Alexithymia represents a deficit in identifying and expressing emotions, paucity of fantasies, and an externally oriented cognitive style. Currently, numerous studies document that alexithymia and several mental and somatic disorders are significantly related. Several findings also indicate that this association might be caused by alexithymia related dysregulation of neuroendocrine and immune functions. Together these findings indicate that stressors related to alexithymia could underlie the process of neuroendocrine and immune dysregulation that likely may present a significant risk, sustaining and mediating pathogenesis of several disorders and particulary psychosomatic illnesses. In this context, it is also known that several proinflammatory cytokines may play a role in pain generation and that alexithymia is significantly associated with pain symptoms in several pain disorders. Following these findings this study includes several new data developing current state of the art and showing some alexithymia specific changes in patients with neurological disorders. Main finding of this study shows that alexithymia and anxiety in their specific interactions are linked to increased levels of interleukine-8 (IL-8) in cerebrospinal fluid (CSF) in the group of patients with non-inflammatory neurological...

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Past work has linked self-injurious behavior (SIB) to a history of traumatic experiences and to problems regulating affect. While this affect dysregulation is conceptualized as occurring at a biological (as well as a behavioral) level, relatively little is known about the biological mechanisms involved. The current study explored whether reactivity of the hypothalamic-pituitary-adrenal (HPA) axis to an interpersonal stressor mediated the relation between trauma and SIB in a sample of 178 18-21 year-old heterosexual dating couples. As predicted, both trauma experience and symptoms positively predicted SIB. While the mediating model was not supported, SIB was associated with an HPA axis response marked by heightened reactivity to interpersonal stress within the context of lower cortisol levels. Trauma symptoms and experience interacted with adult attachment security to predict HPA axis response in different ways for men and women, a compelling set of findings suggesting the importance of contextual factors in the study of trauma and HPA axis function. Future directions for the study of trauma, HPA axis reactivity, and SIB are discussed.

Bakgrund: Demens drabbar en stor del av den äldre befolkningen och antalet insjuknade väntas stadigt stiga. Det finns i dagsläget ingen sjukdomsbotande behandling och etiologin är oklar. Hypotalamus-hypofys-binjurebark (HPA)-axeln är ett neuroendokrint system som aktiveras vid exponering för endo- respektive exogena stressorer. Aktivering leder till frisättning av glukokortikoider från binjurebarken. Cirkulerande glukokortikoider (kortisol) påverkar kognitiva funktioner och verkar ha effekt på plasticiteten vid hippocampus, som är en region viktig för minnesfunktioner. Förhöjda kortisolhalter har korrelerats med snabbare kognitiv nedgång och pågående Alzheimers sjukdom. HPA-axeldysfunktion och förhöjda kortisolhalter har föreslagits vara en möjlig bidragande orsak till kognitiv funktionsnedsättning och demens. Syfte: Undersöka om HPA-axeldysfunktion med förhöjda kortisolhalter bidrar till demensutveckling. Metod: Systematisk litteratursökning med på förhand implementerade inklusions- respektive exklusionskriterier. Sökningar utfördes på databaserna Pubmed och Web of Science med sökorden ”dementia”, ”Alzheimer’s”, ”longitudinal”, ”cortisol”. Resultat: Av sex granskade artiklar kunde fem korrelera förhöjda kortisolhalter med senare nedsatt kognitiv förmåga eller demens. Resultaten varierade beroende på vilka effektvariabler som användes i samband med analys. Slutsats: Inkluderade studier uppvisade viss ökad förekomst av HPA-axeldysfunktion och förhöjda kortisolhalter i samband med senare demens eller kognitiv funktionsnedsättning. Det går dock inte att utesluta att förhöjda kortisolhalter orsakas av patofysiologiska förändringar i samband med det begynnande sjukdomsförloppet. / Background: Dementia affects a large part of the elderly population, and the incidence is expected to keep rising. However, there is no available disease-curing treatment nor is the etiology yet fully understood. The hypothalamus-pituitary-adrenal (HPA) axis is a neuroendocrine system that is activated under exposure to endo- and/or exogenous stressors. Activation leads to the release of glucocorticoids from the adrenal cortex. Circulating glucocorticoids (cortisol) affects cognitive functions including hippocampal plasticity. Elevated cortisol levels have been associated with ongoing Alzheimer’s disease and a more rapid cognitive decline. Thus, HPA axis dysfunction with elevated cortisol levels have been suggested as a possible contributor to cognitive impairment and dementia. Objective: To investigate if HPA axis dysfunction and elevated cortisol levels are a contributing cause of dementia. Method: Systematic literature search with pre-implemented inclusion and exclusion criteria. Searches were carried out on Pubmed and Web of Science using the words "dementia", "Alzheimer's", "longitudinal", "cortisol". Results: Associations between elevated cortisol levels and later cognitive decline or dementia was made in five out of six reviewed studies. The results varied depending on the effect variables used in connection with the analysis. Conclusion: Reviewed studies showed some degree of associations between high cortisol levels and later cognitive decline or dementia. It is however impossible to rule out the possibility of elevated cortisol levels as part of the initial disease progression, rather than a cause of disease.

