Salivary cortisol secretion in remitted bipolar patients and offspring of bipolar parents
Open accessAbstract
Objectives: It is generally believed that cortisol secretion normalizes during clinical remission in mood disorders. However, this assumption has been challenged by preliminary reports of enhanced cortisol secretion in remitted bipolar patients and in the offspring of bipolar parents. The purpose of this study is to replicate findings of increased cortisol secretion during clinical remission in bipolar patients and in the offspring of bipolar parents, rigorously controlling for known confounders. Methods: We conducted intensive cortisol sampling (six samples per day for three test days, on three consecutive weekends) on 15 bipolar type I and type II patients and 28 unrelated offspring of bipolar parents. Offspring had a history of unipolar depression. Participation was restricted to cases in complete sustained remission. Controls were matched as closely as possible for age, sex, and education. Mood and sleep measures were recorded on each sampling day. Results: In total, 743 samples were collected from the patient group and 576 from controls. Correcting for repeat measures, there was no statistically significant difference in cortisol secretion at any sampling time between remitted bipolar patients, remitted offspring of bipolar parents, and normal controls. The cortisol waking response did not differ between patients and controls. Covariates, including sex, age, Beck depression score and hours of sleep, were not statistically significant. Conclusions: Our observations are consistent with the view that complete sustained clinical remission is associated with normal salivary cortisol levels throughout the day. A personal or family history of bipolar disorder per se does not appear to confer added risk for increased salivary cortisol secretion during sustained clinical remission.
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Two studies failed to find significant differences in basal cortisol or in ACTH response to CRH among offspring or relatives of bipolar disorder patients.
“while two studies failed to find significant differences in basal CORT (Deshauer et al. 2006) or in ACTH response to CRH (Ronsaville et al. 2006).”
From The HPA axis in bipolar disorder: Systematic review and meta-analysis (2016) · cites this paper as Deshauer et al. 2006
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Cites
Carroll, B. J. (1981) · Archives of General Psychiatry · doi:10.1001/archpsyc.1981.01780260017001 · Cited by 2,243 · see citing works
Pruessner, J. C., Wolf, O. T., Hellhammer, D. H., Buske-Kirschbaum, A., von Auer, K., Jobst, S., Kaspers, F., & Kirschbaum, C. (1997) · Life Sciences · doi:10.1016/s0024-3205(97)01008-4 · Cited by 1,450 · see citing works
The cortisol awakening response - normal values and confounds.
Wüst, S., Wolf, J. M., Hellhammer, D. H., Federenko, I. S., Schommer, N. C., & Kirschbaum, C. (2000) · PubMed · Cited by 700 · see citing works
Genetic factors, perceived chronic stress, and the free cortisol response to awakening
Wüst, S., Federenko, I. S., Hellhammer, D. H., & Kirschbaum, C. (2000) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(00)00021-4 · Cited by 642 · see citing works
The Dexamethasone Suppression Test for Diagnosis and Prognosis in Psychiatry: Commentary and Review
Arana, G. W. (1985) · Archives of General Psychiatry · doi:10.1001/archpsyc.1985.01790350067012 · Cited by 526 · see citing works
Metabolic syndrome in bipolar disorder: findings from the Bipolar Disorder Center for Pennsylvanians
Fagiolini, A. M., Frank, E., Scott, J., Turkin, S. R., & Kupfer, D. J. (2005) · Bipolar Disorders · doi:10.1111/j.1399-5618.2005.00234.x · Cited by 451 · see citing works
Is Response to Prophylactic Lithium a Familial Trait?
