Abstract
BackgroundPrevious studies have shown associations between obsessive-compulsive disorder (OCD) and hypothalamic-pituitary-adrenal axis activity (HPA). We aimed to investigate the association between obsessive-compulsive (OC) symptoms and HPA axis functionality in a non-clinical sample and to explore whether there are sex differences in this relationship.MethodsOne hundred eighty-three healthy individuals without any psychiatric diagnosis (80 men, 103 women; mean age 41.3 ± 17.9 years) were recruited from the general population. The Obsessive-Compulsive Inventory Revised (OCI-R) was used to assess OC symptoms. State-trait anxiety, perceived stress, and stressful life events were also assessed. Saliva cortisol levels were determined at 6 time points (awakening, 30 and 60 min post-awakening, 10:00 a.m., 23:00 p.m. and 10:00 a.m. the following day of 0.25 mg dexamethasone intake [that occurred at 23:00 p.m.]). Three HPA axis measures were calculated: cortisol awakening response (CAR), cortisol diurnal slope, and cortisol suppression ratio after dexamethasone (DSTR). Multiple linear regression analyses were used to explore the association between OC symptoms and HPA axis measures while adjusting for covariates. Our main analyses were focused on OCI-R total score, but we also explored associations with specific OC symptom dimensions.ResultsNo significant differences were observed between males and females in OC symptoms, anxiety measures, stress, or cortisol measures. In the multiple linear regression analyses between overall OC symptoms and HPA axis measures, a female sex by OC symptoms significant interaction (standardized beta = − 0.322; p = 0.023) for the CAR (but not cortisol diurnal slope nor DSTR) was found. Regarding specific symptom dimensions, two other sex interactions were found: a blunted CAR was associated with obsessing symptoms in women, whereas a more flattened diurnal cortisol slope was associated with ordering symptoms in men.ConclusionsThere are sex differences in the association between OC symptoms and HPA axis measures in healthy individuals.
Highlights
Obsessive-compulsive disorder (OCD) is a common chronic long-lasting psychiatric disorder, with a prevalence of 2.3% that interferes with all aspects of life of the individual [1]
We found that trait anxiety was a moderator of the relationship between obsessive-compulsive disorder (OCD) and hypothalamicpituitary-adrenal axis activity (HPA) axis measures, as OCD patients with greater trait anxiety showed an increased cortisol awakening response (CAR) and reduced cortisol suppression after dexamethasone administration
We found a female sex by OC symptoms significant interaction, indicating that the relationship between OC symptoms and the CAR differs between men and women
Summary
Obsessive-compulsive disorder (OCD) is a common chronic long-lasting psychiatric disorder, with a prevalence of 2.3% that interferes with all aspects of life of the individual [1]. Obsessive-compulsive (OC) symptoms are not exclusive of OCD. They are prevalent in non-clinical samples, with clinically relevant symptoms in about 21.7% of the general population [3]. A series of cortico-striato-thalamo-cortical circuits that are associated with these cognitive changes are believed to underpin the expression of compulsive behaviors [4]. Previous studies have shown associations between obsessive-compulsive disorder (OCD) and hypothalamicpituitary-adrenal axis activity (HPA). We aimed to investigate the association between obsessive-compulsive (OC) symptoms and HPA axis functionality in a non-clinical sample and to explore whether there are sex differences in this relationship
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