Recent life events, cortisol, dehydroepiandrosterone and the onset of major depression in high-risk adolescents
Open accessAbstract
Background: It is not clear whether cortisol or dehydroepiandrosterone (DHEA) hypersecretion increases the risk for major depression in the presence of undesirable life events. Aims: To determine whether there is a specific pattern of psychoendocrine factors that predicts the onset of major depressive disorder. Method: 180 adolescents (73 boys, 107 girls) at high risk for psychopathology were assessed for cortisol, DHEA, depressive symptoms, life events and psychiatric disorder at entry and 12 months later. Results: Major depression was predicted for both genders by the additive effects of: higher depressive symptoms; personal disappointments and losses only in the month before onset; one or more daily levels of cortisol at 08.00 h or DHEA at 20.00 h greater than the 80th percentile of the daily mean. Conclusions: A subgroup of adolescents may carry a physiological risk for major depression which may be either of genetic and/or earlier psychosocial origin.
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Written from the paper’s full text.
TL;DR
In high-risk adolescents, onset of DSM-IV major depression over 12 months was predicted by recent proximal disappointments/losses, higher depressive symptoms, and daily peaks of morning cortisol or evening DHEA. These psychosocial and endocrine predictors appeared independent.
Key findings
- Of 171 reassessed adolescents, 30 (18%) had an onset of DSM-IV major depression. Cases were more likely than non-cases to have undesirable events only in the preceding month: 18/30 (60%) v. 31/141 (22%), exact test P=0.0001, odds ratio 5.4 (95% CI 2.4–12.2); general event burden over 12 months did not differ.
- In conditional fixed-effects logistic regression, only disappointments (OR 58.9, P=0.0001, 95% CI 7.0–495.5) and permanent losses (OR 8.8, P=0.004, 95% CI 2.02–38.6) in the month before onset predicted MDD, along with lower mood and feelings scores (OR 1.1, P=0.051, 95% CI 1.00–1.13).
- Peak cortisol at 08.00 h (OR 7.1, P=0.008, 95% CI 1.67–30.4) and peak DHEA at 20.00 h (OR 4.2, P=0.02, 95% CI 1.2–14.7) predicted subsequent MDD; absolute mean hormone levels did not contribute to the model.
- Peak-positive status was unrelated to life events or MFQ scores, and only 16/30 (53%) MDD episodes were preceded by a disappointment or loss event.
Methods
- Prospective high-risk sample: 1451 adolescents screened; 180 high-risk adolescents (73 boys, 107 girls) entered, and 171 completed psychosocial and endocrine follow-up; 30 MDD onsets occurred.
- Measures at entry and 12 months included Kiddie-SADS, life events interview, Mood and Feelings Questionnaire, and salivary cortisol and DHEA at 08.00 h and 20.00 h over 4 consecutive days; a peak was defined a priori as one or more level greater than the 80th percentile of the daily group mean (by gender, and by age for DHEA).
- Analysis used exact statistics, Bonferroni-corrected ANOVA on log-transformed continuous data, and conditional fixed-effects logistic regression to predict MDD onset.
Limitations
- Stated: the small number of boys with depression limited gender analyses; only 4 days of saliva collection were undertaken and the validity of the peak measure requires further investigation; it remains unclear whether peaks are psychopathologically significant only in high-risk adolescents; the design was not adequate to test physiological reactivity to minor events or hassles; nearly all subjects were post-pubertal, so puberty-related endocrine risk could not be assessed; findings may not generalise to adolescents not at high risk.
- Evident from the text: the observational design cannot establish causality, and life events and mood were assessed by self-report.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
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Cites
Statistics
Claims the paper makes
3 of 14 cited sources checked · 1 supported · 0 flagged · accuracy not yet measured
- Premisecitation§ Personal disappointments, loss Personal disappointments, loss and subsequent MDD and subsequent MDD
A previous paper showed that the onset of MDD occurs in 90% of cases from the high-risk population with antecedent ongoing psychosocial adversities.
“A previous paper showed that the onset A previous paper showed that the onset of MDD occurs in of MDD occurs in 4 490% of cases from the 90% of cases from the high-risk population with antecedent high-risk population with antecedent ongoing psychosocial adversities (Goodyer ongoing psychosocial adversities (Goodyer et al et al, 2000).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Goodyer et al, 2000 source
In “Correlates of major depression” (page unavailable), the paper says 90% of MDD cases were preceded by two or more undesirable life events in the year before entry. It does not establish that those adversities were ongoing. In “Onsets of major depression by 12-month follow-up” (page unavailable), it reports that 30 of 172 high-risk subjects (17%) developed MDD—not 90% of the high-risk group. (LLM, conf=0.86)
Experimental — accuracy not yet measured
- Findingown data§ Antecedent depressive symptoms Antecedent depressive symptoms
A post hoc examination of this high-risk sample showed no difference in MFQ scores at entry between those onsets with identified proximal events (26.47, s.d. 11.77) and those without (23.2, s.d. 7.47).
“A A post hoc post hoc examination of the characteris-examination of the characteristics of this high-risk sample showed no tics of this high-risk sample showed no difference in MFQ scores at entry between difference in MFQ scores at entry between those onsets with identified proximal events those onsets with identified proximal events (`events-driven') 26.47 (s.d.(`events-driven') 26.47 (s.d.11.77”
Quote in the paperNot a substantial claim - Findingown data§ Peaks Peaks
Those who were peak-positive for cortisol at 08.00 h and 20.00 h were significantly older than those who were not.
“Those who were peak-positive for corti-Those who were peak-positive for cortisol at 08.00 h and 20.00 h were signifi-sol at 08.00 h and 20.00 h were significantly older than those who were not cantly older than those who were not”
Quote in the paperNot a substantial claim - Findingown data§ Peaks Peaks
There was no association between the proportions of subjects who were cortisol and DHEA peak-positive at either time point.
“There was no association between the There was no association between the proportions of subjects who were cortisol proportions of subjects who were cortisol and DHEA peak-positive at either time and DHEA peak-positive at either time point.point.”
Quote in the paperNot a substantial claim - Findingown data§ Peak hormones, life events and Peak hormones, life events and depressive symptoms at entry depressive symptoms at entry
In high-risk adolescents, the onset of subsequent major depressive disorder is associated with being cortisol peak-positive at 08.00 h (OR 7.1; P=0.008, 95% CI 1.67-30.4).
“cortisol peak-positive at 08.00 h (OR cortisol peak-positive at 08.00 h (OR7.1;7.1; P P0.008, 95% CI 0.008, 95% CI1.67±30.4)”
- Also stated in: § Personal disappointments, loss Personal disappointments, loss and subsequent MDD and subsequent MDD · plain
“Cortisol peaks 08.00 h Cortisol peaks 08.00 h 7.1 7.1 0.008 0.008 1.67^30.41.67^30.4”
Quote in the paperSubstantial claim - Also stated in: § Personal disappointments, loss Personal disappointments, loss and subsequent MDD and subsequent MDD · plain
- Findingown data§ Peak hormones and subsequent Peak hormones and subsequent MDD MDD
The occurrence of peaks in morning cortisol is predictive of subsequent MDD in high-risk adolescents.
“This paper shows, for the first time, This paper shows, for the first time, that the occurrence of peaks in morning that the occurrence of peaks in morning cortisol is predictive of subsequent MDD cortisol is predictive of subsequent MDD in high-risk adolescents.”
- Also stated in: § Additional information · plain
“Daily peaks of morning cortisol or evening dehydroepiandrosterone also predict Daily peaks of morning cortisol or evening dehydroepiandrosterone also predict onset.”
Quote in the paperSubstantial claim - Also stated in: § Additional information · plain
- Findingown data§ Peak hormones, life events and Peak hormones, life events and depressive symptoms at entry depressive symptoms at entry
In high-risk adolescents, the onset of subsequent major depressive disorder is associated with being DHEA peak-positive at 20.00 h (OR 4.2, P=0.02, 95% CI 1.2-14.7).
“DHEA peak-positive at 20.00 h (OR peak-positive at 20.00 h (OR4.2, 4.2, P P0.02, 95% CI 0.02, 95% CI1.2±14.7)”
- Also stated in: § Personal disappointments, loss Personal disappointments, loss and subsequent MDD and subsequent MDD · plain
“DHEA peaks 20.00 h DHEA peaks 20.00 h 4.2 4.2 0.02 0.02 1.2^14.7 1.2^14.7”
Quote in the paperSubstantial claim - Also stated in: § Personal disappointments, loss Personal disappointments, loss and subsequent MDD and subsequent MDD · plain
- Findingown data§ Personal disappointments, loss Personal disappointments, loss and subsequent MDD and subsequent MDD
Among recent undesirable life events, only those in the preceding month are associated with the onset of disorder.
