Cortisol Production Rate in Posttraumatic Stress Disorder

Context: Several authors have reported the unsuspected finding of low cortisol levels (urinary, salivary, and serum) in patients with posttraumatic stress disorder (PTSD). Objective: Our objective was to assess concentrations of cortisol and its predominant metabolites, cortisol production rate (CPR), and glucocorticoid receptor (GR) binding characteristics in PTSD compared with normal subjects. Design: Matched PTSD patients and control subjects had CPR determined by a stable isotope dilution technique after infusion of deuterated cortisol. Serum cortisol, urinary cortisol, and its metabolites were measured by gas chromatography/mass spectrometry. GR binding capacity (Ro) and ligand binding affinity (Kd) were measured in mononuclear leukocytes. Setting: All subjects were tested during a 40-h admission in an inpatient clinical research center. Patients and Participants: Ten patients with PTSD were matched by age and gender with 10 controls. Outcome Measures: Statistical comparison was conducted for various...