Recent findings have highlighted the association between changes in the activity of the HPA axis, primarily its end-hormone, cortisol and OCD. However, to date, cortisol levels of OCD patients have been assessed mainly in body fluids, such as serum, saliva or urine, frequently leading to ambiguous results because of their inherent lack of stability. The aim of this study was to investigate time-integrated levels of stress exposure in 32 OCD patients and 32 sex and age-matched healthy controls by measuring endogenous cortisol in hair segments reflecting the last 3 months preceding hair collection. Psychometric parameters, including BDI, FQ, STAI, PSS and ECQ-R, were obtained in all participants; Y-BOCS was performed in the OCD patients. The OCD patients exhibited significantly higher scores in all psychometric instruments administered and lower hair cortisol concentrations than the healthy controls (p = 0.001, r = 0.41). No significant correlations were found between the HCC and the Y-BOCS total scores. After having sorted OCD patients into subtypes, according to the nature of their symptomatology, the “washers/cleaners” category showed the lowest HCC (compared to the “checking/harming”, “ordering/symmetry” and “sexual/religious obsessions” categories). The novel finding of chronic low cortisol secretion in OCD patients could be attributed to a possible down-regulation of the HPA axis, as an adaptive response to chronic stress exposure. Given that the OCD subtypes reflect the great heterogeneity in the OCD spectrum, studies with larger samples should extend the investigation of HCC in patients with distinctive symptomatology, so as to develop a basis for better neuroendocrine profiling and understanding of the pathophysiology of OCD. Further work is needed in exploring HPA axis’ activity over the natural course and treatments of the disorder.

最近的发现凸显了HPA轴活动的变化之间的关联，主要是其末端激素，皮质醇和OCD。然而，迄今为止，主要在体液中评估了强迫症患者的皮质醇水平，例如血清，唾液或尿液，由于其固有的稳定性不足，常常导致结果不明确。这项研究的目的是通过测量反映头发收集前最后三个月的头发部分的内源性皮质醇，调查32位强迫症患者以及32位性别和年龄匹配的健康对照者的时间综合暴露水平。在所有参与者中获得了包括BDI，FQ，STAI，PSS和ECQ-R在内的心理测量参数；Y-BOCS在强迫症患者中进行。与健康对照组相比，强迫症患者在所有使用的心理测验仪器中均表现出明显更高的分数，并且头发中的皮质醇浓度更低（p = 0.001，r = 0.41）。在HCC和Y-BOCS总分之间未发现显着相关性。在根据症状的性质将OCD患者分类为亚型后，“洗衣机/清洁工”类别的HCC最低（与“检查/伤害”，“秩序/对称”和“性/宗教痴迷”类别相比） ）。在强迫症患者中慢性低皮质醇分泌的新发现可能归因于HPA轴可能的下调，这是对慢性应激暴露的适应性反应。鉴于OCD亚型反映了OCD光谱中的巨大异质性，对较大样本进行的研究应扩大对具有独特症状的患者进行HCC的研究，从而为更好地进行神经内分泌分析和了解OCD的病理生理学奠定基础。在探索HPA轴在自然过程和疾病治疗中的活动方面，需要做进一步的工作。