Relationship between serum oxytocin levels, attachment styles and disease severity in patients with generalized anxiety disorder

AIM: We aimed to demonstrate the relationship between plasma oxytocin levels, attachment styles, and disease severity in patients with generalized anxiety disorder, and to examine the relationship between variables. METHODS: Between March and September 2023, 44 patients diagnosed with generalized anxiety disorder according to DSM-V criteria, who presented to the Psychiatry Outpatient Clinic of Balıkesir University Hospital, were included in the study. Additionally, 39 healthy volunteers with similar sociodemographic characteristics were recruited. After providing information about the study and obtaining written consent from the participants, sociodemographic data were collected using a demographic information form. The Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), Generalized Anxiety Disorder 7 (GAD-7) Scale, and Adult Attachment Styles Scale (AASS) were administered to all participants. Plasma oxytocin levels of the participants were determined using the ELISA method from blood samples collected after the administration of the scales. RESULTS: The median oxytocin level was significantly lower in the patient group (129.2 pg/mL) compared to the control group (175.1 pg/mL) (P=0.011). Correlation analysis was conducted to determine the relationship between HAMA and YAB7 scores and oxytocin levels. However, no statistically significant relationship was observed between HAMA scores (P=0.325, r=-0.109), YAB7 scores (P=0.293, r=-0.117), and oxytocin levels. According to the AASS, 45.5% of patients were classified as secure, 40.9% as avoidant, and 13.6% as anxious, while 61.5% of the control group were classified as secure, 30.8% as avoidant, and 7.7% as anxious. There was no statistically significant difference between the groups (P=0.321). When the AASS scores were compared pairwise in terms of oxytocin levels for anxious, avoidant, and secure groups, no statistically significant difference was observed between the groups. A ROC curve was generated to evaluate the performance of plasma oxytocin levels in predicting generalized anxiety disorder. Upon examination of the curve, sensitivity and specificity rates were calculated as 66.7% and 61.4%, respectively, for a cutoff value of 135.9 pg/mL (AUC: 0.663, 95% CI: 0.543-0.782). CONCLUSION: Our study results indicate that, consistent with our hypothesis, plasma oxytocin levels are lower in patients diagnosed with generalized anxiety disorder (GAD) compared to the control group. Our findings support the view that plasma oxytocin levels may be associated with the etiology of GAD. Furthermore, our study suggests that oxytocin could be considered a potential biomarker in the diagnosis of GAD. Keywords: Oxytocin, Generalized Anxiety Disorder, Attachment