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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)
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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

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