Grof, P., Duffy, A., Cavazzoni, P., Grof, E., Garnham, J., MacDougall, M., O'Donovan, C., & Alda, M. (2002) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v63n1013 · Cited by 438 · see citing works
Self-citationBurden of general medical conditions among individuals with bipolar disorder
Kilbourne, A. M., Cornelius, J. R., Han, X., Pincus, H. A., Shad, M. U., Salloum, I. M., Conigliaro, J. C., & Haas, G. L. (2004) · Bipolar Disorders · doi:10.1111/j.1399-5618.2004.00138.x · Cited by 413 · see citing works
Historical perspectives and natural history of bipolar disorder
Angst, J., & Sellaro, R. (2000) · Biological Psychiatry · doi:10.1016/s0006-3223(00)00909-4 · Cited by 393 · see citing works
Holsboer, F., Lauer, C. J., Schreiber, W., & Krieg, J.-C. (2008) · Neuroendocrinology · doi:10.1159/000127023 · Cited by 369 · see citing works
Hypothalamic-pituitary-adrenal axis function in patients with bipolar disorder
Watson, S., Gallagher, P., Ritchie, J. C., Ferrier, I. N., & Young, A. H. (2004) · British Journal of Psychiatry · doi:10.1192/bjp.184.6.496 · Cited by 343 · see citing works
Demographic and Clinical Characteristics of Individuals in a Bipolar Disorder Case Registry
Kupfer, D. J., Frank, E., Grochocinski, V. J., Cluss, P. A., Houck, P. R., & Stapf, D. A. (2002) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v63n0206 · Cited by 294 · see citing works
Circadian secretion of cortisol in bipolar disorder.
Cervantes, P., Gelber, S., Kin, F. N. K. N. Y., Nair, V. N. P., & Schwartz, G. J. (2001) · PubMed Central · Cited by 163 · see citing works
Duffy, A. C., Alda, M., Kutcher, S., Fusee, C., & Grof, P. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.3.431 · Cited by 98 · see citing works
Self-citationBschor, T. (2002) · Neuropsychopharmacology · doi:10.1016/s0893-133x(02)00323-8 · Cited by 84 · see citing works
High levels of cortisol among adolescent offspring of parents with bipolar disorder: a pilot study
Ellenbogen, M. A., Hodgins, S., & Walker, C. D. (2003) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(02)00135-x · Cited by 77 · see citing works
Relationship of sleep abnormalities to patient genotypes in Prader-Willi syndrome
Vgontzas, A. N., Kales, A., Seip, J. R., Mascari, M. J., Bixler, E. O., Myers, D. C., Vela‐Bueno, A., & Rogan, P. K. (1996) · American Journal of Medical Genetics · doi:10.1002/(sici)1096-8628(19960920)67:5 · Cited by 73 · see citing works
Serial dexamethasone suppression tests among rapidly cycling bipolar patients.
Jf, G., DeVigne, J.-P., Albala, A. A., Tarika, J., Buttenheim, M., Eiser, A. S., & Carroll, B. J. (1982) · PubMed · Cited by 49 · see citing works
Patterns of DST positivity in remitted affective disorders
Deshauer, D., Grof, E., Alda, M., & Grof, P. (1999) · Biological Psychiatry · doi:10.1016/s0006-3223(98)00334-5 · Cited by 47 · see citing works
Self-citationUnipolar relatives in bipolar pedigrees: A search for indicators of underlying bipolarity
Blacker, D., Lavori, P. W., Faraone, S. V., et al. (1993) · American Journal of Medical Genetics · doi:10.1002/ajmg.1320480405 · Cited by 32 · see citing works
Serial dexamethasone suppression tests among rapidly cycling bipolar patients
Greden, J. F., DeVigne, J.-P., Albala, A. A., Tarika, J., Buttenheim, M., Eiser, A. S., & Bj, C. (1982) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-198212000-00031 · Cited by 26 · see citing works
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Cited by
Sorted by citations
Hair cortisol, stress exposure, and mental health in humans: A systematic review
Staufenbiel, S. M., Penninx, B. W. J. H., Spijker, A. T., Elzinga, B. M., & van Rossum, E. F. C. (2013) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2012.11.015 · Cited by 736 · see citing works
