Higher perceived stress but lower cortisol levels found among young Greek adults living in a stressful social environment in comparison with Swedish young adults
Open accessAbstract
The worldwide financial crisis during recent years has raised concerns of negative public health effects. This is notably evident in southern Europe. In Greece, where the financial austerity has been especially pronounced, the prevalence of mental health problems including depression and suicide has increased, and outbreaks of infectious diseases have risen. The main objective in this study was to investigate whether different indicators of health and stress levels measured by a new biomarker based on cortisol in human hair were different amongst comparable Greek and Swedish young adults, considering that Sweden has been much less affected by the recent economic crises. In this cross-sectional comparative study, young adults from the city of Athens in Greece (n = 124) and from the city of Linkoping in Sweden (n = 112) participated. The data collection comprised answering a questionnaire with different health indicators and hair samples being analyzed for the stress hormone cortisol, a biomarker with the ability to retrospectively measure long-term cortisol exposure. The Greek young adults reported significantly higher perceived stress (p<0.0001), had experienced more serious life events (p = 0.002), had lower hope for the future (p<0.0001), and had significantly more widespread symptoms of depression (p<0.0001) and anxiety (p<0.0001) than the Swedes. But, the Greeks were found to have significantly lower cortisol levels (p<0.0001) than the Swedes, and this difference was still significant in a multivariate regression (p<0.0001), after adjustments for potential intervening variables. A variety of factors related to differences in the physical or socio-cultural environment between the two sites, might possibly explain this finding. However, a potential biological mechanism is that long-term stress exposure could lead to a lowering of the cortisol levels. This study points out a possible hypothesis that the cortisol levels of the Greek young adults might have been suppressed and their HPA-axis down-regulated after living in a stressful environment with economic and social pressure.
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Some cross-sectional studies have shown positive associations between hair cortisol and clinically diagnosed depressed patients (mostly inpatients) and between hair cortisol and self-reported depressive symptoms in non-clinical community samples.
“Some cross-sectional studies have also shown positive associations between hair cortisol and clinically diagnosed depressed patients (mostly inpatients; Dettenborn et al., 2012) as well as between hair cortisol and self-reported depressive symptoms in non-clinical community samples (Abell et al., 2016; Faresjo et al., 2013; Stalder et al., 2014; Wikenius et al., 2016).”
From Chronic Stress, Hair Cortisol and Depression: A Prospective and Longitudinal Study of Medical Internship (2018) · cites this paper as Faresjo et al., 2013
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Cites
A Global Measure of Perceived Stress
Cohen, S., Kamarck, T., & Mermelstein, R. (1983) · Journal of Health and Social Behavior · doi:10.2307/2136404 · Cited by 32,807 · see citing works
McEwen, B. S. (1993) · Archives of Internal Medicine · doi:10.1001/archinte.153.18.2093 · Cited by 4,365 · see citing works
Psychological Stress and Disease
Cohen, S., Janicki-Deverts, D., & Miller, G. E. (2007) · JAMA · doi:10.1001/jama.298.14.1685 · Cited by 3,168 · see citing works
Stress and Health: Major Findings and Policy Implications
Thoits, P. A. (2010) · Journal of Health and Social Behavior · doi:10.1177/0022146510383499 · Cited by 1,967 · see citing works
Stuckler, D., Basu, S., Suhrcke, M., Coutts, A., & McKee, M. (2009) · The Lancet · doi:10.1016/s0140-6736(09)61124-7 · Cited by 1,486 · see citing works
Financial crisis, austerity, and health in Europe
Karanikolos, M., Mladovsky, P., Cylus, J., Thomson, S., Basu, S., Stückler, D., Mackenbach, J. P., & McKee, M. (2013) · The Lancet · doi:10.1016/s0140-6736(13)60102-6 · Cited by 1,388 · see citing works
Twenty-four hour pattern of the episodic secretion of cortisol in normal subjects
WEITZMAN, E. D., FUKUSHIMA, D., NOGEIRE, C., ROFFWARG, H., GALLAGHER, T. F., & HELLMAN, L. (1971) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-33-1-14 · Cited by 1,258 · see citing works
Fries, E., Hesse, J., Hellhammer, J., & Hellhammer, D. H. (2005) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2005.04.006 · Cited by 1,204 · see citing works
Burnout, Perceived Stress, and Cortisol Responses to Awakening
