Depersonalization disorder (DPD) comprises one of the five major dissociative disorders and its occurrence appears to bear a relationship to lifetime experience of traumatic stressors. The neurochemistry of DPD is not known, but the overlap of depersonalization and posttraumatic stress symptoms suggests that an investigation of the possible role of the sympathetic nervous system and the HPA axis would be a worthwhile pilot study in this disorder. These two systems have been extensively studied in PTSD, and have revealed a sympathetic overactivation and cortisol non-suppression to low-dose dexamethasone challenge. The specific hypotheses of the protocol are as follows: Hypothesis 1: DPD subjects will have elevated plasma epinephrine and norepinephrine compared to normal controls. Hypothesis 2: DPD subjects will have elevated plasma cortisol levels compared to normal controls. Hypothesis 3: DPD subjects will have elevated 24 hour urine cortisol, epinephrine, and norepinephrine compared to normal controls. Hypothesis 4: DPD subjects will exhibit less cortisol suppression in response to low-dose dexamethasone challenge compared to normal controls.
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