Lower cortisol levels predict recurrence in remitted patients with recurrent depression: A 5.5 year prospective study

Autor: Aart H. Schene, Claudi L H Bockting, Anja Lok, Ieke Visser, Johanna Assies, Maarten W. J. Koeter
Přispěvatelé: Clinical Psychology and Experimental Psychopathology, Other departments, Amsterdam Neuroscience, Adult Psychiatry, Cancer Center Amsterdam, Amsterdam Public Health, Graduate School
Jazyk: angličtina
Rok vydání: 2012
Předmět:
Male
SALIVARY CORTISOL
Hydrocortisone
Pituitary-Adrenal System
RELAPSE
Severity of Illness Index
Cortisol
Childhood trauma
POSTTRAUMATIC-STRESS-DISORDER
Recurrence
Risk Factors
Longitudinal Studies
Prospective Studies
FAMILIAL RISK
Prospective cohort study
Depression (differential diagnoses)
Depression
Relapse/recurrence
Follow-up
Middle Aged
Psychiatry and Mental health
Major depressive disorder
Female
PREVENTIVE COGNITIVE THERAPY
Psychology
hormones
hormone substitutes
and hormone antagonists
medicine.drug
Adult
Hypothalamo-Hypophyseal System
medicine.medical_specialty
endocrine system
Cortisol awakening response
CRH TEST
Predictive Value of Tests
Internal medicine
Severity of illness
medicine
Humans
Risk factor
Saliva
Psychiatry
METAANALYSIS
Biological Psychiatry
NEGATIVE LIFE EVENTS
AXIS ACTIVITY
Depressive Disorder
HPA axis
MAJOR DEPRESSION
medicine.disease
Prediction
Zdroj: Psychiatry Research, 200(2-3), 281-287. ELSEVIER IRELAND LTD
Psychiatry research, 200(2-3), 281-287. Elsevier Ireland Ltd
ISSN: 0165-1781
DOI: 10.1016/j.psychres.2012.03.044
Popis: Major Depressive Disorder (MDD) is a highly recurrent disease. Stress-responsive system dysfunction seems to persist after remission. In patients with more chronic and recurrent depressive episodes, state related HPA-axis dysregulation might be a risk factor for prospective recurrence. This study examines the predictive effect of cortisol on consecutive episodes in remitted recurrently depressed patients.Cortisol was assessed in saliva in remitted recurrently depressed patients (n=55) that were followed up prospectively for 5.5 years after remission. Recurrence was assessed using a well validated structured interview.Lower mean morning cortisol levels predicted earlier time to recurrence over 5.5 year after correction for residual symptoms (p=0.015). Residual symptoms and childhood trauma slightly confounded the association between cortisol and recurrence. Lower cortisol levels were associated with having experienced traumatic childhood life events (42.3% in patients with lower cortisol versus 19.2% in patients with higher cortisol).Our study provides further support for the predictive role over 5.5 year of HPA axis dysregulation, i.e. lower morning cortisol levels, of recurrence in recurrently depressed patients. Childhood trauma is associated to having lower cortisol levels. It might have long term consequences for dealing with stress and the HPA-axis. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
Databáze: OpenAIRE
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