Basal blood DHEA-S/cortisol levels predicts EMDR treatment response in adolescents with PTSD

This study investigated changing cortisol and DHEA-S levels post EMDR therapy and the relationship between treatment response and basal cortisol, and DHEA-S levels before treatment.

Article Abstract

“Objective: In literature, recent evidence has shown that the hypothalamic–pituitary–adrenal (HPA) axis can be dysregulated in patients with post-traumatic stress disorder (PTSD) and HPA axis hormones may predict the psychotherapy treatment response in patients with PTSD. In this study, it was aimed to investigate changing cortisol and DHEA-S levels post-eye movement desensitization and reprocessing (EMDR) therapy and the relationship between treatment response and basal cortisol, and DHEA-S levels before treatment.

Method: The study group comprised 40 adolescents (age, 12–18 years) with PTSD. The PTSD symptoms were assessed using the Child Depression Inventory (CDI) and Child Post-traumatic Stress Reaction Index (CPSRI) and the blood cortisol and DHEA-S were measured with the chemiluminescence method before and after treatment. A maximum of six sessions of EMDR therapy were conducted by an EMDR level-1 trained child psychiatry resident. Treatment response was measured by the pre- to post-treatment decrease in self-reported and clinical PTSD severity.

Results: Pre- and post-treatment DHEA-S and cortisol levels did not show any statistically significant difference. Pre-treatment CDI scores were negatively correlated with pre-treatment DHEA-S levels (r: −0.39). ROC analysis demonstrated that the DHEA-S/cortisol ratio predicts treatment response at a medium level (AUC: 0.703, p: .030, sensitivity: 0.65, specificity: 0.86).

Conclusion: The results of this study suggested that the DHEA-S/cortisol ratio may predict treatment response in adolescents with PTSD receiving EMDR therapy. The biochemical parameter of HPA-axis activity appears to be an important predictor of positive clinical response in adolescent PTSD patients, and could be used in clinical practice to predict PTSD treatment in the future.”

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Usta, M. B., Gumus, Y. Y., Say, G. N., Bozkurt, A., Sahin, B., & Karabekiroglu, K. (2018). Basal blood DHEA-S/cortisol levels predicts EMDR treatment response in adolescents with PTSD. Nordic Journal of Psychiatry, 72(3), 164-172. https://doi.org/10.1080/08039488.2017.1406984