Posttraumatic Stress Disorder and Stress-related Hormones – What’s the Connection?

Mental Health


Basal levels of steroid hormones dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S) are not significantly different in patients with posttraumatic stress disorder compared with non-trauma-exposed subjects.

Approximately 10% of individuals exposed to traumatic events develop posttraumatic stress disorder (PTSD). Symptoms of PTSD include re-experiencing the traumatic event, negative cognitive and mood changes, and hyper-reactivity.

To further understand the causes of PTSD and identify effective treatments, scientists have been examining the brain differences between those with PTSD and those without. They have discovered that the way the hypothalamic-pituitary-adrenocortical (HPA) axis functions in PTSD patients is different from non-trauma-exposed subjects. Activation of the HPA-axis results in secretion of several steroid hormones including DHEA and DHEA-S.

A study by Mirjam van Zuiden and colleagues published in Psychoneuroendocrinology investigated whether consistent differences in basal DHEA and DHEA-S exist between individuals with PTSD and those without. The investigators gathered data from nine DHEA studies and eight DHEA-S studies involving adults with and without PTSD.

Overall analysis of the data found no significant difference in DHEA levels between individuals with PTSD and those without PTSD (p = 0.33). Similarly, no overall significant difference in DHEA-S was observed between PTSD patients and control subjects (p = 0.12). However, a significantly higher level of DHEA-S in individuals with PTSD versus non-trauma-exposed subjects was observed in a subgroup analysis (p < 0.001). The subgroup analysis included three DHEA-S studies which had greater similarity in study design and participant characteristics than the overall analysis. The results did indicate that trauma may play a role in increasing the levels of DHEA and DHEA-S, irrespective of posttraumatic stress disorder.

These findings indicate no link between PTSD status and basal DHEA and DHEA-S concentrations. However, there is evidence that the ratio of these steroids to other stress-related hormones such as cortisol play a role in PTSD.Furthermore, the authors note that “additional research is necessary to confirm whether basal DHEA and DHEA-S levels are indeed affected by trauma exposure irrespective of subsequent PTSD development and whether PTSD may have additional independent effects.”

Written by Cindi A. Hoover, Ph.D.

Source: van Zuiden M, Haverkort SQ, Tan Z, Daams J, Lok A, Olff M. DHEA and DHEA-S levels in posttraumatic stress disorder: A meta-analytic review. 2017. Psychoneuroendocrinology 84:76-82.



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