Morning cortisol as a risk factor for subsequent major depressive disorder in adult women
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Background: Whether individual differences in cortisol contribute to subsequent major depressive disorder (MDD) is unknown. Aims: To determine whether premorbid levels of salivary cortisol and dehydroepiandrosterone (DHEA) were associated with subsequent MDD and how these related to psychosocial factors known to increase the risk for MDD. Method: Adult women ( n =116) were recruited from general practices. None was currently depressed; 83 were ‘psychosocially vulnerable’ to MDD, 33 were not. Salivary steroids (cortisol and DHEA at 08.00 h and 20.00 h), recent life events, current mood and social support were assessed at entry. Onset of MDD was recorded during 13 months' follow-up. Results: There were no associations between salivary cortisol or DHEA and recent life events or vulnerability. Twenty-eight onsets of MDD occurred during the follow-up period. This was associated with: severe adverse life events and difficulties during the follow-up period; mean morning cortisol levels at entry; and the presence of any of three vulnerability factors. Conclusions: Individual differences in morning salivary cortisol levels may represent an independent risk factor for subsequent MDD. The origin of these differences in cortisol is not yet understood.
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Several prospective studies have shown that morning cortisol levels, around the peak of the diurnal rhythm, prospectively predict depressive episodes or symptoms.
“Several prospective studies of HPA functioning and depression have shown that cortisol levels during the morning (rather than average or total cortisol levels throughout the day), around the peak of cortisol’s diurnal rhythm, prospectively predict depressive episodes or symptoms (Harris et al. 2000; Halligan et al. 2007; Goodyer et al. 2010).”
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 Harris et al. 2000
The Results (‘Hormone levels at entry and subsequent MDD’) report that morning cortisol, but not evening cortisol, was significantly associated with subsequent major depression in the adult women studied. The Discussion likewise says the association was limited to morning cortisol, when levels are highest. The paper does not establish the claim’s comparison with average or total cortisol levels throughout the day. (LLM, conf=0.86)
Experimental — accuracy not yet measuredCortisol levels in MDD are elevated, with a moderate effect size.
“Two meta-analyses 64,65 concluded that cortisol levels in MDD were elevated, with a moderate effect size.”
From Major depressive disorder (2016) · cites this paper as [64]
The Discussion (p. 508) describes elevated cortisol as characteristic of current MDD, supporting the direction of the claim. But this paper is a prospective study of women without MDD at baseline, not a meta-analysis, and it does not report a moderate effect size for cortisol levels in MDD. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThere is some evidence that HPA axis dysregulation may precede depression.
“There is some evidence that HPA axis dysregulation may precede depression (Adam et al., 2010; Harris et al., 2000)”
From Chronic Stress, Hair Cortisol and Depression: A Prospective and Longitudinal Study of Medical Internship (2018) · cites this paper as Harris et al., 2000
Elevated 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 Harris et al., 2000
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Self-citation
- Authors
- Harris, T. O., Borsanyi, S., Messari, S., Stanford, K., Cleary, S. E., Shiers, H. M., Brown, G. W., & Herbert, J.
- Affiliations
- St Thomas' Hospital (GB)
- University of Cambridge (GB)
- Corresponding author
- Herbert, J.
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2000-12
- Volume
- 177
- Issue
- 6
- Pages
- 505-510
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2135445988
- Semantic Scholar
- 9b663c81758492049a24ea494e349418b1f7584c
- Cited by
- 220
- References
- 24
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 7 · 2023: 1 · 2022: 9 · 2021: 9 · 2020: 10 · 2019: 4 · 2018: 11 · 2017: 7 · 2016: 13 · 2015: 11 · 2014: 8 · 2013: 9 · 2012: 9
- FWCI
- 2.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- major depressive disorder, salivary cortisol, dehydroepiandrosterone, morning cortisol, women, risk factors, psychosocial vulnerability, life events, social support, mood
- MeSH terms
- Adolescent, Adult, Analysis of Variance, Depressive Disorder, Female, Follow-Up Studies, Humans, Hydrocortisone, Life Change Events, Middle Aged, Saliva, Time Factors
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