Ž . Psychiatry Research 104 2001 8589 Brief report Basal activity of the hypothalamic  pituitary  adrenal axis in patients with depersonalization disorder Biba R. Stanton a , Anthony S. David b,c,  , Anthony J. Cleare c , Mauricio Sierra b , Michelle V. Lambert c , Mary L. Phillips b , Richard J. Porter a , Peter Gallagher a , Allan H. Young a a School of Neurosciences Di  ision of Psychiatry, Uni  ersity of Newcastle-upon-Tyne, Newcastle-upon-Tyne, UK b Depersonalisation Research Unit, Institute of Psychiatry, London SE5 8AF, UK c Di  ision of Psychological Medicine, GKT School of Medicine, London SE5 8AZ, UK Received 17 November 2000; received in revised form 12 June 2001; accepted 5 August 2001 Abstract Depersonalisation disorder may occur during severe anxiety or following a traumatic event, suggesting a possible Ž . role of stress hormones. This study investigated basal activity of the hypothalamic  pituitary  adrenal HPA axis in patients with depersonalisation disorder. Salivary cortisol levels were measured at four time points over 12 h in Ž . Ž . patients with depersonalisation disorder N 13 , major depressive disorder MDD, N 14 and healthy controls Ž . N 13 . Beck Depression Inventory scores were significantly higher in depersonalised subjects than controls, while MDD subjects demonstrated higher scores than both groups. Basal cortisol levels of depersonalised subjects were significantly lower than those of MDD subjects but not healthy controls. These results point to reduced basal activity of the HPA axis in depersonalisation disorder. This pilot study supports the distinction between depersonalisation disorder and major depressive disorder which should be examined in a larger sample.  2001 Elsevier Science Ireland Ltd. All rights reserved. Keywords: Depersonalisation disorder; Hypothalamicpituitary adrenal axis; Salivary cortisol  Corresponding author. Section of Neuropsychiatry, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK. Tel.: 44-20-7848-0138; fax: 44-20-7848-0572. Ž . E-mail address: a.david@iop.kcl.ac.uk A.S. David . 0165-178101$ - see front matter  2001 Elsevier Science Ireland Ltd. All rights reserved. Ž . PII: S 0 1 6 5 - 1 7 8 1 01 00291-8