Introducing a novel method to assess cumulative steroid concentrations: increased hair cortisol concentrations over 6 months in medicated patients with depression
Open accessAbstract
Depression has been linked to increased cortisol concentrations using point measures taken from urine, blood, or saliva samples. However, with regard to hypercortisolism-induced consequences, long-term cumulative cortisol burden is of relevance. Our objective was to use hair analysis as a new method to assess cortisol exposure over 6 months in depressed patients and healthy controls. We examined 23 depressed patients (8 men and 15 women, mean age: 41.6 years ( ± standard deviation (SD), 13.1 years); mean duration of current depressive episode 9 months ( ± SD, 13 months)) and 64 healthy controls, matched for age and gender. Cortisol concentrations in two 3-cm hair segments from near to the scalp were analyzed, representing cortisol secretion during the 6 months prior to sampling. Compared with healthy individuals, depressed patients had higher hair cortisol concentrations in the first (mean ± SD: 26.7 ± 20.8 vs. 18.7 ± 11.5 pg/mg, p < 0.05) and second hair segment (mean ± SD: 21.9 ± 23.7 vs. 13.4 ± 9.6 pg/mg, p < 0.05). In conclusion, hair cortisol analysis confirmed enhanced cortisol secretion in depressed patients over a prolonged time period. Because of the retrospective and cumulative nature of cortisol in hair, the assessment of hair cortisol concentration may help in addressing unanswered questions regarding hypothalamic-pituitary-adrenal axis overactivity and associated health consequences in psychiatric disorders.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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?
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 Dettenborn et al., 2012
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Tabachnick, B. G., & Fidell, L. S. (1983) · Cited by 79,888 · see citing works
(1998) · The Journal of Clinical Psychiatry · Cited by 19,139 · see citing works
The mini international neuropsychiatric interview
Lecrubier, Y., Sheehan, D. V., Hergueta, T., & Weiller, E. (1998) · European Psychiatry · doi:10.1016/s0924-9338(99)80239-9 · Cited by 5,882 · see citing works
State of the art in hair analysis for detection of drug and alcohol abuse
Pragst, F., & Balı́ková, M. (2006) · Clinica Chimica Acta · doi:10.1016/j.cca.2006.02.019 · Cited by 1,058 · see citing works
Major depressive disorder and hypothalamic-pituitary-adrenal axis activity
Vreeburg, S. A., Hoogendijk, W. J. G., van Pelt, J., DeRijk, R. H., Verhagen, J. C. M., van Dyck, R., Smit, J. H., Zitman, F. G., & Penninx, B. W. J. H. (2009) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2009.50 · Cited by 792 · cited 2× · see citing works
“Our findings of HPA axis hyperactivity extend previous results on increased cortisol concentrations captured via saliva, blood, and urine sampling (Nemeroff and Vale 2005; Vreeburg et al. 2009).”
