Trauma Severity in Early Childhood Correlates with Stress and Satiety Hormone Levels in a Pilot Cohort Receiving Diamorphine Maintenance Treatment.
AIMS
Childhood trauma is of importance for the manifestation of substance-related disorders and maintenance of hypothalamic-pituitary-adrenal (HPA)-axis disorders. Since stress plays a crucial role in opioid compliance and craving, we investigated the immediate effects of diacetylmorphine application on the HPA axis. In particular, adrenocorticotropic hormone (ACTH) and cortisol secretion, as well as satiety regulating proopiomelanocortin peptides α-melanocyte-stimulating hormone (MSH) and β-endorphin (END) in a cohort of opioid-dependent patients in diamorphine maintenance treatment concerning the clinical severity of their childhood trauma.


METHODS
We compared the serum levels of ACTH, cortisol, MSH, and END in 15 opioid-dependent patients. All participants received treatment with diamorphine and were observed at 5 timepoints before and after injection. We split the cohort into 2 subgroups concerning childhood trauma measured by the Childhood Trauma Questionnaire.


RESULTS
Splitting in 2 subgroups for mild (5) and severe trauma (10), we found that while both groups show a significant reduction of ACTH and cortisol levels over time, slopes display different progressions over time for cortisol (F[1.6] = 9.38, p = 0.02), while remaining identical for ACTH (F[1.6] = 1.69, p = 0.24). Also, levels of both MSH and END were significantly lower in severely traumatized patients.


CONCLUSIONS
For the first time, we present a detailed representation of stress- and addiction-related proteins for the first 5 h after diamorphine application, demonstrating the interrelationship between stress hormones and childhood trauma as well as its potential effects on the progression of addictions such as opioid dependence.
['Groh|Adrian|A|', 'Rhein|Mathias|M|', 'Roy|Mandy|M|', 'Gessner|Christine|C|', 'Lichtinghagen|Ralf|R|', 'Heberlein|Annemarie|A|', 'Hillemacher|Thomas|T|', 'Bleich|Stefan|S|', 'Walter|Marc|M|', 'Frieling|Helge|H|']
D000324:Adrenocorticotropic Hormone D000328:Adult D000076783:Adverse Childhood Experiences D002648:Child D015331:Cohort Studies D005260:Female D003932:Heroin D006556:Heroin Dependence D006801:Humans D006854:Hydrocortisone D007030:Hypothalamo-Hypophyseal System D008297:Male D008875:Middle Aged D010913:Pituitary-Adrenal System D013315:Stress, Psychological D011795:Surveys and Questionnaires D014947:Wounds and Injuries D001615:beta-Endorphin
Stress Diamorphine Adrenocorticotropic hormone Cortisol Proopiomelanocortin Heroin Hypothalamic-pituitary-adrenal axis Opioid depence