{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:19:18Z","timestamp":1792048758902,"version":"4.4.0"},"reference-count":53,"publisher":"Royal College of Psychiatrists","issue":"5","license":[{"start":{"date-parts":[[2018,1,2]],"date-time":"2018-01-02T00:00:00Z","timestamp":1514851200000},"content-version":"unspecified","delay-in-days":3715,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2007,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Post-traumatic stress disorder (PTSD) has inconsistently been associated with lower levels of cortisol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To compare basal cortisol levels in adults with current PTSD and in people without psychiatric disorder.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Systematic review and meta-analysis. Standardised mean differences (SMD) in basal cortisol levels were calculated and random-effects models using inverse variance weighting were applied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Across 37 studies, 828 people with PTSD and 800 controls did not differ in cortisol levels (pooled SMD = \u22120.12, 95% C1= \u22120.32 to 0.080). Subgroup analyses revealed that studies assessing plasma or serum showed significantly lower levels in people with PTSD than in controls not exposed to trauma. Lower levels were also found in people with PTSD when females were included, in studies on physical or sexual abuse, and in afternoon samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Low cortisol levels in PTSD are only found under certain conditions. Future research should elucidate whether low cortisol is related to gender or abuse and depends on the measurement methods used.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.bp.106.024877","type":"journal-article","created":{"date-parts":[[2007,10,31]],"date-time":"2007-10-31T23:52:52Z","timestamp":1193874772000},"page":"387-392","source":"Crossref","is-referenced-by-count":567,"title":["Cortisol and post-traumatic stress disorder in adults"],"prefix":"10.1192","volume":"191","author":[{"given":"Marie-Louise","family":"Meewisse","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes B.","family":"Reitsma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giel-Jan","family":"De Vries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berthold P. R.","family":"Gersons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miranda","family":"Olff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2018,1,2]]},"reference":[{"key":"S0007125000247181_ref40","doi-asserted-by":"publisher","DOI":"10.1159\/000070009"},{"key":"S0007125000247181_ref42","first-page":"611","article-title":"The potential role of hypocortisolism in the pathophysiology of PTSD and psoriasis","volume":"23","author":"Thaller","year":"1999","journal-title":"Collegium Antropologium"},{"key":"S0007125000247181_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(03)00692-9"},{"key":"S0007125000247181_ref49","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1995.03950190065010"},{"key":"S0007125000247181_ref48","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1176\/ajp.150.1.83","article-title":"Enhanced suppression of cortisol following dexamethasone administration in posttraumatic stress disorder","volume":"150","author":"Yehuda","year":"1993","journal-title":"American Journal of Psychiatry"},{"key":"S0007125000247181_ref46","first-page":"11","article-title":"Determination of cortisol in saliva and serum by a luminescence-enhanced enzyme immunoassay","volume":"50","author":"Westermann","year":"2004","journal-title":"Clinical Laboratory"},{"key":"S0007125000247181_ref22","doi-asserted-by":"publisher","DOI":"10.1002\/smi.1001"},{"key":"S0007125000247181_ref53","doi-asserted-by":"publisher","DOI":"10.1016\/S0306-4530(03)00052-0"},{"key":"S0007125000247181_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2005.08.002"},{"key":"S0007125000247181_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/0006-3223(90)90452-8"},{"key":"S0007125000247181_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-1781(03)00098-2"},{"key":"S0007125000247181_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2004.08.006"},{"key":"S0007125000247181_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2004.06.001"},{"key":"S0007125000247181_ref25","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.313.7060.808"},{"key":"S0007125000247181_ref29","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.161.8.1390"},{"key":"S0007125000247181_ref20","doi-asserted-by":"publisher","DOI":"10.1159\/000070018"},{"key":"S0007125000247181_ref8","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1176\/ajp.156.4.585","article-title":"Serial CSF corticotropin-releasing hormone levels and adrenocortical activity in combat veterans with posttraumatic stress disorder","volume":"156","author":"Baker","year":"1999","journal-title":"American Journal of