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Postpartum depression is a psychiatric disorder affecting a substantial proportion of newly delivered women, and remains a significant cause of childbirth-related morbidity. The aim of the present thesis was to examine psychological, endocrine and genetic aspects of postpartum depression in a large, population-based sample of women in Uppsala, Sweden. All included studies were undertaken as parts of the BASIC-project, a longitudinal study on psychological wellbeing during pregnancy and the postpartum period. Study participants were screened for depressive symptoms in pregnancy week 17 and 32 as well as at six weeks and six months postpartum, mainly by use of the Swedish version of the Edinburgh Postnatal Depression Scale (EPDS). Furthermore, personality was assessed with the Swedish universities Scale of Personality (SSP) in pregnancy week 32. Evening cortisol levels in saliva were measured in pregnancy week 36 and at six weeks postpartum. Blood samples were obtained to measure corticotropin-releasing hormone levels (CRH) and to perform genetic analyses. The results of this thesis demonstrate that neuroticism is a strong and independent predictive factor of depressive symptoms at six weeks and six months postpartum, and has a significant mediatory role in the association between a single nucleotide polymorphism in the hydroxysteroid (11-beta) dehydrogenase 1 gene (HSD11B1) and postpartum depression. Furthermore, women with postpartum depressive symptoms present with a dysregulated hypothalamic-pituitary-adrenal axis activity in terms of elevated cortisol levels postpartum, as well as elevated CRH levels in mid-gestation. In conclusion, this thesis develops current knowledge on several attributes of postpartum depression. Further studies are required to replicate and expand on these results, which would further contribute to early identification of women at risk of postpartum depression and adoption of proper interventions that may moderate the short- and long-term consequences of the disorder.

Bakgrund: Stress samt stressrelaterad psykisk ohälsa ökar i samhället och det är viktigt att finna alternativ som bromsar utvecklingen. Stress är ett normalt fysiologiskt tillstånd men under längre tid utan återhämtning kan stress leda till psykisk ohälsa. Yogastudier har visat en stressreducerande effekt på humör och yoga har blivit ett populärt alternativ för att minska upplevda stressymptom. Det kan därför vara intressant att studera bakomliggande mekanismer till upplevd stressreducering. Hormonet kortisol ökar vid stress. Kanske har yoga stressreducerande effekt via sänkning av hormonet. Syfte: Studiens syfte är att studera om upplevd stressreducering vid yogautövande har ett samband med sänkta kortisolnivåer hos friska vuxna individer. Metod: En systematisk litteraturstudie genomfördes på artiklar publicerade 2009-2018. Artiklarna söktes upp i PubMed samt Web of Science. Resultat: Nio studier granskades (sju experimentella och två observationsstudier). Sex studier visade helt eller delvis sänkt kortisolnivå. En experimentell samt två observationsstudier visade inte signifikant lägre kortisolnivåer. Delvis förbättrat humör och kognitiv förmåga sågs i studierna. Slutsats: Sänkta kortisolnivåer vid yogautövande sågs. Dock fanns studier som inte visade minskade kortisolnivåer och studierna har brister som sänker bevisstyrkan. Bättre studier behövs för att kunna fastställa ett samband. / Background: Stress and stress-related mental illness is increasing in our society and it is important to find options to slow down the development. Stress is a normal physical condition but for a long time without recovery stress can lead to mental illness. Yoga studies have shown a stress-reducing effect on mood and yoga has become a popular option to reduce perceived stress symptoms. Therefore it can be interesting to study underlying mechanisms for perceived stress reduction. The hormone cortisol increases during stress. Perhaps yoga has a stress-reducing effect through decreasing the hormone. Aims: The aim of the study is to exam whether perceived stress reduction in yoga practice is related to lowered cortisol levels in healthy adults. Methods: A systematic literature study was carried out on articles published in 2009-2018. The articles were searched in PubMed and Web of Science. Results: Nine studies were reviewed (seven experimental and two observations studies). Six studies showed complete or partial reduction of cortisol levels. An experimental and two observation studies did not show significantly lower cortisol levels. Partially improved mood and cognitive ability were seen. Conclusions: Decreased cortisol levels in yoga practice were observed. However, there were studies that did not show decreased cortisol levels and the studies have shortcomings that lower the strength of evidence. Better studies are needed to establish a relationship.