“So far as recent undesirable life events are con-recent undesirable life events are concerned, only those in the preceding month cerned, only those in the preceding month are associated with the onset of disorder.”
Quote in the paperSubstantial claim - Findingown data§ Peak hormones, life events and Peak hormones, life events and depressive symptoms at entry depressive symptoms at entry
Peak cortisol at 08.00 h at entry was significantly associated with subsequent MDD.
“A significant association was found for peak significant association was found for peak cortisol at 08.00 h (18/28 (64%) cortisol at 08.00 h (18/28 (64%) v. v. 52/ 52/ 137 (38%), exact test 137 (38%), exact test P P0.012, odds ratio 0.012, odds ratio 2.9, 95% CI 1.3±6.7),and peak DHEA at 2.9, 95% CI 1.3±6.7),and peak DHEA at 20.00 h (11/27 (41%) 20.00 h (11/27 (41%) v. v. 25/136 (18%), 25/136 (18%”
Quote in the paperSubstantial claim - Findingown data§ Life events Life events
There was no effect of age on onset of major depression for either gender.
“There was no effect of age for either gender.”
Quote in the paperNot a substantial claim - Findingnone given§ Peak hormones and subsequent Peak hormones and subsequent MDD MDD
Peaks were more likely in older high-risk adolescents of either gender.
“Peaks were also more likely in older high-risk adolescents of likely in older high-risk adolescents of either gender.”
Quote in the paperNot a substantial claim - Findingown data§ Types of events Types of events
Only disappointments and permanent losses in the first month before interview/onset were associated with subsequent MDD.
“Only disappointments and permanent Only disappointments and permanent losses in the first month before interview/ losses in the first month before interview/ onset were associated with subsequent onset were associated with subsequent MDD.”
Quote in the paperSubstantial claim - Findingown data§ Peaks Peaks
There were no significant differences in the proportion of peak-positive subjects at 08.00 h for either hormone in either males or females.
“The findings show that there were no significant differences in the there were no significant differences in the proportion of peak-positive subjects at proportion of peak-positive subjects at 08.00 h for either hormone in either males 08.00 h for either hormone in either males or females.”
Quote in the paperNot a substantial claim - Findingnone given§ Personal disappointments, loss Personal disappointments, loss and subsequent MDD and subsequent MDD
The gender difference in reporting of negative events is confined solely to events that are not associated with onset of disorder.
“The gender difference in reporting of negative events is confined reporting of negative events is confined solely to events that are not associated with solely to events that are not associated with onset of disorder.”
Quote in the paperSubstantial claim - Findingown data§ Peak hormones and subsequent Peak hormones and subsequent MDD MDD
Peaks in evening DHEA were also associated with subsequent MDD.
“Peaks in evening DHEA were also associated with subse-DHEA were also associated with subsequent MDD.”
Quote in the paperSubstantial claim - Findingown data§ Peak hormones, life events and Peak hormones, life events and depressive symptoms at entry depressive symptoms at entry
Peak DHEA at 20.00 h at entry was significantly associated with subsequent MDD.
“A significant association was found for peak significant association was found for peak cortisol at 08.00 h (18/28 (64%) cortisol at 08.00 h (18/28 (64%) v. v. 52/ 52/ 137 (38%), exact test 137 (38%), exact test P P0.012, odds ratio 0.012, odds ratio 2.9, 95% CI 1.3±6.7),and peak DHEA at 2.9, 95% CI 1.3±6.7),and peak DHEA at 20.00 h (11/27 (41%) 20.00 h (11/27 (41%) v. v. 25/136 (18%), 25/136 (18%”
Quote in the paperSubstantial claim - Findingown data§ Timing of events Timing of events
Significantly more girls than boys reported experiencing one or more events over the rest of the 2- to 12-month period.
“By contrast, significantly more girls than By contrast, significantly more girls than boys reported experiencing one or more boys reported experiencing one or more events over the rest of the 2-to 12-month events over the rest of the 2-to 12-month period (exact test, period (exact test, P P0.028, odds 0.028, odds ratio ratio2.5;95% CI 1.17±5.49).”
Quote in the paperNot a substantial claim - Findingown data§ Peak hormones and subsequent Peak hormones and subsequent MDD MDD
There is no relation between peaks for either hormone, higher self-report depression scores and the occurrence of life events.
“There is no relation between peaks for either hormone, higher self-report peaks for either hormone, higher self-report depression scores and the occurrence of life depression scores and the occurrence of life events, further suggesting that these factors events, further suggesting that these factors may be independent.”
Quote in the paperSubstantial claim - Findingown data§ Peak hormones, life events and Peak hormones, life events and depressive symptoms at entry depressive symptoms at entry
Mean scores on the MFQ scale were not significantly different between peak-positive and peak-negative groups for cortisol or DHEA at either time point.
“Mean scores on the MFQ scale were not Mean scores on the MFQ scale were not significantly different between peak-significantly different between peak-positive and peak-negative groups for positive and peak-negative groups for cortisol or DHEA at either time point.cortisol or DHEA at either time point.”
Quote in the paperNot a substantial claim - Findingown data§ Antecedent depressive symptoms Antecedent depressive symptoms
There were no differences in the psychosocial risk profiles of the events-driven and non-event-driven groups.
“There were no differences in the psychosocial risk pro-no differences in the psychosocial risk profiles of the two groups.”
Quote in the paperNot a substantial claim - Findingown data§ Peak hormones, life events and Peak hormones, life events and depressive symptoms at entry depressive symptoms at entry
There were no associations between peak positive status and the number of events.
“Neither were there any associations with the number of events.”
Quote in the paperNot a substantial claim - Findingown data§ Peak hormones, life events and Peak hormones, life events and depressive symptoms at entry depressive symptoms at entry
There were no associations between peak positive status and any type of event either at 1 month or 2-12 months before onset or during follow-up.
“There were no associations between peak There were no associations between peak positive status and any type of event either positive status and any type of event either at 1 month or 2±12 months before onset or at 1 month or 2±12 months before onset or during follow-up.Neither were there any during follow-up.Neither were there any associations with the number of events.”
Quote in the paperSubstantial claim - Findingcitation§ Antecedent depressive symptoms Antecedent depressive symptoms
There are additive effects between current mood at entry and the impact of proximal life events.
“However, there are additive effects However, there are additive effects between current mood at entry and the between current mood at entry and the impact of proximal life events, further impact of proximal life events, further confirming that higher levels of depressive confirming that higher levels of depressive symptoms are associated with subsequent symptoms are associated with subsequent”
Quote in the paperNot a substantial claim - Study design and conductown data§ METHOD METHOD Population ascertainment Population ascertainment
There was no difference in mean symptom scores between adolescents whose parents did and did not return the screening questionnaires.
“There was no difference in the mean There was no difference in the mean scores for adolescents whose parents did scores for adolescents whose parents did and did not return the questionnaires: and did not return the questionnaires: returnees ( returnees (n n690), 21.”
Quote in the paperNot a substantial claim - Interpretationnone given§ Peak hormones and subsequent Peak hormones and subsequent MDD MDD
Mean values will not delineate subjects with extreme day-to-day variation of either hormone.
“The latter will not delineate subjects with The latter will not delineate subjects with extreme day-to-day variation of either extreme day-to-day variation of either hormone.”
Quote in the paperSubstantial claim - Interpretationreasoning§ Additional information
The origins of the hormonal predictors of onset are not related to the immediate psychosocial environment.
“The origins of these hormonal predictors are not related to the immediate psychosocial environment.”
Quote in the paperSubstantial claim - Study design and conductown data§ Puberty, hormones Puberty, hormones and subsequent MDD and subsequent MDD
Because nearly all subjects were post-pubertal, the study cannot assess the puberty-related endocrine risk in relation to that presented by peaks in cortisol or DHEA.
“Since nearly all our subjects were post-pubertal, nearly all our subjects were post-pubertal, we cannot assess this risk in relation to that we cannot assess this risk in relation to that presented by peaks in cortisol or DHEA.”