Pruessner, J. C., Hellhammer, D. H., & Kirschbaum, C. (1999) · Psychosomatic Medicine · doi:10.1097/00006842-199903000-00012 · Cited by 822 · see citing works
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
Health effects of financial crisis: omens of a Greek tragedy
Kentikelenis, A., Karanikolos, M., Papanicolas, I. N., Basu, S., McKee, M., & Stückler, D. (2011) · The Lancet · doi:10.1016/s0140-6736(11)61556-0 · Cited by 652 · see citing works
Kirschbaum, C., Tietze, A., Skoluda, N., & Dettenborn, L. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2008.08.024 · Cited by 584 · see citing works
Measurement of cortisol in human Hair as a biomarker of systemic exposure
Koren, G., Grace Walsh, R. N., Tokmakejian, S., & Uum, S. H. M. V. (2007) · Clinical and investigative medicine · doi:10.25011/cim.v30i5.2894 · Cited by 578 · see citing works
Why Zebras Don't Get Ulcers: An Updated Guide to Stress, Stress Related Diseases, and Coping
Sapolsky, R. M. (1998) · Medical Entomology and Zoology · Cited by 444 · see citing works
Cardiovascular consequences of cortisol excess
Whitworth, J. A., Williamson, P. M., Mangos, G., & Kelly, J. J. (2005) · Vascular Health and Risk Management · doi:10.2147/vhrm.2005.1.4.291 · Cited by 393 · see citing works
Perceived stress and cortisol levels predict speed of wound healing in healthy male adults
Ebrecht, M., Hextall, J. M., Kirtley, L.-G., Taylor, A., Dyson, M., & Weinman, J. A. (2003) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(03)00144-6 · Cited by 369 · see citing works
Detection of physiological concentrations of cortisol and cortisone in human hair
Raul, J.-S., Cirimele, V., Ludes, B., & Kintz, P. (2004) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2004.02.010 · Cited by 348 · see citing works
Uum, S. H. M. V., Sauvé, B., Fraser, L.-A., Morley-Forster, P., Paul, T. L., & Koren, G. (2008) · Stress · doi:10.1080/10253890801887388 · Cited by 332 · see citing works
An assessment of cortisol analysis in hair and its clinical applications
Gow, R., Thomson, S., Rieder, M., Van Uum, S., & Koren, G. (2010) · Forensic Science International · doi:10.1016/j.forsciint.2009.12.040 · Cited by 329 · see citing works
Evaluation of a method to measure long term cortisol levels
Manenschijn, L., Koper, J. W., Lamberts, S. W. J., & van Rossum, E. F. C. (2011) · Steroids · doi:10.1016/j.steroids.2011.04.005 · Cited by 322 · see citing works
Measurement and meaning of salivary cortisol: A focus on health and disease in children
Jessop, D. S., & Turner‐Cobb, J. M. (2008) · Stress · doi:10.1080/10253890701365527 · Cited by 284 · see citing works
Higher cortisol content in hair among long-term unemployed individuals compared to controls
Dettenborn, L., Tietze, A., Bruckner, F., & Kirschbaum, C. (2010) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2010.04.006 · Cited by 280 · see citing works
Dettenborn, L., Tietze, A., Kirschbaum, C., & Stalder, T. (2012) · Stress · doi:10.3109/10253890.2012.654479 · Cited by 277 · see citing works
(1998) · PubMed · Cited by 260 · see citing works
Cortisol in hair measured in young adults - a biomarker of major life stressors?
Karlén, J., Ludvigsson, J., Frostell, A. S., Theodorsson, E., & Faresjö, T. (2011) · BMC Clinical Pathology · doi:10.1186/1472-6890-11-12 · Cited by 217 · see citing works
Self-citationIncreased Salivary Cortisol Reliably Induced by a Protein-Rich Midday Meal
Gibson, E. L., Checkley, S., Papadopoulos, A., Poon, L., Daley, S., & Wardle, J. (1999) · Psychosomatic Medicine · doi:10.1097/00006842-199903000-00014 · Cited by 211 · see citing works
Major Depression in Late Life Is Associated with Both Hypo- and Hypercortisolemia
Bremmer, M. A., Deeg, D. J. H., Beekman, A. T. F., Penninx, B. W. J. H., Lips, P. T. A. M., & Hoogendijk, W. J. G. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.11.033 · Cited by 200 · see citing works
Madianos, M. G., Economou, M. P., Alexiou, T., & Stefanis, C. N. (2010) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-010-0265-4 · Cited by 162 · see citing works
Hammerfald, K., Eberle, C., Grau, M., KINSPERGER, A., Zimmermann, A., Ehlert, U., & Gaab, J. (2005) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2005.08.007 · Cited by 160 · see citing works
Davenport, M. D., Lutz, C. K., Tiefenbacher, S., Novak, M. A., & Meyer, J. S. (2008) · Biological Psychiatry · doi:10.1016/j.biopsych.2007.10.025 · Cited by 160 · see citing works
Diversity of hair growth profiles
Loussouarn, G., Rawadi, C. E., & Genain, G. (2005) · International Journal of Dermatology · doi:10.1111/j.1365-4632.2005.02800.x · Cited by 146 · see citing works
Circadian Rhythm of Salivary Cortisol, 17α-Hydroxyprogesterone, and Progesterone in Healthy Children
Gröschl, M., Rauh, M., & Dörr, H.-G. (2003) · Clinical Chemistry · doi:10.1373/49.10.1688 · Cited by 145 · see citing works
The effect of macroeconomic variables on suicide
