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Patterns of endogenous steroids in apathetic refugee children are compatible with long-term stress
Department of Clinical Neuroscience, Karolinska Institutet, Sweden.
Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Chemistry - BMC, Analytical Chemistry. Uppsala University, Science for Life Laboratory, SciLifeLab.
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Sweden.
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Sweden.
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2012 (English)In: BMC Research Notes, ISSN 1756-0500, Vol. 5, no 186Article in journal (Refereed) Published
Abstract [en]


During the last few years, a number of children of asylum applicants in Sweden developed an apathetic or unconscious state. The syndrome was perceived as new, and various explanations were advanced such as; factitious disorder, intoxication, or stress. Considering a potential association between traumatic stress and regulation of steroids biosynthesis, this study explored whether changes in concentrations of endogenous steroids were associated with the above syndrome.


Eleven children were recruited in the study. Concentrations of steroids in blood samples were determined using high sensitivity liquid chromatography tandem mass spectrometry methods. Symptoms were assessed with a clinical rating scale developed for the study. Steroid concentrations were measured at the entry into study and after recovery; and concentrations were evaluated for the association with the symptoms in apathetic children.


 Cortisol and cortisone concentrations at baseline were negatively associated with duration of the symptoms from entry into the study to clinical recovery. Concentrations of pregnanes (pregnenolone, 17-OH-pregnenolone, and dehydroepiandrosterone) and 17-OH-progesterone were increased in the symptomatic state and decreased after the recovery.


 Pattern of low cortisol concentrations found in apathetic children is consistent with long-term stress. An increase of upstream steroid metabolites such as pregnanes and 17-OH-progesterone was found to be associated with the symptomatic state.

Place, publisher, year, edition, pages
2012. Vol. 5, no 186
Keyword [en]
Apathetic refugee children, Dissociative disorders, Cortisol, Steroids, Neurosteroids, Mass spectrometry
National Category
Medical and Health Sciences Chemical Sciences
URN: urn:nbn:se:uu:diva-175967DOI: 10.1186/1756-0500-5-186PubMedID: 22524234OAI: diva2:533758
Swedish Research Council
Available from: 2012-06-14 Created: 2012-06-14 Last updated: 2012-08-27Bibliographically approved

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