Quote in the paperSubstantial claim - Premisecitation§ Hormone reactivity Hormone reactivity to environmental demands to environmental demands
There is evidence that cortisol reactivity occurs when subjects are put into stressful circumstances, particularly those associated with an increase in negative mood.
“There is evidence that cortisol reactivity does occur when subjects are reactivity does occur when subjects are put into stressful circumstances, parti-put into stressful circumstances, particularly those that are associated with an in-cularly those that are associated with an increase in negative mood (van Eck crease in negative mood (van Eck et al et al, , 1996).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites van Eck et al, 1996 source
- Interpretationcitation§ Personal disappointments, loss Personal disappointments, loss and subsequent MDD and subsequent MDD
These findings differ from those that suggest gender-differentiated effects of life events in the onset of subsequent disorder.
“These findings differ from those that suggest gender-differen-from those that suggest gender-differentiated effects of life events in the onset of tiated effects of life events in the onset of subsequent disorder (Petersen subsequent disorder (Petersen et al et al, 1991).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Petersen et al, 1991 source
- Interpretationreasoning§ Antecedent depressive symptoms Antecedent depressive symptoms
Highly proximal events may exert their psychopathological effects by increasing an already rising level of depressive symptoms above clinical threshold.
“This leads to the tentative con-events.This leads to the tentative conclusion that highly proximal events may clusion that highly proximal events may exert their psychopathological effects by exert their psychopathological effects by increasing an already rising level of de-increasing an already rising level of depressive symptoms above clinical threshold.pressive symptoms above clinical threshold”
Quote in the paperSubstantial claim - Premisecitation§ Antecedent depressive symptoms Antecedent depressive symptoms
Higher levels of depressive symptoms are associated with subsequent onset of MDD in this high-risk group.
“confirming that higher levels of depressive confirming that higher levels of depressive symptoms are associated with subsequent symptoms are associated with subsequent onset of MDD in this high-risk group onset of MDD in this high-risk group (Lewinsohn (Lewinsohn et al et al, 1995).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Lewinsohn et al, 1995 source
- Interpretationown data§ Puberty, hormones Puberty, hormones and subsequent MDD and subsequent MDD
The findings suggest a putative causal role for cortisol and DHEA that is not a consequence of highly proximal recent life events or subclinical depressive symptoms.
“The findings in this paper suggest a puta-The findings in this paper suggest a putative causal role for cortisol and DHEA that tive causal role for cortisol and DHEA that is not a consequence of highly proximal is not a consequence of highly proximal recent life events or subclinical depressive recent life events or subclinical depressive symptoms.”
Quote in the paperSubstantial claim - Interpretationown data§ Personal disappointments, loss Personal disappointments, loss and subsequent MDD and subsequent MDD
In adolescents at high risk for psychopathology, there are both psychosocial and endocrine contributions to the precursors for major depression.
“The findings in this paper suggest that, in The findings in this paper suggest that, in adolescents at high risk for psycho-adolescents at high risk for psychopathology, there are both psychosocial pathology, there are both psychosocial and endocrine contributions to the pre-and endocrine contributions to the precursors for major depression.”
Quote in the paperSubstantial claim - Interpretationown data§ Personal disappointments, loss Personal disappointments, loss and subsequent MDD and subsequent MDD
Nearly half of the episodes of MDD arise in high-risk individuals who are not exposed to immediate proximal life events.
“Thus, nearly half of the episodes event.Thus, nearly half of the episodes arise in high-risk individuals who are not arise in high-risk individuals who are not exposed to these immediate proximal exposed to these immediate proximal experiences.”
Quote in the paperSubstantial claim
- Classified as probably not a substantial claim. 17
- May combine two claims. 16
- The quote only partly states this claim. 1
Classified as probably not a substantial claim. May combine two claims.
Premisecitation§ Declaration of interest Declaration of interest FundingRecent undesirable events and subclinical depressive symptoms correlate with subsequent onset of major depressive disorder in adolescents.
“Recent undesirable events and subclinical Recent undesirable events and subclinical depressive symptoms are known to corre-depressive symptoms are known to correlate with subsequent onset of major de-late with subsequent onset of major depressive disorder (MDD) in adolescents pressive disorder (MDD) in adolescents (Lewinsohn (Lewinsohn et al et al, 1995;Goodyer , 1995;Goodyer et al et al, , 2000).”
Quote in the paperSubstantial claim1 of 2 sources checked- cites Lewinsohn et al, 1995 source
- cites Goodyer et al, 2000 source
In “Correlates of major depression” (page unavailable), the paper reports that higher baseline MFQ depressive-symptom scores were significantly associated with subsequent MDD. But “Risk factors at entry and subsequent MDD” reports no significant difference in measured risk-factor exposure between high-risk adolescents who did and did not develop MDD. Recent undesirable events were common in both groups, so this paper does not establish the claimed association for those events. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Peak hormones and subsequent Peak hormones and subsequent MDD MDDMean salivary DHEA at 08.00 h is associated with subsequent MDD in a combined analysis of both low- and high-risk adolescents.
“It has already been suggested that mean salivary DHEA been suggested that mean salivary DHEA at 08.00 h is associated with subsequent at 08.00 h is associated with subsequent MDD in a combined analysis of both low-MDD in a combined analysis of both lowand high-risk adolescents (Goodyer and high-risk adolescents (Goodyer et al et al, , 2000).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Goodyer et al, 2000 source
May combine two claims.
Findingown data§ Mean levels Mean levelsMean salivary cortisol was higher in girls than boys at 08.00 h but not at 20.00 h.
“Mean salivary cortisol was higher in girls Mean salivary cortisol was higher in girls than boys at 08.00 h ( than boys at 08.00 h (F F(1172) (1172)6.24,6.24, P P0.013 (Bonferroni)) but not at 20.00 h.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ Mean levels Mean levelsMean salivary DHEA was higher in girls than boys at 08.00 h and at 20.00 h.
“Mean salivary DHEA was also higher in Mean salivary DHEA was also higher in girls than boys at 08.00 h ( girls than boys at 08.00 h (F F(1164) (1164)6.23,6.23, P P0.014) and at 20.00 h ( 0.014) and at 20.00 h (F F(1164) (1164)4.23,4.23, P P0.041).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ Personal disappointments, loss Personal disappointments, loss and subsequent MDD and subsequent MDDThere is no evidence that the proximal life-event process is influenced by the number of events in the preceding 11 months, or that it is dependent on social connectivity between similar types of events over this time frame.
“There is no evidence that this proximal There is no evidence that this proximal process is influenced by the number of process is influenced by the number of events in the preceding 11 months, or that events in the preceding 11 months, or that it is dependent on social connectivity it is dependent on social connectivity between similar types of events over this between similar types of events over”
Quote in the paperSubstantial claimMay combine two claims. The quote only partly states this claim.
Findingown data§ Personal disappointments, loss Personal disappointments, loss and subsequent MDD and subsequent MDDDisappointments and loss events in the one month closest to onset remain highly significant predictors of onset, with higher self-report mood and feeling scores also retained in the model.
“Disappointments 1 month before onset Disappointments 1 month before onset 58.9 58.9 0.0001 0.0001 7.0^495.57.0^495.5Permanent losses 1 month before onset Permanent losses 1 month before onset 8.8 8.8 0.004 0.004 2.02^38.62.02^38.6”
- Also stated in: § Additional information · plain
“Highly proximal (within 1 month) disappointments or personal losses are Highly proximal (within 1 month) disappointments or personal losses are associated with the onset of major depressive disorder in high-risk adolescents.”
Quote in the paperSubstantial claim- Also stated in: § Additional information · plain
May combine two claims.
Findingown data§ Mean levels Mean levelsThere was a large diurnal variation in mean cortisol and a much smaller one in DHEA.
“There was a large diurnal variation in mean There was a large diurnal variation in mean cortisol (am:pm ratio 12:8) and a much cortisol (am:pm ratio 12:8) and a much smaller one in DHEA (am:pm ratio 2:1).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown data§ Hormone measures Hormone measuresCortisol assay intra-assay variation was 5.7% and inter-assay variation was 5.6%.
“Intra-assay variation was 5.7%; inter-assay variation was 5.6%.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Premisecitation§ Declaration of interest Declaration of interest FundingElevated corticosteroids increase the liability for affective illness.