Potential problems with the interpretation of hair analysis results
Wennig, R. (2000) · Forensic Science International · doi:10.1016/s0379-0738(99)00146-2 · Cited by 677 · see citing works
Analysis of endogenous cortisol concentrations in the hair of rhesus macaques
Davenport, M. D., Tiefenbacher, S., Lutz, C. K., Novak, M. A., & Meyer, J. S. (2006) · General and Comparative Endocrinology · doi:10.1016/j.ygcen.2006.01.005 · Cited by 659 · cited 3× · see citing works
“…indeed reflect adrenal production stems from the data indicating (a) high correlations between hair cortisol levels and salivary cortisol levels (Davenport et al. 2006; D’Anna-Hernandez et al. 2011), (b) high hair cortisol levels in known hypercortisolemic states (i.e. Cushing’s Syndrome,…”
Kirschbaum, C., Tietze, A., Skoluda, N., & Dettenborn, L. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2008.08.024 · Cited by 584 · see citing works
Self-citationMeasurement 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
Ito, N., Ito, T., Kromminga, A., Bettermann, A., Takigawa, M., Kees, F., Straub, R. H., & Paus, R. (2005) · The FASEB Journal · doi:10.1096/fj.04-1968fje · Cited by 498 · see citing works
Neuroimmunology of Stress: Skin Takes Center Stage
Arck, P., Slominski, A. T., Theoharides, T. C., Peters, E. M. J., & Paus, R. (2006) · Journal of Investigative Dermatology · doi:10.1038/sj.jid.5700104 · Cited by 484 · see citing works
Hippocampal volume, memory, and cortisol status in major depressive disorder: Effects of treatment
Vythilingam, M., Vermetten, E., Anderson, G. M., Luckenbaugh, D., Anderson, E. R., Snow, J., Staib, L. H., Charney, D. S., & Bremner, J. D. (2004) · Biological Psychiatry · doi:10.1016/j.biopsych.2004.04.002 · Cited by 477 · see citing works
(2005) · PubMed · Cited by 470 · see citing works
O'Brien, J. T. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.11.2081 · Cited by 409 · see citing works
DST Studies in Psychotic Depression: A Meta-Analysis
Nelson, J. C., & Davis, J. M. (1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.11.1497 · Cited by 356 · see citing works
D'Anna‐Hernandez, K., Ross, R. G., Natvig, C. L., & Laudenslager, M. L. (2011) · Physiology & Behavior · doi:10.1016/j.physbeh.2011.02.041 · Cited by 346 · 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
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
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
Self-citationThe relationship between stress and hair cortisol in healthy pregnant women
Kalra, S., Einarson, A., Karaskov, T., Uum, S. H. M. V., & Koren, G. (2007) · Clinical and investigative medicine · doi:10.25011/cim.v30i2.986 · Cited by 238 · see citing works
Hypercortisolemic Depression Is Associated With Increased Intra-Abdominal Fat
Weber-Hamann, B., Hentschel, F., Kniest, A., Deuschle, M., Colla, M., Lederbogen, F., & Heuser, I. (2002) · Psychosomatic Medicine · doi:10.1097/00006842-200203000-00010 · Cited by 219 · see citing works
Hair analysis provides a historical record of cortisol levels in Cushing's syndrome
Thomson, S., Koren, G., Fraser, L.-A., Rieder, M., Friedman, T. C., & Van Uum, S. H. M. (2009) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/s-0029-1220771 · Cited by 218 · see citing works
Cognitive Impairment in Major Depression: Association with Salivary Cortisol
Hinkelmann, K., Moritz, S., Botzenhardt, J., Riedesel, K., Wiedemann, K., Kellner, M. B., & Otte, C. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2009.06.023 · Cited by 216 · see citing works
Self-citationNeuroendocrinological mechanisms of actions of antidepressant drugs
Schüle, C. (2007) · Journal of Neuroendocrinology · doi:10.1111/j.1365-2826.2006.01516.x · Cited by 167 · see citing works
Reppermund, S., Zihl, J., Lucae, S., Horstmann, S., Kloiber, S., Holsboer, F., & Ising, M. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.09.027 · Cited by 147 · see citing works
The neuropsychological profile of psychotic major depression and its relation to cortisol
