Publication Name	World Journal of Psychiatry
Manuscript ID	111523
Country	Greece

Category	Gastroenterology & Hepatology
Manuscript Type	Prospective Study
Article Title	Hypothalamic-pituitary-adrenal dysregulation and psychological distress in Crohn’s disease: Insights from acute and chronic stress responses
Manuscript Source	Invited Manuscript
All Author List	Effrosini Laoudi, Demetra Papalouka, Georgios Kokkotis, Michael Gkizis, Aimilia Mantzou, Georgios Lyrakos, Panagiotis Markopoulos, Paraskevi Prapa, Theodoros Voulgaris, John Vlachogiannakos, Ioannis Papaconstantinou and Giorgos Bamias
Funding Agency and Grant Number
Corresponding Author	Panagiotis Markopoulos, Consultant, MD, PhD, Department of Gastroenterology, Metaxa Cancer Hospital, 51 Mpotasi Street, Piraeus 18537, Greece. panosmarkmd@gmail.com
Key Words	Crohn’s disease; Chronic stress; Acute stress; Hypothalamic-pituitary-adrenal axis dysregulation; Hair cortisol; Salivary cortisol
Core Tip	In this prospective study, we evaluated both acute and chronic stress responses in patients with Crohn’s disease using objective biomarkers - salivary and hair cortisol - in two distinct patient groups. In addition, we assessed perceived psychological stress via validated psychometric tools and compared these findings with those of a control group of patients with cancer. Our findings reveal a significantly decreased cortisol response to chronic stress in patients with Crohn’s disease, along with high levels of perceived stress, anxiety, and depression.
Citation	Laoudi E, Papalouka D, Kokkotis G, Gkizis M, Mantzou A, Lyrakos G, Markopoulos P, Prapa P, Voulgaris T, Vlachogiannakos J, Papaconstantinou I, Bamias G. Hypothalamic-pituitary-adrenal dysregulation and psychological distress in Crohn’s disease: Insights from acute and chronic stress responses. World J Psychiatry 2025; In press

Received	2025-07-02 02:53
Peer-Review Started	2025-07-02 02:53
To Make the First Decision
Return for Revision	2025-07-29 08:32
Revised	2025-08-07 12:10
Second Decision	2025-11-20 02:31
Accepted by Journal Editor-in-Chief
Accepted by Executive Editor-in-Chief	2025-11-27 06:46
Articles in Press	2025-11-27 06:46
Publication Fee Transferred
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2220-3206 (online)
Open Access	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Copyright	© The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Permissions	For details, please visit: http://www.wjgnet.com/bpg/gerinfo/207
Publisher	Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Website	http://www.wjgnet.com