“although elevated corticosteroids increase although elevated corticosteroids increase the liability for affective illness (Lewis & the liability for affective illness (Lewis & Smith, 1983).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Lewis & Smith, 1983 source
Classified as probably not a substantial claim.
Premisecitation§ Definition of high risk Definition of high riskRecent undesirable life events exert their greatest risk when they occur as additive experiences in multiples greater than 2 over the previous 12 months.
“Recent undesirable life events exert their Recent undesirable life events exert their greatest risk when they occur as additive greatest risk when they occur as additive experiences in multiples greater than 2 over experiences in multiples greater than 2 over the previous 12 months (Goodyer, 1995).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Goodyer, 1995
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S2 (checkable).
Interpretationreasoning§ Peak hormones and subsequent Peak hormones and subsequent MDD MDDMeasuring peaks gives a different perspective on endocrine function from determining mean values.
“Measuring peaks gives a different perspective on endocrine gives a different perspective on endocrine function from determining mean values.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Peak hormones and subsequent Peak hormones and subsequent MDD MDDThe peak-type measure has been used to estimate variability or 'reactivity' in cortisol in children.
“This type of measure has been used to estimate measure has been used to estimate variability or `reactivity' in cortisol in variability or `reactivity' in cortisol in children (Gunnar, 1998).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Gunnar, 1998 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ Antecedent depressive symptoms Antecedent depressive symptomsIn a recent longitudinal study, depressive symptoms over 4 years increased the risk for internalising disorder, with parent-child disagreements exerting their effects indirectly by increasing the level of depressive symptoms over time.
“In a recent longitudinal study, depressive symptoms longitudinal study, depressive symptoms over 4 years increased the risk for inter-over 4 years increased the risk for internalising disorder, with parent±child dis-nalising disorder, with parent±child disagreements exerting their effects indirectly agreements exerting their effects indirectly by increasing the level of depressive by increasing”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Rueter et al, 1999 source
May combine two claims.
Premisecitation§ Puberty, hormones Puberty, hormones and subsequent MDD and subsequent MDDDHEA levels increase during puberty in both boys and girls, whereas cortisol levels remain relatively unaltered.
“As for the latter, it is well known that DHEA for the latter, it is well known that DHEA levels increase during puberty in both boys levels increase during puberty in both boys and girls, whereas cortisol levels remain and girls, whereas cortisol levels remain relatively unaltered (Kroboth relatively unaltered (Kroboth et al et al, 1999;, 1999;Parker, 1999).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Kroboth et al, 1999; Parker, 1999
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Study design and conductnone given§ Puberty, hormones Puberty, hormones and subsequent MDD and subsequent MDDThe findings may not generalise to adolescents not at high risk as defined.
“The findings may not generalise to adolescents not at high risk as defined.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown data§ Hormone measures Hormone measuresDHEA assay intra-assay variation was 5.1% and inter-assay variation was 7.4%.
“Intra-assay variation was 5.1%, inter-assay variation was 7.4%.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing). May combine two claims.
Premisecitation§ Puberty, hormones Puberty, hormones and subsequent MDD and subsequent MDDIt is postulated that rising levels of testosterone and/or oestrogen are themselves related to increased risk for MDD in girls.
“For example, it is postulated that rising For example, it is postulated that rising levels of testosterone and/or oestrogen are levels of testosterone and/or oestrogen are themselves related to increased risk for themselves related to increased risk for MDD in girls (Angold MDD in girls (Angold et al et al, 1999).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Angold et al, 1999 source
Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.
Interpretationreasoning§ Peak hormones and subsequent Peak hormones and subsequent MDD MDDThe origins of individual variation in peak levels for both hormones may arise in more distal adverse environments and/or from genetic influences.
“The origins of individual variation in peak levels for both hormones variation in peak levels for both hormones may arise in more distal adverse environ-may arise in more distal adverse environments and/or from genetic influences.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationreasoning§ Peak hormones and subsequent Peak hormones and subsequent MDD MDDHormone peaks, higher self-report depression scores and the occurrence of life events may be independent factors.
“events, further suggesting that these factors events, further suggesting that these factors may be independent.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoning§ Hormone reactivity Hormone reactivity to environmental demands to environmental demandsThe current design is not an adequate test of a possible physiological reactivity model in which hour-to-hour variation is a function of minor events or hassles rather than major events in recent weeks.
“The current design is not an adequate test The current design is not an adequate test of a possible physiological reactivity model of a possible physiological reactivity model where hour-to-hour variation can be a where hour-to-hour variation can be a function of minor events or hassles in function of minor events or hassles in people's lives rather than major events in people's lives rather than”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown data§ Peak hormones and subsequent Peak hormones and subsequent MDD MDDThe validity of the peak measure requires further investigation: only 4 days of saliva collection was undertaken and it is unclear whether this is sufficient to obtain a representative sample of subjects liable to 'peak' levels.
“The validity of the peak measure requires further investigation.Only 4 days requires further investigation.Only 4 days of saliva collection was undertaken and it of saliva collection was undertaken and it is unclear whether this is sufficient to obtain is unclear whether this is sufficient to obtain a representative sample of subjects liable to a representative sample of subjects liable to `peak'”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Peak hormones and subsequent Peak hormones and subsequent MDD MDDIn well children, morning cortisol levels in the highest interquartile range, rather than the daily mean, are associated with a solitary and negative affective behavioural style.
“For example, in well children it is morning example, in well children it is morning cortisol levels in the highest interquartile cortisol levels in the highest interquartile range, rather than the daily mean, that are range, rather than the daily mean, that are associated with a solitary and negative associated with a solitary and negative affective behavioural style (Gunnar, 1998).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Gunnar, 1998 source
May combine two claims.
Interpretationreasoning§ Personal disappointments, loss Personal disappointments, loss and subsequent MDD and subsequent MDDProvided that the recognition of proximal events is accurate, there may be other factors predisposing to disorder.
“Provided that the recognition of proximal events is accurate, this suggests of proximal events is accurate, this suggests that there may be other factors that there may be other factors predisposing to disorder.”
Quote in the paperSubstantial claim- The authors state this as an assumption: The recognition of proximal life events is accurate.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given§ Additional informationThe findings are constrained by the number of daily salivary samples.
“The findings are constrained by the number of daily salivary samples.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given§ Additional informationThe number of cases prevents more detailed analyses of gender differences.
“The number of cases prevents more detailed analyses of gender differences.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown data§ Conclusions Conclusions A subgroup ofA subgroup of adolescents may carry a physiological risk for major depression which may be either of genetic and/or earlier psychosocial origin.
“A subgroup of A subgroup of adolescents may carry a physiological risk adolescents may carry a physiological risk for major depression which may be either for major depression which may be either of genetic and/or earlier psychosocial of genetic and/or earlier psychosocial origin.origin.”
Quote in the paperSubstantial claim
The authors state this as an assumption.
The recognition of proximal life events is accurate.
“Provided that the recognition of proximal events is accurate, this suggests of proximal events is accurate, this suggests that there may be other factors that there may be other factors predisposing to disorder.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Major depression is associated with an abnormal stress response system.
“As a stress-related disorder, major depression is associated with an abnormal stress response system.”
From Epigenetic regulation in major depression and other stress-related disorders: molecular mechanisms, clinical relevance and therapeutic potential (2023) · cites this paper as [120]
The “Peak hormones and subsequent MDD” section reports that morning cortisol and evening DHEA peaks predicted later major depression in high-risk adolescents, and describes peak levels as a possible index of HPA-axis dysregulation. This supports a link with stress-related hormonal activity, but the paper does not establish that major depression generally is associated with an abnormal stress response system. Passage page numbers are not available in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredExcessive cortisol release in response to stress and impaired GR-mediated feedback inhibition have been known for decades.
“For example, excessive cortisol release in response to stress and impaired GR-mediated feedback inhibition have been known for decades.120,121”
From Epigenetic regulation in major depression and other stress-related disorders: molecular mechanisms, clinical relevance and therapeutic potential (2023) · cites this paper as [120]
The ‘Hormone reactivity to environmental demands’ section says cortisol reactivity occurs in stressful circumstances, but notes that this study could not adequately test rapid stress responses. The ‘Peak hormones and subsequent MDD’ section discusses cortisol peaks and receptors, but does not establish excessive stress-induced cortisol release or impaired GR-mediated feedback inhibition. No page numbers were provided for these passages. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPrior research has demonstrated unique effects of elevated morning cortisol and of stressful life events in the month prior to depressive onset.
