Elevated morning serum interleukin (IL)-6 or evening salivary cortisol concentrations predict posttraumatic stress disorder in children and adolescents six months after a motor vehicle accident

Psychoneuroendocrinology. 2007 Sep-Nov;32(8-10):991-9. doi: 10.1016/j.psyneuen.2007.07.001. Epub 2007 Sep 7.


Background: This study examined prospectively the activity of the hypothalamic-pituitary-adrenal axis, the sympathetic nervous system and inflammatory factors in children shortly after a motor vehicle accident (MVA) in relation to later posttraumatic stress disorder (PTSD) development.

Patients and methods: Fifty six children, aged 7-18, were studied after an MVA and 1 and 6 months later; 40 subjects served as controls. Morning serum cortisol and interleukin (IL)-6 and plasma catecholamine concentrations were measured within 24h after the event. Salivary cortisol was measured 5 times at defined time points during the same day. PTSD diagnoses 1 and 6 months later were based on K-SADS interview.

Results: Morning serum IL-6 concentrations, measured within the first 24h after the accident, were higher in children that developed PTSD 6 months later than those who did not and those of the control group. Longitudinal IL-6 measurements revealed normalization of IL-6 in the PTSD group, while no differences between the three groups were detected 1 and 6 months later. Evening salivary cortisol and morning serum IL-6 after the accident were positively inter-related (r=0.54, p<0.001) and in separate regression analyses both predicted PTSD development 6 months later. In contrast, morning serum IL-6 did nor correlate with morning serum or salivary cortisol concentrations.

Conclusions: Immediate posttraumatic alterations in neuroendocrine or inflammatory factors-increased evening salivary cortisol and/or increased morning serum IL-6 concentrations-are involved in subsequent PTSD development in children and adolescents.

Publication types

  • Evaluation Study

MeSH terms

  • Accidents, Traffic / psychology*
  • Adolescent
  • Case-Control Studies
  • Child
  • Circadian Rhythm*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hydrocortisone / analysis*
  • Interleukin-6 / blood*
  • Longitudinal Studies
  • Male
  • Motor Vehicles
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Saliva / chemistry*
  • Stress Disorders, Post-Traumatic / blood
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Time Factors


  • Interleukin-6
  • Hydrocortisone