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Salivary alpha-amylase (sAA) has been suggested to reflect stress-related body changes. Psychosocial stress increases the release of salivary alpha-amylase, which reflects the activity of the sympathetic-adrenal-medullary (SAM) system. Therefore, it is presumed that sAA measurement is a useful tool for evaluating the SAM system. In addition, previous studies examining the response of sAA levels to SAM system activity showed that increased sAA levels were correlated with increased plasma catecholamine, indicating sympathetic nervous system activation. So far, numerous studies have shown that changes in sAA levels are dependent on stress stimuli. It is difficult to objectively evaluate the emotional and physical state. sAA measurement can be performed easily and quickly, and therefore, could be used to aid the evaluation of the psychosocial and/or physical stress levels. It is very important to be able to evaluate and understand the level of psychosocial and/or physical stress (distress) experienced by patients. The measurement of sAA is expected to be useful tool as a patient distress. In panic disorder, stressful events are frequently comprised of both neutral and emotionally arousing information, yet the impact of stress on emotional and neutral events is still not fully understood. The hippocampus contains dense concentrations of receptors for stress hormones (such as cortisol), and elevated stress hormone levels can impair performance on hippocampal-dependent memory tasks. Yet, cortisol can also facilitate memory for emotional information, and this involves interactions between the hippocampus and amygdala. Physiological and psychological stresses have the short-term effects on salivary amylase (sAA) and salivary cortisol levels during both emotional and neutral episodes. The stress manipulation results sAA and salivary cortisol responsiveness. The stress manipulation also increases salivary cortisol levels, catecholamine function as indicated by

Acute Stress in Patients with Panic Disorder Produces Effects on Salivary Amylase and Cortisol