“prior research has demonstrated unique effects of elevated morning cortisol and of stressful life events in the month prior to depressive onset (Goodyer et al. 2000)”
From The cortisol awakening response predicts major depression: predictive stability over a 4-year follow-up and effect of depression history (2013) · cites this paper as Goodyer et al. 2000
In “Peak hormones, life events and depressive symptoms at entry” (page unavailable), the paper reports separate associations of 08.00 h cortisol peaks and disappointments or losses in the month closest to onset with subsequent depression. The claim is broader than the finding: the predictive cortisol measure was a peak, not elevated absolute cortisol levels, and the significant life events were specifically disappointments and losses. (LLM, conf=0.84)
Experimental — accuracy not yet measuredElevated morning cortisol is prospectively predictive of depression.
“it is elevated morning cortisol that is prospectively predictive of depression (Goodyer et al., 2000; Halligan et al., 2007; Harris et al., 2000).”
From Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence (2010) · cites this paper as Goodyer et al., 2000
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Reported cortisol am:pm ratio conflicts with the reported means
MinorThe stated 12:8 ratio is 1.5:1. Table 2 reports morning and evening cortisol means of 3.23 and 0.47 ng/ml for males, and 3.9 and 0.45 ng/ml for females-approximately 6.9:1 and 8.7:1, respectively.
“cortisol (am:pm ratio 12:8) and a much”
“Mean Mean 3.23 3.23 0.47 0.47 0.27 0.27 0.13 0.13 3.9 3.9 0.45 0.45 0.34 0.34 0.18 0.18”
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Malhi, G. S., & Mann, J. J. (2018) · The Lancet · doi:10.1016/s0140-6736(18)31948-2 · Cited by 4,099 · see citing works
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“Harris et al. (2000) found that higher morning (but not evening) cortisol level, life events, and vulnerability status all predicted depression onset (but they did not test for interactions); Goodyer et al. (2000) found similar results with adolescent depression.”
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Self-citationYoga, mindfulness-based stress reduction and stress-related physiological measures: A meta-analysis.
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“Some authors argue that clinical depression represents a dysregulated adaptive stress response (Gold, 2015), which is supported by evidence that elevated cortisol levels predict the onset of depressive disorder (Goodyer et al., 2000; LeMoult et al., 2015).”
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Prenatal Anxiety Predicts Individual Differences in Cortisol in Pre-Adolescent Children
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“Among adolescents at risk for depression, major disappointments and permanent losses predicted the onset of major depression in the ensuing month, with odds ratios of 58.9 (7.0-495.5) and 8.8 (2.02-38.6), respectively (Goodyer et al. 2000).”
InfluentialVan den Bergh, B. R. H., Van Calster, B., Smits, T., Van Huffel, S., & Lagae, L. (2008) · Neuropsychopharmacology · doi:10.1038/sj.npp.1301450 · Cited by 434 · see citing works
“Finally, we did not measure the adolescents’ stress concurrently with their cortisol assessment, therefore, we cannot rule out its influence on cortisol (Goodyer et al, 2000).”
BackgroundLopez-Duran, N. L., Kovacs, M., & George, C. J. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2009.03.016 · Cited by 425 · see citing works
“…basal cortisol after remission from anMDD episode, indicating that HPA-axis dysregulation may be accentuated during depressive states, there is also evidence that HPA-dysregulation is already present prior to the onset of depressive symptoms (Halligan et al., 2007) or MDD (Goodyer et al., 2000b).”
BackgroundMaternal Stress During Pregnancy Predicts Cognitive Ability and Fearfulness in Infancy
Bergman, K., Sarkar, P., O’Connor, T. G., Modi, N., & Glover, V. A. S. (2007) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e31814a62f6 · Cited by 430 · see citing works
“, elevated saliva cortisol concentrations), a profile that is also found in adolescents and adults experiencing the onset of a major depressive episode (Goodyer et al., 2000; Harris et al., 2000).”
Maternal depression and psychiatric outcomes in adolescent offspring: A 13-year longitudinal study
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“Depressive disorder was just beginning to emerge in our sample at 13 years; the earliest onset of depression Child characteristics Proportion of boys 51.2% 47.3% χ2(1)=0.15 Age at assessment (months: S.D.) 160.8 (3.8) 159.9 (1.7) t(92)=1.46 Tanner stage (mean 1–5: S.D.) 3.3 (0.9) 3.3 (0.6) Z (N=91)= −0.33 Number of ad…”
MethodInfluentialAdolescent depression: Description, causes, and interventions
Hankin, B. L. (2005) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2005.10.012 · Cited by 391 · see citing works
“[62] Goodyer IM, Herbert J, Tamplin A, Altham PME.”
BackgroundDo Corticosteroids Damage the Brain?
Herbert, J., Goodyer, I. M., Grossman, A. B., Hastings, M. H., de Kloet, E. R., Lightman, S. L., LUPIEN, S. J., Roozendaal, B., & Seckl, J. R. (2006) · Journal of Neuroendocrinology · doi:10.1111/j.1365-2826.2006.01429.x · Cited by 384 · see citing works
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“A significant association was found between morning peak levels of salivary cortisol and subsequent MDD in prospective investigations of 180 adolescents at high risk for psychopathology (Goodyer et al., 2000).”
BackgroundExposure to postnatal depression predicts elevated cortisol in adolescent offspring
Halligan, S. L., Herbert, J., Goodyer, I. M., & Murray, L. (2004) · Biological Psychiatry · doi:10.1016/j.biopsych.2003.09.013 · Cited by 342 · see citing works
“Elevations in morning cortisol levels, particularly the occurrence of one or more very high morning cortisol values, predict the development of depressive disorder in those exposed to psychosocial risk factors for depression (Goodyer et al 2000; Harris et al 2000).”
BackgroundInfluentialSelf-citationAdam, E. K. (2006) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2006.01.010 · Cited by 322 · see citing works
The neuropathology of primary mood disorder
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“…axis (HPA), thereby relating it to the hypercortisolaemia and other signs of HPA axis dysfunction which occur in mood disorders (Checkley, 1996: Plotsky et al., 1998) and which may be a risk factor for them (Starkman et al., 1999; Goodyer et al., 2000; Harris et al., 2000).”
BackgroundProspective prediction of major depressive disorder from cortisol awakening responses in adolescence
Adam, E. K., Doane, L. D., Zinbarg, R. E., Mineka, S., Craske, M. G., & Griffith, J. W. (2010) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2009.12.007 · Cited by 315 · see citing works
Cortisol and DHEA in development and psychopathology
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“Several prospective studies have identified a higher cortisol/DHEA ratio as a risk factor prior to the onset of major depressive disorder among children and adolescents (Angold et al., 1999; Goodyer et al., 1996; Goodyer et al., 2000a, 2000b; Goodyer et al., 2001).”
BackgroundCortisol and depression: three questions for psychiatry
Herbert, J. (2013) · Psychological Medicine · doi:10.1017/s0033291712000955 · Cited by 301 · see citing works
“…Cushing’s syndrome) or exogenous (therapeutic), may result in depression (Butler & Besser, 1968 ; Jeffcoate et al. 1979 ; Lewis & Smith, 1983) ; and morning cortisol levels at the higher end of the normal range are a risk factor for subsequent depression (Goodyer et al. 2000 ; Harris et al. 2000).”
BackgroundInfluentialSelf-citationPsychological and educational interventions for preventing depression in children and adolescents
Merry, S., Hetrick, S. E., Cox, G., Brudevold‐Iversen, T., Bir, J. J., & McDowell, H. (2011) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003380.pub3 · Cited by 298 · see citing works
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“This view is supported not only by prospective studies identifying an elevated cortisol level as a precursor to the onset of firstepisode major depression (76), as well as relapse (77), but also by studies observing increasedHPA axis activation among the euthymic relatives of individuals with a history of depression,…”
Course and outcome of child and adolescent major depressive disorder
Birmaher, B. B., Arbelaez, C., & Brent, D. (2002) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/s1056-4993(02)00011-1 · Cited by 270 · see citing works
“For example, anxiety disorders are associated with the onset and longer episodes of depression but seem not to affect the risk for recurrence [3,8,25,35,45,54,64, 74–77].”
