MASHBANK

Mood- Anxiety and Somatoform (MAS) disorders are highly prevalent psychiatric
disorders with significant morbidity. The treatment succes is limited and
recurrence rates are high. Genetic vulnerability and environmental influences
are important precipitating factors in these disorders. Hyperactivity of the
Hypothalamic-Pituitary-Adrenal (HPA) axis is found in more than half of the
patients. Genetic variance in glucocorticoid receptors have been associated
with regulation of the HPA-axis, and with the occurrence of MAS-disorders.
In Rivierduinen, a mental health organization in the Netherlands, and in the
Leiden University Medical Center, department of psychiatry, all patients with
MAS-disorders are extensively phenotyped with psychometric scales. This
phenotyping is performed periodically, with the objective of monitoring of the
treatment.

The aim of this study is to investigate the role of the HPA-axis in
MAS-disorders. By measuring cortisol in saliva the HPA-axis functioning can be
determined (endophenotype), and by collecting buccal cells from which DNA will
be isolated, single nucleotide polymorphisms in genes related to the HPA-axis
can be identified (genotype).

Observational study

The MASHBANK-project will take approximately 30 minutes per patient. The
collection of buccal cells will take place during a routine visit to the
psychiatric nurse. The collection of buccal cells may cause slight discomfort,
but is in general not painful and it doesnt cause any bleeding.
The coolection of saliva will take place when the patient is at home. The
patient has to chew on a swab on seven different time points. The saliva
collection is not painful. For a dexamethasone-suppression-test it is necessary
that the patient takes one tablet of dexamethasone 0,5 mg on one occasion. Side
effects of this dose of dexamethasone are extremely rare. The total estimated
time of the investigation is about 30 minutes.