and Sturgis, EM (2013) Impact of enhanced detection on the increase in thyroid cancer incidence in the United States: review of incidence trends by socioeconomic status within the surveillance, epidemiology, and end results registry, 1980–2008. Thyroid 23, 103110.Google Scholar
Lin, DY, Wei, LJ and Ying, Z (1993) Checking the cox model with cumulative sums of martingale-based residuals. Biometrika 80, 557572.Google Scholar
Mason, J, Weizman, R, Laor, N, Wang, S, Schujovitsky, A, Abramovitz-Schneider, P, Feiler, D and Charney, D (1996) Serum triiodothyronine elevation with posttraumatic stress disorder: a cross-cultural study. Biological Psychiatry 39, 835838.Google Scholar
McLeod, DS, Caturegli, P, Cooper, DS, Matos, PG and Hutfless, S (2014) Variation in rates of autoimmune thyroid disease by race/ethnicity in US military personnel. Journal of American Medical Association 311, 15631565.Google Scholar
Mennemeier, M, Garner, RD and Heilman, KM (1993) Memory, mood and measurement in hypothyroidism. Journal of Clinical and Experimental Neuropsychology 15, 822831.Google Scholar
Mizokami, T, Wu Li, A, El-Kaissi, S and Wall, JR (2004) Stress and thyroid autoimmunity. Thyroid 14, 10471055.Google Scholar
Morgan, CA III, Hazlett, G, Wang, S, Richardson, EG Jr, Schnurr, P and Southwick, SM (2001) Symptoms of dissociation in humans experiencing acute, uncontrollable stress: a prospective investigation. American Journal of Psychiatry 158, 12391247.Google Scholar
National Institute of Diabetes and Digestive and Kidney Diseases (2017) Hypothyroidism (Underactive Thyroid) U.S. Department of Health and Human Services. [cited 2017 07/17/2017] Available from: https://www.niddk.nih.gov/health-information/endocrine-diseases/hypothyroidism/Google Scholar
Neylan, TC, Brunet, A, Pole, N, Best, SR, Metzler, TJ, Yehuda, R and Marmar, CR (2005) PTSD symptoms predict waking salivary cortisol levels in police officers. Psychoneuroendocrinology 30, 373381.Google Scholar
Neylan, TC, Sun, B, Rempel, H, Ross, J, Lenoci, M, O'Donovan, A and Pulliam, L (2011) Suppressed monocyte gene expression profile in men versus women with PTSD. Brain, Behavior, and Immunity 25, 524531.Google Scholar
North, CS, Nixon, SJ, Shariat, S, Mallonee, S, McMillen, JC, Spitznagel, EL and Smith, EM (1999) Psychiatric disorders among survivors of the Oklahoma City bombing. Journal of American Medical Association 282, 755762.Google Scholar
O'Donovan, A, Sun, B, Cole, S, Rempel, H, Lenoci, M, Pulliam, L and Neylan, T (2011) Transcriptional control of monocyte gene expression in post-traumatic stress disorder. Disease Markers 30, 123132.Google Scholar
O'Donovan, A, Cohen, BE, Seal, KH, Bertenthal, D, Margaretten, M, Nishimi, K and Neylan, TC (2015) Elevated risk for autoimmune disorders in Iraq and Afghanistan veterans with posttraumatic stress disorder. Biological Psychiatry 77, 365374.Google Scholar
Olff, M, Guzelcan, Y, de Vries, GJ, Assies, J and Gersons, BP (2006) HPA- and HPT-axis alterations in chronic posttraumatic stress disorder. Psychoneuroendocrinology 31, 12201230.Google Scholar
Olivier, J, May, WL and Bell, ML (2017) Relative effect sizes for measures of risk. Communications in Statistics-Theory and Methods 46, 67746781.Google Scholar
Olmos, RD, Figueiredo, RC, Aquino, EM, Lotufo, PA and Bensenor, IM (2015) Gender, race and socioeconomic influence on diagnosis and treatment of thyroid disorders in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Brazilian Journal of Medical and Biological Research 48, 751758.Google Scholar
Pace, TW and Heim, CM (2011) A short review on the psychoneuroimmunology of posttraumatic stress disorder: from risk factors to medical comorbidities. Brain, Behavior, and Immunity 25, 613.Google Scholar