BackgroundPuberty and the emergence of gender differences in psychopathology
Hayward, C., & Sanborn, K. (2002) · Journal of Adolescent Health · doi:10.1016/s1054-139x(02)00336-1 · Cited by 270 · see citing works
Low salivary cortisol levels and externalizing behavior problems in youth
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Heritability of cortisol levels: review and simultaneous analysis of twin studies
Bartels, M., den Berg, M. V., Sluyter, F., Boomsma, D. I., & de Geus, E. J. C. (2002) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(02)00003-3 · Cited by 259 · see citing works
“…in cortisol levels play a prominent role as an explanatory variable in studies on physical (Walker, 1996; Mantero and Boscaro, 1992; Pedersen and Hoffman-Goetz, 2000; Roy et al., 2001; Rosmond and Bjorntorp, 2000c) and mental health (Young et al., 2000; Posener et al., 2000; Goodyer et al., 2000).”
BackgroundDepression in Children and Adolescents
Garber, J. (2006) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2006.07.007 · Cited by 263 · see citing works
Characteristics, correlates, and outcomes of childhood and adolescent depressive disorders
Rao, U., & Chen, L.-A. (2009) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2009.11.1/urao · Cited by 252 · see citing works
Yuan, M., Yang, B., Rothschild, G., Mann, J. J., Sanford, L. D., Tang, X., Huang, C., Wang, C., & Zhang, W. (2023) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-023-01519-z · Cited by 246 · see citing works
“120,121 The NR3C1 gene encodes for the GR, 122,123 which is an essential component of the HPA axis.”
BackgroundDuffy, A. C., Alda, M., Crawford, L., Milin, R., & Grof, P. (2007) · Bipolar Disorders · doi:10.1111/j.1399-5618.2007.00421.x · Cited by 233 · see citing works
Salivary cortisol and dehydroepiandrosterone in relation to puberty and gender
Netherton, C. M., Goodyer, I. M., Tamplin, A., & Herbert, J. (2003) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(02)00150-6 · Cited by 231 · see citing works
Self-citationShirtcliff, E. A., & Essex, M. J. (2008) · Developmental Psychobiology · doi:10.1002/dev.20336 · Cited by 231 · see citing works
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Halligan, S. L., Herbert, J., Goodyer, I., & Murray, L. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.09.011 · Cited by 217 · see citing works
Self-citationMorning cortisol as a risk factor for subsequent major depressive disorder in adult women
Harris, T. O., Borsanyi, S., Messari, S., Stanford, K., Cleary, S. E., Shiers, H. M., Brown, G. W., & Herbert, J. (2000) · British Journal of Psychiatry · doi:10.1192/bjp.177.6.505 · Cited by 220 · see citing works
Self-citationVrshek-Schallhorn, S., Doane, L. D., Mineka, S., Zinbarg, R. E., Craske, M. G., & Adam, E. K. (2013) · Psychological Medicine · doi:10.1017/s0033291712001213 · Cited by 220 · see citing works
“To our knowledge, prior research has demonstrated unique effects of elevated morning cortisol and of stressful life events in the month prior to depressive onset (Goodyer et al. 2000), but research has not tested whether morning cortisol peaks (or an elevated CAR) significantly interact with stressful life events in p…”
BackgroundEmotional Regulation and Depression: A Potential Mediator between Heart and Mind
Compare, A., Zarbo, C., Shonin, E., Gordon, W. V., & Marconi, C. (2014) · Cardiovascular Psychiatry and Neurology · doi:10.1155/2014/324374 · Cited by 220 · see citing works
Burton, E. M., Stice, E. M., & Seeley, J. R. (2004) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.72.4.689 · Cited by 217 · see citing works
“We located only two studies with adolescents that examined onset of depressive pathology ( Goodyer, Herbert, Tamplin, & Altham, 2000; Lewinsohn, Allen, Seeley, & Gotlib, 1999); in both studies major life stress predicted onset of major depression.”
BackgroundSteptoe, A., Gibson, E. L., Hamer, M., & Wardle, J. (2006) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2006.10.001 · Cited by 210 · see citing works
“High cortisol early in the day has also been found to predict future depressive illness in high risk adolescents and women (Goodyer et al., 2000; Harris et al., 2000).”
BackgroundYehuda, R., Halligan, S. L., Golier, J. A., Grossman, R., & Bierer, L. M. (2003) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(03)00052-0 · Cited by 206 · see citing works
“Furthermore, within the last decade, the relevance of traumatic events in the personal history of depressed patients has been increasingly recognized (Goodyer et al., 2000; Heim et al., 2000; Kohn et al., 2001).”
BackgroundPossible role of cortisol and dehydroepiandrosterone in human development and psychopathology
Goodyer, I. M., Park, R. J., Netherton, C. M., & Herbert, J. (2001) · The British Journal of Psychiatry · doi:10.1192/bjp.179.3.243 · Cited by 197 · see citing works
Self-citationHighly neurotic never-depressed students have negative biases in information processing
CHAN, S. W. Y., GOODWIN, G. M., & HARMER, C. J. (2007) · Psychological Medicine · doi:10.1017/s0033291707000669 · Cited by 195 · see citing works
“Longitudinal studies have provided evidence that cortisol level predicts subsequent depression onset in adult women (Harris et al. 2000) and adolescents (Goodyer et al. 2000).”
BackgroundNot fade away: the HPA axis and depression
Cowen, P. J. (2010) · Psychological Medicine · doi:10.1017/s0033291709005558 · Cited by 191 · see citing works
“Indeed, there is evidence to suggest that elevated salivary cortisol secretion is predictive of future depressive episodes in both young people and adults (Goodyer et al. 2000 ; Harris et al. 2000).”
Chen, C., Nakagawa, S., An, Y., Ito, K., Kitaichi, Y., & Kusumi, I. (2016) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2016.12.001 · Cited by 191 · see citing works
“Longitudinal studies have shown that higher basal plasma CORT levels, particularly in the morning, predicts the onset or development of depression in adolescent boys and girls and adult women (Goodyer et al 2000; Harris et al 2000; Goodyer et al 2009).”
Zajkowska, Z., Gullett, N., Walsh, A. E. L., Zonca, V., Pedersen, G. A., Souza, L., Kieling, C., Fisher, H. L., Kohrt, B. A., & Mondelli, V. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105625 · Cited by 191 · see citing works
Ruttle, P. L., Shirtcliff, E. A., Serbin, L. A., Fisher, D. B., Stack, D. M., & Schwartzman, A. E. (2010) · Hormones and Behavior · doi:10.1016/j.yhbeh.2010.10.015 · Cited by 188 · see citing works
“…literature is much clearer with nearly all of the longitudinal studies reporting that elevated basal cortisol levels precede the onset of later internalizing symptoms in children (Smider et al., 2002) and depression in adolescents (Goodyer et al., 1996, 2000, 2001; Halligan et al., 2007).”
Recent developments in understanding the psychosocial aspects of depression
Harris, T. (2001) · British Medical Bulletin · doi:10.1093/bmb/57.1.17 · Cited by 180 · see citing works
Bio-social origins of depression in the community
Strickland, P., Deakin, J. F. W., Percival, C., Dixon, J., Gater, R. A., & Goldberg, D. P. (2002) · The British Journal of Psychiatry · doi:10.1192/bjp.180.2.168 · Cited by 171 · see citing works
Early experience and depressive disorders: human and non-human primate studies
Gilmer, W. S., & McKinney, W. T. (2003) · Journal of Affective Disorders · doi:10.1016/s0165-0327(03)00046-6 · Cited by 169 · see citing works
“In their study of adolescents, might develop a clinical depression based upon their Goodyer et al. (1998, 2000) reported that elevated interpretation of life events.”
BackgroundDevelopmental origins of the human hypothalamic-pituitary-adrenal axis
Howland, M. A., Sandman, C. A., & Glynn, L. M. (2017) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2017.1356222 · Cited by 171 · see citing works
The complex neurobiology of resilient functioning after childhood maltreatment
Ioannidis, K., Askelund, A. D., Kievit, R., & van Harmelen, A. (2020) · BMC Medicine · doi:10.1186/s12916-020-1490-7 · Cited by 163 · see citing works
“DHEA acts as a natural antagonist to cortisol [77], may protect against the harmful effects of hypercortisolism [37, 78] and aids resilient functioning towards outcomes of depression [79, 80].”