BERK, M., Dodd, S., & Henry, M. J. (2005) · Psychological Medicine · doi:10.1017/s0033291705006665 · Cited by 131 · see citing works
Economic crises and mortality: a review of the literature
Falagas, M. E., Vouloumanou, E. K., Mavros, M. N., & Karageorgopoulos, D. E. (2009) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2009.02124.x · Cited by 131 · see citing works
Hamer, M., Endrighi, R., Venuraju, S. M., Lahiri, A., & Steptoe, A. (2012) · PLoS ONE · doi:10.1371/journal.pone.0031356 · Cited by 128 · see citing works
Inflammation and cortisol response in coronary artery disease
Nijm, J., & Jonasson, L. (2009) · Annals of Medicine · doi:10.1080/07853890802508934 · Cited by 128 · see citing works
Hinkelmann, K., Muhtz, C., Dettenborn, L., Agorastos, A., Wingenfeld, K., Spitzer, C., Gao, W., Kirschbaum, C., Wiedemann, K., & Otte, C. (2013) · Biological Psychiatry · doi:10.1016/j.biopsych.2013.04.021 · Cited by 96 · see citing works
Endocrinology and Metabolism in Exercise
Galbo, H. (1981) · International Journal of Sports Medicine · doi:10.1055/s-2008-1034610 · Cited by 94 · see citing works
Sapolsky, R. M., & Mott, G. E. (1987) · Endocrinology · doi:10.1210/endo-121-5-1605 · Cited by 91 · see citing works
Gur, A., Cevik, R., Nas, K., Colpan, L., & Sarac, S. (2004) · Arthritis Res Ther · doi:10.1186/ar1163 · Cited by 88 · see citing works
Mörelius, E., Nelson, N., & Theodorsson, E. (2004) · Scandinavian Journal of Clinical and Laboratory Investigation · doi:10.1080/00365510410004452 · Cited by 73 · see citing works
Self-citationSuicidality and the economic crisis in Greece
Economou, M. P., Madianos, M. G., Peppou, L. Ε., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61244-6 · Cited by 34 · see citing works
Ramon, S. (1996) · doi:10.1007/978-1-349-24811-7 · Cited by 33 · see citing works
Low Cortisol and Risk and Resilience to Stress-Related Psychiatric Disorders
Binder, E. B., & Holsboer, F. (2012) · Biological Psychiatry · doi:10.1016/j.biopsych.2011.12.008 · Cited by 25 · see citing works
Heim, C. C., & Nater, U. M. (2007) · Elsevier eBooks · doi:10.1016/b978-012373947-6.00698-x · Cited by 6 · see citing works
Heim, C. M., & Nater, U. M. (2007) · Elsevier eBooks · doi:10.1016/b978-012373947-6/00698-x · Cited by 3 · see citing works
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- [27]Dettenborn L, Tietze A, Bruckner F, Kirschbaum C (2010) Higher cortisol content in hair among long-term unemployed individuals compared to controls. Psychoneuroendocrinology 35: 1404– 1409. 20471757
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Gaggioli, A., Pallavicini, F., Morganti, L., Serino, S., Scaratti, C., Briguglio, M., Crifaci, G., Vetrano, N., Giulintano, A., Bernava, G., et al. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.3235 · Cited by 164 · see citing works
Mayer, S. E., Lopez-Duran, N. L., Sen, S., & Abelson, J. L. (2018) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2018.03.020 · Cited by 135 · see citing works
Henley, P., Lowthers, M., Koren, G., Fedha, P. T., Russell, E., VanUum, S., Arya, S., Darnell, R., Creed, I. F., Trick, C. G., et al. (2014) · Canadian Journal of Physiology and Pharmacology · doi:10.1139/cjpp-2014-0035 · Cited by 36 · see citing works
- Authors
- Faresjö, Å., Theodorsson, E., Chatziarzenis, M., Sapouna, V., Claesson, H.-P., Koppner, J., & Faresjö, T.
- Affiliations
- Linköping University (SE)
- Thriasio General Hospital of Elefsina (GR)
- National and Kapodistrian University of Athens (GR)
- Corresponding author
- Faresjö, Åshild
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2013-09-16
- Volume
- 8
- Issue
- 9
- Pages
- e73828
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3774738
- OpenAlex
- W2040181447
- Cited by
- 74
- References
- 46
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 3 · 2023: 3 · 2022: 2 · 2021: 5 · 2020: 9 · 2019: 10 · 2018: 8 · 2017: 5 · 2016: 6 · 2015: 8 · 2014: 7 · 2013: 1
- FWCI
- 3.33
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DiVA (Linkoping University) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National and Kapodistrian University of Athens
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Health Professions › General Health Professions › Employment and Welfare Studies
- Social Sciences › Psychology › Clinical Psychology › Health and Well-being Studies
- Keywords
- perceived stress, cortisol, hair cortisol, financial crisis, austerity, depression, anxiety, hope for the future, life events, young adults, Greece, Sweden, cross-national comparison
- MeSH terms
- Adult, Anxiety, Cross-Sectional Studies, Depression, Greece, Hair, Humans, Hydrocortisone, Surveys and Questionnaires, Stress, Psychological, Sweden, Multivariate Analysis, Young Adult
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