Pace, TW, Wingenfeld, K, Schmidt, I, Meinlschmidt, G, Hellhammer, DH and Heim, CM (2012) Increased peripheral NF-kappaB pathway activity in women with childhood abuse-related posttraumatic stress disorder. Brain, Behavior, and Immunity 26, 1317.Google Scholar
Padyukov, L, Silva, C, Stolt, P, Alfredsson, L and Klareskog, L (2004) A gene-environment interaction between smoking and shared epitope genes in HLA-DR provides a high risk of seropositive rheumatoid arthritis. Arthritis & Rheumatology 50, 30853092.Google Scholar
Palma, BD, Gabriel, A Jr, Colugnati, FA and Tufik, S (2006) Effects of sleep deprivation on the development of autoimmune disease in an experimental model of systemic lupus erythematosus. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology 291, R1527R1532.Google Scholar
Perera, S, Gavian, M, Frazier, P, Johnson, D, Spring, M, Westermeyer, J, Butcher, J, Halcon, L, Robertson, C, Savik, K and Jaranson, J (2013) A longitudinal study of demographic factors associated with stressors and symptoms in African refugees. American Journal of Orthopsychiatry 83, 472482.Google Scholar
Plaza, A, Garcia-Esteve, L, Ascaso, C, Navarro, P, Gelabert, E, Halperin, I, Valdes, M and Martin-Santos, R (2010) Childhood sexual abuse and hypothalamus-pituitary-thyroid axis in postpartum major depression. Journal of Affective Disorders 122, 159163.Google Scholar
Plaza, A, Garcia-Esteve, L, Torres, A, Ascaso, C, Gelabert, E, Luisa Imaz, M, Navarro, P, Valdes, M and Martin-Santos, R (2012) Childhood physical abuse as a common risk factor for depression and thyroid dysfunction in the earlier postpartum. Psychiatry Research 200, 329335.Google Scholar
Poppe, K, Velkeniers, B and Glinoer, D (2008) The role of thyroid autoimmunity in fertility and pregnancy. Nature Clinical Practice Endocrinology & Metabolism 4, 394405.Google Scholar
Radetti, G, Kleon, W, Buzi, F, Crivellaro, C, Pappalardo, L, di Iorgi, N and Maghnie, M (2008) Thyroid function and structure are affected in childhood obesity. The Journal of Clinical Endocrinology and Metabolism 93, 47494754.Google Scholar
Rimm, EB, Stampfer, MJ, Colditz, GA, Chute, CG, Litin, LB and Willett, WC (1990) Validity of self-reported waist and hip circumferences in men and women. Epidemiology 1, 466473.Google Scholar
Roberts, AL, Agnew-Blais, JC, Spiegelman, D, Kubzansky, LD, Mason, SM, Galea, S, Hu, FB, Rich-Edwards, JW and Koenen, KC (2015) Posttraumatic stress disorder and incidence of type 2 diabetes mellitus in a sample of women: a 22-year longitudinal study. Journal of American Medical Association Psychiatry 72, 203210.Google Scholar
Samuels, MH, Pillote, K, Asher, D and Nelson, JC (2003) Variable effects of nonsteroidal antiinflammatory agents on thyroid test results. The Journal of Clinical Endocrinology and Metabolism 88, 57105716.Google Scholar
Schindler, AE (2003) Thyroid function and postmenopause. Gynecological Endocrinology 17, 7985.Google Scholar
Schnurr, P, Vielhauer, M, Weathers, F and Findler, M (1999) The Brief Trauma Questionnaire (BTQ) [Measurement instrument]. Available from: http://www.ptsd.va.govGoogle Scholar
Screening, I, o. M. U. C. o. M. C. o. R. T. (2003). Medicare Coverage of Routine Screening for Thyroid Dysfunction. Washington, DC: National Academies Press (USA).Google Scholar
Sinai, C, Hirvikoski, T, Nordström, A-L, Nordström, P, Nilsonne, Å, Wilczek, A, Åsberg, M and Jokinen, J (2014) Hypothalamic pituitary thyroid axis and exposure to interpersonal violence in childhood among women with borderline personality disorder. European Journal of Psychotraumatology 5, 23911.Google Scholar
Straus, MA, Hamby, SL, Finkelhor, D, Moore, DW and Runyan, D (1998) Identification of child maltreatment with the Parent–Child Conflict Tactics Scales: development and psychometric data for a national sample of American parents. Child Abuse & Neglect 22, 249270.Google Scholar