BackgroundPompili, M., Serafini, G., Innamorati, M., Möller-Leimkühler, A. M., Giupponi, G., Girardi, P., Tatarelli, R., & Lester, D. (2010) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-010-0108-z · Cited by 160 · see citing works
“Considerable evidence suggests that hypercortisolemia is a frequent finding in depressed patients and persists between episodes [82, 86, 107, 203, 264, 280].”
BackgroundEffects of Postnatal Depression on Mother–Infant Interactions and Child Development
Murray, L., Halligan, S. L., & Cooper, P. (2010) · Wiley eBooks · doi:10.1002/9781444327588.ch8 · Cited by 156 · see citing works
Cortisol awakening response is elevated in acute coronary syndrome patients with type-D personality
Whitehead, D. L., Perkins-Porras, L., Strike, P. C., Magid, K. S., & Steptoe, A. (2007) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2006.11.005 · Cited by 159 · see citing works
“Elevated morning cortisol is a risk factor for clinical depression [19,20], and a larger CAR is associated with depressive symptoms [21], low positive affect [22], high levels of perceived stress [23], and chronic job stress [24].”
BackgroundTessner, K., Mittal, V., & Walker, E. (2011) · Schizophrenia bulletin · doi:10.1093/schbul/sbp087 · Cited by 159 · see citing works
The Stressful Life Events Schedule for children and adolescents: development and validation
Williamson, D. E., Birmaher, B. B., Ryan, N. D., Shiffrin, T. P., Lusky, J. A., Protopapa, J., Dahl, R. E., & Brent, D. A. (2003) · Psychiatry Research · doi:10.1016/s0165-1781(03)00134-3 · Cited by 154 · see citing works
“…the child's or adolescent's actions, have been shown to be elevated among children of depressed women (Hammen et al., 1991), elevated among depressed adolescents (Williamson et al., 1995a), genetically mediated (Silberg et al., 1999) and predictive of the onset of depression (Goodyer et al., 2000).”
BackgroundByrne, M. L., Whittle, S., Vijayakumar, N., Dennison, M., Simmons, J. G., & Allen, N. B. (2017) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2016.12.004 · Cited by 150 · see citing works
Steptoe, A., Brydon, L., & Kunz-Ebrecht, S. (2005) · Psychosomatic Medicine · doi:10.1097/01.psy.0000156932.96261.d2 · Cited by 148 · see citing works
The Origins and Development of Psychopathology in Females and Males
Zahn‐Waxler, C., Crick, N. R., Shirtcliff, E. A., & Woods, K. E. (2015) · Wiley eBooks · doi:10.1002/9780470939383.ch4 · Cited by 148 · see citing works
Pubertal neuromaturation, stress sensitivity, and psychopathology
WALKER, E. F., SABUWALLA, Z., & HUOT, R. (2004) · Development and Psychopathology · doi:10.1017/s0954579404040027 · Cited by 144 · see citing works
Hammack, S. E., Cooper, M. A., & Lezak, K. R. (2012) · Neuropharmacology · doi:10.1016/j.neuropharm.2011.02.024 · Cited by 142 · see citing works
“Exposure to traumatic events, such as those that can produce PTSD, also increase the risk for MDD (Goodyer et al., 2000; Heim et al., 2000; Kohn et al., 2001; Mayou et al., 2001; Shalev et al., 1998); however, risk for MDD might also been linked to a variety of negative life events or adversities that do not meet the…”
BackgroundThabrew, H., Stasiak, K., Hetrick, S. E., Wong, S., Huss, J. H., & Merry, S. N. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012489.pub2 · Cited by 141 · see citing works
“Goodyer 2000 Goodyer IM, Tamplin A, Herbert J, Altham PM.”
BackgroundMerry, S., Hetrick, S. E., Cox, G., Brudevold‐Iversen, T., Bir, J. J., & McDowell, H. (2012) · Evidence-Based Child Health A Cochrane Review Journal · doi:10.1002/ebch.1867 · Cited by 129 · see citing works
Psychosocial and endocrine features of chronic first-episode major depression in 8–16 year olds
Goodyer, I. M., Park, R. J., & Herbert, J. (2001) · Biological Psychiatry · doi:10.1016/s0006-3223(01)01120-9 · Cited by 130 · see citing works
Self-citationThe ratio of cortisol/DHEA in treatment resistant depression
Markopoulou, K., Papadopoulos, A. S., Juruena, M. F., Poon, L., Pariante, C. M., & Cleare, A. J. (2008) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2008.08.004 · Cited by 129 · see citing works
“In adolescent depression persistence of an elevated cortisol/DHEA ratio reflects persistence of symptoms of up to 6 months duration (Goodyer et al., 2000).”
BackgroundCortisol secretion in depressed, and at-risk adults
Dienes, K. A., Hazel, N. A., & Hammen, C. L. (2013) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2012.09.019 · Cited by 128 · see citing works
“Longitudinal studies have supported the predictive value of higher morning levels of cortisol for depression onset (e.g., cortisol measured at 8:00am regardless of waking time; Goodyer et al., 2000; Goodyer et al., 2009; Halligan et al., 2007; Harris et al., 2000), but whether waking cortisol predicts similar risk for…”
InfluentialRudolph, K. D., Troop‐Gordon, W., & Granger, D. A. (2010) · Psychopharmacology · doi:10.1007/s00213-010-1879-7 · Cited by 129 · see citing works
“Moreover, elevated basal cortisol levels (Goodyer et al. 2000) and heightened cortisol reactivity to social challenge (Susman et al. 1997) predict depressive symptoms over time, although the evidence for links between heightened cortisol and depression has been mixed in children (Kaufman et al.…”
Salivary Cortisol and Psychopathology in Children Bereaved by the September 11, 2001 Terror Attacks
Pfeffer, C. R., Altemus, M., Heo, M., & Jiang, H. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.07.037 · Cited by 128 · see citing works
Prolonged secretion of cortisol as a possible mechanism underlying stress and depressive behaviour
Qin, D., Rizak, J. D., Feng, X., Yang, S., Lü, L., Pan, L., Yin, Y., & Hu, X. (2016) · Scientific Reports · doi:10.1038/srep30187 · Cited by 130 · see citing works
Izawa, S., Sugaya, N., Shirotsuki, K., Yamada, K. C., Ogawa, N., Ouchi, Y., Nagano, Y., Suzuki, K., & Nomura, S. (2008) · Biological Psychology · doi:10.1016/j.biopsycho.2008.07.003 · Cited by 126 · see citing works
Bhagwagar, Z., & Cowen, P. J. (2008) · Psychological Medicine · doi:10.1017/s0033291707001250 · Cited by 124 · see citing works
“These findings support studies from other high-risk groups of adolescents and adults showing that elevated cortisol secretion is a risk factor for subsequent major depression (Goodyer et al. 2000; Harris et al. 2000).”
BackgroundResultInfluentialThe Effects of Child Maltreatment on the Hypothalamic-Pituitary-Adrenal Axis
Voorhees, E. E. V., & Scarpa, A. (2004) · Trauma Violence & Abuse · doi:10.1177/1524838004269486 · Cited by 125 · see citing works
Marceau, K., Ruttle, P. L., Shirtcliff, E. A., Essex, M. J., & Susman, E. J. (2014) · Developmental Psychobiology · doi:10.1002/dev.21214 · Cited by 120 · see citing works
“…& Altham, 1998; Goodyer, Herbert, & Tamplin, 2003; Goodyer, 2007); however, higher basal DHEA during adolescence has also been associated with more internalizing problems (Goodyer et al., 2000; Shirtcliff, Granger, Booth, & Johnson, 2005; Susman, Granger, Murowchick, Ponirakis, & Worrall, 1996).”
Daytime cortisol and stress reactivity in the offspring of parents with bipolar disorder
Ellenbogen, M. A., Hodgins, S., Walker, C.-D., Couture, S., & Adam, S. (2006) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2006.08.004 · Cited by 114 · see citing works
“Because increasing cortisol levels during adolescence (Goodyer et al., 2000; Walker et al., 2001, 2004), as well as increases in gonadal hormones (Angold et al.”
BackgroundResultInfluentialKovacs, M., & Lopez‐Duran, N. (2010) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2010.02230.x · Cited by 111 · see citing works
“See, for example, the study by Goodyer et al. (2000) that addressed HPA functioning, and a recent investigation of the relations of overt joy and changes in EEG asymmetry in normal children (Light et al.”
