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KMID : 1143820120080020093
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Anxiety and Mood
2012 Volume.8 No. 2 p.93 ~ p.98
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Comparison of the Pattern of Changes in Salivary Cortisol by Degree of Burn and CAPS Score
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김진나:Kim Jin-Na
김지욱:Kim Jee-Wook/최인근:Choi Ihn-Geun/전욱:Chun Wook/서정훈:Seo Cheon-Hoon/김경자:Kim Kyung-Ja/이병철:Lee Boung-Chul
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Abstract
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Objective : Cortisol, a product of hypothalamus-pituitary-adrenal axis (HPA axis), is one of our defensive mechanisms in response to stress. The level of cortisol in the saliva is a major biomarker of the stress response by HPA axis and shows diurnal variation. We measured salivary cortisol level and its diurnal variation to compare the pattern of changes by degree of burn and Clinician-Administered PTSD Scale (CAPS) score.
Methods : We measured the salivary cortisol levels of 37 subjects hospitalized in the burn center at our facility from March to June 2012. Salivary cortisol levels were measured at 6 : 00 AM and at 7 : 00 PM. All subjects were tested for CAPS to evaluate the severity of posttraumatic stress disorder and the Hamilton Depression Rating Scale to evaluate and to control the coexisting depression.
Results : Factorial ANOVA test revealed that there was a statistically significant difference in terms of the effect of the interaction between the degree of burn and the patient's CAPS score. Unlike the mild burn group, in the severe burn group, the patients who had a low CAPS score didn't show a normal diurnal variation and the patients who had a high CAPS score showed the normal diurnal variation. After a few months follow up, we found a greater degree of psychiatric complications in severe burn patients that had a lower cortisol stress response.
Conclusion : We suppose that the disappearance of the stress response changes in salivary cortisol seen in the severe burn group may be caused by an impaired stress response. Through followed observation of the subjects, this disruption of cortisol response may cause psychiatric problems afterwards.
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KEYWORD
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Salivary cortisol, Burn, Clinician-Administered PTSD Scale, Posttraumatic stress disorder
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