Several studies have shown that a large proportion of patients with major depressive disorders exhibit hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis function , expressed by elevated plasma cortisol concentrations. We hypothesize that behavior problem children, particularly those who show concurrent symptoms of depression and anxiety, may have hyperactivity of HPA axis function, as indicated by elevated plasma and salivary cortisol levels. Approximately 80 conduct problem children, aged 6-7 years, will undergo a physical examination in order to get extensive pediatric history (paranatal, developmental and general medical history) ; in addition, plasma ACTH, plasma and salivary cortisol levels will be assessed. This provides the opportunity to evaluate the HPA axis function in these children, to evaluate the correlation between plasma and salivary cortisol levels and to assess cortisol response under stress and nonstress conditions. Such information would be useful in advancing the early screening of children at risk for disruptive behavior disorders and affective disorders.