Sumner, JA, Kubzansky, LD, Elkind, MS, Roberts, AL, Agnew-Blais, J, Chen, Q, Cerda, M, Rexrode, KM, Rich-Edwards, JW, Spiegelman, D, Suglia, SF, Rimm, EB and Koenen, KC (2015) Trauma exposure and posttraumatic stress disorder symptoms predict onset of cardiovascular events in women. Circulation 132, 251259.Google Scholar
Sumner, JA, Kubzansky, LD, Roberts, AL, Gilsanz, P, Chen, Q, Winning, A, Forman, JP, Rimm, EB and Koenen, KC (2016) Post-traumatic stress disorder symptoms and risk of hypertension over 22 years in a large cohort of younger and middle-aged women. Psychological Medicine 46, 31053116.Google Scholar
Sumner, JA, Hagan, K, Grodstein, F, Roberts, AL, Harel, B and Koenen, KC (2017) Posttraumatic stress disorder symptoms and cognitive function in a large cohort of middle-aged women. Depression and Anxiety 34, 356366.Google Scholar
Uddin, M, Aiello, AE, Wildman, DE, Koenen, KC, Pawelec, G, de Los Santos, R, Goldmann, E and Galea, S (2010) Epigenetic and immune function profiles associated with posttraumatic stress disorder. Proceedings of the National Academy of Sciences of the United States of America 107, 94709475.Google Scholar
Vitek, V and Shatney, CH (1987) Thyroid hormone alterations in patients with shock and injury. Injury 18, 336341.Google Scholar
von Kanel, R, Hepp, U, Kraemer, B, Traber, R, Keel, M, Mica, L and Schnyder, U (2007) Evidence for low-grade systemic proinflammatory activity in patients with posttraumatic stress disorder. Journal of Psychiatric Research 41, 744752.Google Scholar
Wang, S and Mason, J (1999) Elevations of serum T3 levels and their association with symptoms in World War II veterans with combat-related posttraumatic stress disorder: replication of findings in Vietnam combat veterans. Psychosomatic Medicine 61, 131138.Google Scholar
Wang, S, Mason, J, Southwick, S, Johnson, D, Lubin, H and Charney, D (1995) Relationships between thyroid hormones and symptoms in combat-related posttraumatic stress disorder. Psychosomatic Medicine 57, 398402.Google Scholar
Wei, J, Sun, G, Zhao, L, Liu, X, Lin, D, Li, T and Ma, X (2014) Hair thyroid hormones concentration in patients with depression changes with disease episodes in female Chinese. Psychiatry Research 220, 251253.Google Scholar
Welsh, CJ, Steelman, AJ, Mi, W, Young, CR, Storts, R, Welsh, TH Jr and Meagher, MW (2009) Neuroimmune interactions in a model of multiple sclerosis. Annals of the New York Academy of Sciences 1153, 209219.Google Scholar
Wiegratz, I, Kutschera, E, Lee, JH, Moore, C, Mellinger, U, Winkler, UH and Kuhl, H (2003) Effect of four oral contraceptives on thyroid hormones, adrenal and blood pressure parameters. Contraception 67, 361366.Google Scholar
Winsa, B, Adami, HO, Bergstrom, R, Gamstedt, A, Dahlberg, PA, Adamson, U, Jansson, R and Karlsson, A (1991) Stressful life events and Graves’ disease. Lancet 338, 14751479.Google Scholar
Yehuda, R, Teicher, MH, Levengood, RA, Trestman, RL and Siever, LJ (1994) Circadian regulation of basal cortisol levels in posttraumatic stress disorder. Annals of the New York Academy of Sciences 746, 378380.Google Scholar
Yehuda, R, Golier, JA and Kaufman, S (2005) Circadian rhythm of salivary cortisol in Holocaust survivors with and without PTSD. American Journal of Psychiatry 162, 9981000.Google Scholar
Young, EA, Kornstein, SG, Harvey, AT, Wisniewski, SR, Barkin, J, Fava, M, Trivedi, MH and Rush, AJ (2007) Influences of hormone-based contraception on depressive symptoms in premenopausal women with major depression. Psychoneuroendocrinology 32, 843853.Google Scholar
Supplementary material: File

Jung et al. supplementary material

Tables S1-S5

Download Jung et al. supplementary material(File)
File 34.3 KB