Psychiatry"},{"key":"S0007125000247181_ref43","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2004.03.009"},{"key":"S0007125000247181_ref12","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1330.011"},{"key":"S0007125000247181_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(00)00352-9"},{"key":"S0007125000247181_ref44","first-page":"2468","article-title":"Effects of gender and age on the levels and circadian rhythmicity of plasma cortisol","volume":"81","author":"Van Cauter","year":"1996","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"S0007125000247181_ref52","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2004.02.010"},{"key":"S0007125000247181_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-1781(02)00126-9"},{"key":"S0007125000247181_ref32","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.133.2.183"},{"key":"S0007125000247181_ref1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.160.9.1705"},{"key":"S0007125000247181_ref3","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","year":"1980"},{"key":"S0007125000247181_ref51","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(02)01357-4"},{"key":"S0007125000247181_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(02)01974-1"},{"key":"S0007125000247181_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2003.12.021"},{"key":"S0007125000247181_ref35","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(01)01264-1"},{"key":"S0007125000247181_ref2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7382.219"},{"key":"S0007125000247181_ref4","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","year":"1987"},{"key":"S0007125000247181_ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-002-0374-5"},{"key":"S0007125000247181_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(94)90048-5"},{"key":"S0007125000247181_ref15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020266"},{"key":"S0007125000247181_ref50","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1176\/ajp.152.7.982","article-title":"Low urinary cortisol excretion in Holocaust survivors with posttraumatic stress disorder","volume":"152","author":"Yehuda","year":"1995b","journal-title":"American Journal of Psychiatry"},{"key":"S0007125000247181_ref37","volume-title":"The Handbook of Research Synthesis","author":"Rosenthal","year":"1994"},{"key":"S0007125000247181_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/0006-3223(90)90654-K"},{"key":"S0007125000247181_ref16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"S0007125000247181_ref47","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-199006000-00004"},{"key":"S0007125000247181_ref17","doi-asserted-by":"publisher","DOI":"10.3109\/00048678909062145"},{"key":"S0007125000247181_ref5","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","year":"1994"},{"key":"S0007125000247181_ref19","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1176\/ajp.154.2.266","article-title":"Behavioral and neuroendocrine responses to sodium lactate infusion in subjects with posttraumatic stress disorder","volume":"154","author":"Jensen","year":"1997","journal-title":"American Journal of Psychiatry"},{"key":"S0007125000247181_ref38","doi-asserted-by":"publisher","DOI":"10.1016\/S0306-4530(02)00086-0"},{"key":"S0007125000247181_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2005.04.009"},{"key":"S0007125000247181_ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2004.12.006"},{"key":"S0007125000247181_ref36","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2003.11.018"},{"key":"S0007125000247181_ref39","doi-asserted-by":"publisher","DOI":"10.1159\/000067185"},{"key":"S0007125000247181_ref45","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1040"},{"key":"S0007125000247181_ref27","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1300215"},{"key":"S0007125000247181_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/0306-4530(89)90006-1"},{"key":"S0007125000247181_ref13","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2249.2003.02075.x"},{"key":"S0007125000247181_ref41","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(96)00489-1"}],"container-title":["British Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007125000247181","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,14]],"date-time":"2023-05-14T15:51:06Z","timestamp":1684079466000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007125000247181\/type\/journal_article"}},"subtitle":["Systematic review and meta-analysis"],"short-title":[],"issued":{"date-parts":[[2007,11]]},"references-count":53,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2007,11]]}},"alternative-id":["S0007125000247181"],"URL":"https:\/\/doi.org\/10.1192\/bjp.bp.106.024877","relation":{},"ISSN":["0007-1250","1472-1465"],"issn-type":[{"value":"0007-1250","type":"print"},{"value":"1472-1465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,11]]}}}