Increase in Concentration of Waking Salivary Cortisol in Recovered Patients With Depression
Abstract
OBJECTIVE: Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis with elevated plasma cortisol levels is characteristic of acute major depression. However, it is unclear whether HPA axis abnormalities are present in fully recovered patients. An increase in salivary cortisol levels after waking provides a simple, dynamic measure of HPA axis activity. The authors measured this increase in recovered depressed patients and in a healthy comparison group. METHOD: Salivary cortisol levels were measured upon waking and at 15-minute intervals for the next hour in 31 medication-free, recovered depressed patients and in 31 matched healthy comparison subjects. RESULTS: The increase in salivary cortisol levels that followed waking was significantly higher in the patients. CONCLUSIONS: Greater secretion of cortisol may be present in depressed subjects after clinical recovery and withdrawal of medication. This may put patients at risk of further episodes of depression as well as comorbid medical conditions, such as coronary heart disease.
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Increased secretion of cortisol has been reported in depressed subjects after clinical recovery and has been suggested to be a vulnerability marker.
“Increased secretion of cortisol has also been reported to be present in depressed subjects after clinical recovery [57], and has been suggested to be a vulnerability marker.”
Euthymic or acutely ill patients with major depression tend to show increased cortisol awakening response.
“Euthymic or acutely ill patients with major depression, a condition usually characterized by elevated cortisol levels during the day (Pariante and Lightman, 2008), tend to show increased cortisol awakening response (Bhagwagar et al., 2003; Bhagwagar et al., 2005).”
From Abnormal cortisol levels during the day and cortisol awakening response in first-episode psychosis: The role of stress and of antipsychotic treatment (2010) · cites this paper as Bhagwagar et al., 2003
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“Increased secretion of cortisol has also been reported to be present in depressed subjects after clinical recovery [57], and has been suggested to be a vulnerability marker.”
- Authors
- Bhagwagar, Z., Hafizi, S., & Cowen, P. J.
- Affiliations
- Warneford Hospital (GB)
- Venue
- American Journal of Psychiatry
- Published
- 2003-10-01
- Volume
- 160
- Issue
- 10
- Pages
- 1890-1891
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2010799016
- Cited by
- 161
- References
- 8
- Citations by year
- 2023: 5 · 2022: 3 · 2021: 2 · 2020: 7 · 2019: 4 · 2018: 8 · 2017: 7 · 2016: 11 · 2015: 3 · 2014: 14 · 2013: 15 · 2012: 8
- FWCI
- 2.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- salivary cortisol, HPA axis dysregulation, major depressive disorder, remitted depression, recovered patients, cortisol secretion, coronary heart disease risk
- MeSH terms
- Adult, Depressive Disorder, Female, Humans, Hydrocortisone, Male, Middle Aged, Saliva, Wakefulness
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