The HPA axis in bipolar disorder: Systematic review and meta-analysis
Belvederi Murri, M., Prestia, D., Mondelli, V., Pariante, C., Patti, S., Olivieri, B., Arzani, C., Masotti, M., Respino, M., Antonioli, M., et al. (2016) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2015.10.014 · Cited by 391 · see citing works
Knorr, U., Vinberg, M., Kessing, L. V., & Wetterslev, J. (2010) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2010.04.001 · Cited by 317 · see citing works
Morning cortisol levels in schizophrenia and bipolar disorder: a meta-analysis
Girshkin, L., Matheson, S. L., Shepherd, A. M., & Green, M. J. (2014) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2014.07.013 · Cited by 215 · see citing works
Sleep- and circadian rhythm–associated pathways as therapeutic targets in bipolar disorder
Bellivier, F., Geoffroy, P.-A., Etain, B., & Scott, J. (2015) · Expert Opinion on Therapeutic Targets · doi:10.1517/14728222.2015.1018822 · Cited by 104 · see citing works
Hypothalamic-pituitary-adrenal axis and clinical symptoms in first-episode psychosis
Belvederi Murri, M., Pariante, C. M., Dazzan, P., Hepgul, N., Papadopoulos, A. S., Zunszain, P., Di Forti, M., Murray, R. M., & Mondelli, V. (2012) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2011.08.013 · Cited by 93 · see citing works
Havermans, R., Nicolson, N. A., Berkhof, J., & deVries, M. W. (2011) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2010.07.016 · Cited by 79 · see citing works
Ellenbogen, M. A., Santo, J. B., Linnen, A., Walker, C., & Hodgins, S. (2010) · Bipolar Disorders · doi:10.1111/j.1399-5618.2009.00770.x · Cited by 72 · see citing works
Aydin, A., Selvi, Y., Besiroglu, L., Boysan, M., Atli, A., Ozdemir, O., Kilic, S., & Balaharoglu, R. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.04.007 · Cited by 40 · see citing works
Childhood trauma and HPA axis functionality in offspring of bipolar parents
Schreuder, M. M., Vinkers, C. H., Mesman, E., Claes, S., Nolen, W. A., & Hillegers, M. H. J. (2016) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2016.09.017 · Cited by 37 · see citing works
Spijker, A. T., Giltay, E. J., van Rossum, E. F. C., Manenschijn, L., DeRijk, R. H., Haffmans, J., Zitman, F. G., & Hoencamp, E. (2011) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2011.03.020 · Cited by 30 · see citing works
Feng, H., Ho, A. W.-Y., Lei, B., Chan, J. W. Y., Wang, J., Liu, Y., Tsang, J. C. C., Chan, N. Y., Lam, S. P., Merikangas, K. R., et al. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.07.029 · Cited by 11 · see citing works
- Authors
- Deshauer, D., Duffy, A., Meaney, M., Sharma, S., & Grof, P.
- Affiliations
- University of Ottawa (CA)
- McGill University (CA)
- University of Toronto (CA)
- Corresponding author
- Deshauer, Dorian
- Venue
- Bipolar Disorders
- Publisher
- Wiley
- Published
- 2006-07-18
- Volume
- 8
- Issue
- 4
- Pages
- 345-349
- ISSN
- 1398-5647 (ISSN-L)
- 1399-5618
- OpenAlex
- W2067723782
- Cited by
- 53
- References
- 21
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2022: 2 · 2021: 6 · 2018: 1 · 2017: 1 · 2016: 4 · 2015: 3 · 2014: 7 · 2013: 3 · 2012: 4
- FWCI
- 1.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Bipolar Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- salivary cortisol, bipolar disorder, clinical remission, offspring of bipolar parents, familial risk, diurnal cortisol rhythm, major depressive disorder, mood disorders
- MeSH terms
- Adolescent, Adult, Bipolar Disorder, Female, Humans, Hydrocortisone, Male, Middle Aged, Radioimmunoassay, Retrospective Studies, Saliva, Child of Impaired Parents
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