BackgroundAdrenal androgen and gonadal hormone levels in adolescent girls with conduct disorder
PAJER, K. A., Tabbah, R., Gardner, W. P., Rubín, R. T., Czambel, R. K., & Wang, Y. (2006) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2006.09.005 · Cited by 114 · see citing works
“, psychiatric co-morbidity (including substance abuse disorders) (Angold et al., 1999; Brown and Dobs, 2002; Goodyer et al., 2000; Sierksma et al., 2004), nicotine use (Martin et al.”
BackgroundPuberty and perimenopause: Reproductive transitions and their implications for women's health
Hoyt, L. T., & Falconi, A. M. (2015) · Social Science & Medicine · doi:10.1016/j.socscimed.2015.03.031 · Cited by 116 · see citing works
“Higher prevalence of mood disorders and symptoms during puberty and perimenopause is usually tied to fluctuations in sex hormones (Angold et al., 1999; Freeman et al., 2006, 2004; Goodyer et al., 2001; Goodyer et al., 2000; Halbreich and Kahn, 2001; NolenHoeksema, 2001; Schmidt, 2005; Steiner et al., 2003).”
BackgroundAdam, E. K., Vrshek‐Schallhorn, S., Kendall, A. D., Mineka, S., Zinbarg, R. E., & Craske, M. G. (2014) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2014.02.014 · Cited by 110 · see citing works
“Waking cortisol levels (S1, taken immediately upon waking) were also examined due to past research suggesting their importance in predicting mood disorders (Goodyer et al., 2000; Halligan et al., 2007), and in response to recommendations that waking cortisol levels also be examined when examining the CAR (Clow et al.”
Heaney, J. L. J., Phillips, A. C., & Carroll, D. (2010) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2010.07.009 · Cited by 109 · see citing works
“Psychosocial factors have been related to a dysregulated diurnal profile in adolescents ( [Goodyer et al., 2000], [Greaves ‐ Lord et al., 2007] and [Van den Bergh et al., 2008]).”
Are Stress-Induced Cortisol Changes During Pregnancy Associated With Postpartum Depressive Symptoms?
Nierop, A., Bratsikas, A., Zimmermann, R., & Ehlert, U. (2006) · Psychosomatic Medicine · doi:10.1097/01.psy.0000244385.93141.3b · Cited by 110 · see citing works
“Another finding was revealed in a sample of 180 adolescents at high risk for psychopathology, in which the occurrence of peaks in morning cortisol emerged as predictive for subsequent nonpuerperal major depression at a 12-month follow up (41).”
BackgroundExercise and Depressive Symptoms in Adolescents
Toseeb, U., Brage, S., Corder, K. L., Dunn, V. J., Jones, P. B., Owens, M., Clair, M. S., van Sluijs, E. M. F., & Goodyer, I. M. (2014) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2014.1794 · Cited by 107 · see citing works
Self-citationUnderstanding Familial Risk for Depression
Gotlib, I. H., Joormann, J., & Foland‐Ross, L. C. (2014) · Perspectives on Psychological Science · doi:10.1177/1745691613513469 · Cited by 105 · see citing works
“These preliminary findings are important in adding to extant literature in which the initial associations among baseline anomalies in cortisol (Adam et al., 2010; Goodyer et al., 2000), brain function (Whalley et al.”
BackgroundHigh susceptibility to chronic social stress is associated with a depression-like phenotype
Schmidt, M. V., Scharf, S. H., Sterlemann, V., Ganea, K., Liebl, C., Holsboer, F., & Müller, M. B. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2009.10.002 · Cited by 103 · see citing works
“Chronic or traumatic stress experiences that occur during vulnerable developmental time periods, such as childhood abuse, are correlated with an increased risk for psychiatric disease (Goodyer et al., 2000; Corcoran et al., 2003) and permanent HPA axis alteration (Heim and Nemeroff, 2001).”
BackgroundTesting a Gender Additive Model: The Role of Body Image in Adolescent Depression
Bearman, S. K., & Stice, E. M. (2008) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-008-9248-2 · Cited by 104 · see citing works
“It was surprising that stressful life events did not significantly predict depression onset in the present study, because this has been a consistent predictor of depression in prior research (Cohen et al. 1984; Goodyer et al. 2000;”
ResultDepression is associated with flatter cortisol rhythms in patients with coronary artery disease
Bhattacharyya, M. R., Molloy, G. J., & Steptoe, A. (2008) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2008.03.012 · Cited by 103 · see citing works
Serotonin transporter genotype, morning cortisol and subsequent depression in adolescents
Goodyer, I. M., Bacon, A., Ban, M., Croudace, T. J., & Herbert, J. (2009) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.108.054775 · Cited by 101 · see citing works
“11,12 13–15 Cortisol levels are also higher in the offspring of parents with depression, 16,17 who are also more liable to depression.”
Self-citationLopez‐Duran, N. L., Nusslock, R., George, C. J., & Kovács, M. (2012) · Psychophysiology · doi:10.1111/j.1469-8986.2011.01332.x · Cited by 101 · see citing works
Diurnal patterns of salivary cortisol across the adolescent period in healthy females
Oskis, A., Loveday, C., Hucklebridge, F. H., Thorn, L., & Clow, A. (2008) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2008.09.009 · Cited by 100 · see citing works
“However, despite interest in exploring associations with coincident or future psychopathology ( Goodyer et al., 2000; Halligan et al., 2007; Sondeijker et al., 2007, 2008), there is a shortage of reliable literature on HPA axis function in healthy adolescence, as indexed by salivary cortisol.”
BackgroundLongitudinal hypothalamic-pituitary-adrenal axis trait and state effects in recurrent depression
Lok, A., Mocking, R. J. T., Ruhé, H. G., Visser, I., Koeter, M. W. J., Assies, J., Bockting, C. L. H., Olff, M., & Schene, A. H. (2012) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2011.10.005 · Cited by 99 · see citing works
“This is further supported by studies reporting sustained higher cortisol concentrations preceding a first MDE (Modell et al., 1998; Goodyer et al., 2000; Mannie et al., 2007).”
Larzelere, M., & Jones, G. N. (2008) · Primary Care Clinics in Office Practice · doi:10.1016/j.pop.2008.07.011 · Cited by 99 · see citing works
“Stress has long been thought to precipitate mental illness, especially in vulnerable individuals (eg, stress–diathesis model).(41) Stress also has been associated with increased psychiatric morbidity and relapse risk in numerous psychiatric disorders.”
BackgroundGeneral and specific effects of early-life psychosocial adversities on adolescent grey matter volume
Walsh, N., Dalgleish, T., Lombardo, M. V., Dunn, V. J., van Harmelen, A., Ban, M., & Goodyer, I. M. (2014) · NeuroImage Clinical · doi:10.1016/j.nicl.2014.01.001 · Cited by 97 · see citing works
“At ages 14 and 17, participants in the ROOTS cohort had completed a self-report measure of negative life events and difficulties [modified from Goodyer et al. (2000)], occurring to them, their family or closest friends over the preceding 12 months.”
Self-citationPositive memory specificity is associated with reduced vulnerability to depression
Askelund, A. D., Schweizer, S., Goodyer, I. M., & van Harmelen, A. (2019) · Nature Human Behaviour · doi:10.1038/s41562-018-0504-3 · Cited by 98 · see citing works
Self-citation
- Authors
- Goodyer, I. M., Herbert, J., Tamplin, A., & Altham, P. M. E.
- Affiliations
- University of Cambridge (GB)
- Corresponding author
- Goodyer, I. M.
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2000-12
- Volume
- 177
- Issue
- 6
- Pages
- 499-504
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2012890086
- Semantic Scholar
- 6c85c649cc75f9d4e0099585c659d58034db3f7b
- Cited by
- 436
- References
- 27
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 12 · 2023: 7 · 2022: 7 · 2021: 26 · 2020: 19 · 2019: 10 · 2018: 20 · 2017: 14 · 2016: 28 · 2015: 15 · 2014: 24 · 2013: 19 · 2012: 22
- FWCI
- 3.99
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust
- Medical Research Council
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- major depressive disorder, adolescents, cortisol, dehydroepiandrosterone, life events, depressive symptoms, high-risk adolescents, psychosocial risk factors, diurnal cortisol rhythm, depression onset
- MeSH terms
- Adolescent, Child, Dehydroepiandrosterone, Depressive Disorder, Female, Humans, Hydrocortisone, Life Change Events, Male, Puberty, Surveys and Questionnaires, Risk Factors, Saliva, Risk Assessment
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