Cortisol awakening response and subsequent depression: prospective longitudinal study.

TitleCortisol awakening response and subsequent depression: prospective longitudinal study.
Publication TypeJournal Article
Year of Publication2014
AuthorsCarnegie R, Araya R, Ben-Shlomo Y, Glover V, O'Connor TG, O'Donnell K, Pearson R, Lewis G
JournalBr J Psychiatry
Volume204
Issue2
Pagination137-43
Date Published2014 Feb
ISSN1472-1465
KeywordsAdolescent, Circadian Rhythm, Confounding Factors (Epidemiology), Depression, England, Epidemiologic Methods, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, International Classification of Diseases, Male, Pituitary-Adrenal System, Saliva, Socioeconomic Factors, Wakefulness
Abstract

BACKGROUND: Some studies have found an association between elevated cortisol and subsequent depression, but findings are inconsistent. The cortisol awakening response may be a more stable measure of hypothalamic-pituitary-adrenal function and potentially of stress reactivity.AIMS: To investigate whether salivary cortisol, particularly the cortisol awakening response, is associated with subsequent depression in a large population cohort.METHOD: Young people (aged 15 years, n = 841) from the Avon Longitudinal Study of Parents and Children (ALSPAC) collected salivary cortisol at four time points for 3 school days. Logistic regression was used to calculate odds ratios for developing depression meeting ICD-10 criteria at 18 years.RESULTS: We found no evidence for an association between salivary cortisol and subsequent depression. Odds ratios for the cortisol awakening response were 1.24 per standard deviation (95% CI 0.93-1.66, P = 0.14) before and 1.12 (95% CI 0.73-1.72, P = 0.61) after adjustment for confounding factors. There was no evidence that the other cortisol measures, including cortisol at each time point, diurnal drop and area under the curve, were associated with subsequent depression.CONCLUSIONS: Our findings do not support the hypothesis that elevated salivary cortisol increases the short-term risk of subsequent depressive illness. The results suggest that if an association does exist, it is small and unlikely to be of clinical significance.

DOI10.1192/bjp.bp.113.126250
Alternate JournalBr J Psychiatry
PubMed ID24311550
PubMed Central IDPMC3909839
Grant ListR01 MH073842 / MH / NIMH NIH HHS / United States
084268/2/07/Z / / Wellcome Trust / United Kingdom
092731 / / Wellcome Trust / United Kingdom
MC_PC_15018 / / Medical Research Council / United Kingdom
74882 / / Medical Research Council / United Kingdom
076467 / / Wellcome Trust / United Kingdom
097825 / / Wellcome Trust / United Kingdom
G9815508 / / Medical Research Council / United Kingdom