Altered stress response and consequent elevated levels of circulating glucocorticoids have been found in neuropsychiatric disorders such as depression or anxiety disorders and proposed to also play a role in the pathophysiology of obsessive-compulsive disorder (OCD). Despite the observation that stressful events may precede the disease onset or even exacerbate its symptoms, studies in this field do not always report consistent results regarding the cortisol profile of OCD patients. As such, a systematic review and meta-analysis was developed to clarify this issue. This systematic review and meta-analysis was elaborated according to the PRISMA method. The analytical procedures were implemented using Metafor package in R software. Nineteen studies were included in the systematic review and 18 were included in the meta-analysis. The meta-analytic results demonstrated that OCD patients had significantly higher cortisol levels compared to controls (d = 0.76, SE = 0.146, p < 0.001). For studies using the average of multiple assessments, the standardized coefficient was significantly higher when compared to studies focusing on single measurements. Both the systematic review and meta-analysis suggest that cortisol levels are significantly higher in OCD patients than healthy individuals.

中文翻译：

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强迫症与皮质醇的关系：系统评价和荟萃分析

在抑郁症或焦虑症等神经精神疾病中发现了压力反应的改变和随之而来的循环糖皮质激素水平升高，并提出也在强迫症 (OCD) 的病理生理学中发挥作用。尽管观察到压力事件可能在疾病发作之前甚至加剧其症状，但该领域的研究并不总是报告关于强迫症患者皮质醇谱的一致结果。因此，开发了系统评价和荟萃分析来澄清这个问题。本系统评价和荟萃分析是根据 PRISMA 方法进行的。分析程序使用 R 软件中的 Metafor 包实现。19 项研究被纳入系统评价，18 项研究被纳入荟萃分析。荟萃分析结果表明，与对照组相比，强迫症患者的皮质醇水平显着更高（d = 0.76，SE = 0.146，p < 0.001）。对于使用多次评估平均值的研究，与专注于单一测量的研究相比，标准化系数显着更高。系统评价和荟萃分析都表明，强迫症患者的皮质醇水平明显高于健康人。