Gomez, R. G., Fleming, S. H., Keller, J., Flores, B., Kenna, H., DeBattista, C., Solvason, B., & Schatzberg, A. F. (2006) · Biological Psychiatry · doi:10.1016/j.biopsych.2005.11.010 · Cited by 127 · see citing works
Tobias Stalder, A., Kirschbaum, C., Heinze, K., Steudte‐Schmiedgen, S., Foley, P., Tietze, A., & Dettenborn, L. (2010) · Biological Psychology · doi:10.1016/j.biopsycho.2010.08.005 · Cited by 126 · see citing works
Self-citationHPLC-FLU detection of cortisol distribution in human hair
Gao, W., Xie, Q., Jin, J., Qiao, T., Wang, H., Chen, L., Deng, H., & Lu, Z. (2010) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2010.01.014 · Cited by 101 · see citing works
Depressive symptoms and metabolic risk: Effects of cortisol and gender
Muhtz, C., Zyriax, B., Klähn, T., Windler, E., & Otte, C. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2009.01.016 · Cited by 84 · see citing works
Self-citationBschor, T. (2002) · Neuropsychopharmacology · doi:10.1016/s0893-133x(02)00323-8 · Cited by 84 · see citing works
Dowlati, Y., Herrmann, N., Swardfager, W., Thomson, S., OH, P. I., Uum, S. H. M. V., Koren, G., & Lanctôt, K. L. (2010) · PubMed Central · Cited by 83 · see citing works
Sharpley, C., Kauter, K., & McFarlane, Jr. (2009) · Physiological Research · doi:10.33549/physiolres.931544 · Cited by 69 · see citing works
Longitudinal Course of Adolescent Depression: Neuroendocrine and Psychosocial Predictors
Rao, U., Hammen, C. L., & Poland, R. E. (2010) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2009.09.008 · Cited by 67 · see citing works
Schüle, C., Baghai, T. C., Eser, D., Zwanzger, P., Jordan, M., Buechs, R., & Rupprecht, R. (2006) · Psychopharmacology · doi:10.1007/s00213-006-0382-7 · Cited by 62 · see citing works
Michopoulos, I., Zervas, I. M., Pantelis, C., Tsaltas, E., Papakosta, V., Boufidou, F., Nikolaou, C., Papageorgiou, C., Soldatos, C. R., & Lykouras, L. (2008) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-007-0781-8 · Cited by 60 · see citing works
Kauffman, R. P., Castracane, V. D., White, D. L., Baldock, S. D., & Owens, R. (2005) · Gynecological Endocrinology · doi:10.1080/09513590500216800 · Cited by 53 · see citing works
Maes, M. H. J., Calabrese, J. R., & Meltzer, H. Y. (1994) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/0278-5846(94)90008-6 · Cited by 50 · see citing works
Bičı́ková, M., Hampl, R., Hill, M., Řı́pová, D., Mohr, P., & Putz, Z. (2011) · PubMed · Cited by 46 · see citing works
Scharnholz, B., Weber-Hamann, B., Lederbogen, F., Schilling, C., Gilles, M., Onken, V., Frankhauser, P., Kopf, D., & Deuschle, M. (2010) · Psychiatry Research · doi:10.1016/j.psychres.2009.08.010 · Cited by 28 · see citing works
Sharpley, C. F., Kauter, K., & McFarlane, J. R. (2010) · Physiological Research · doi:10.33549/physiolres.931874 · Cited by 28 · see citing works
Long-Term Benzodiazepine Use and Salivary Cortisol
Manthey, L., Giltay, E. J., van Veen, T., Neven, A. K., Vreeburg, S. A., Penninx, B. W. J. H., & Zitman, F. G. (2010) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3181d41f41 · Cited by 24 · see citing works
Joining the dots: neurobiological links in a functional analysis of depression
Sharpley, C. F., & Bitsika, V. (2010) · Behavioral and Brain Functions · doi:10.1186/1744-9081-6-73 · Cited by 14 · see citing works
Long-Term Outcome after Lithium Augmentation in Unipolar Depression: Focus on HPA System Activity
Adli, M., Bschor, T., Bauer, M., Lucka, C., Lewitzka, U., Ising, M., Uhr, M., Müller-Oerlinghausen, B., & Baethge, C. (2009) · Neuropsychobiology · doi:10.1159/000234814 · Cited by 8 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Stress-related and basic determinants of hair cortisol in humans: a meta-analysis
Stalder, T., Steudte-Schmiedgen, S., Alexander, N., Klucken, T., Vater, A., Wichmann, S., Kirschbaum, C., & Miller, R. (2017) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2016.12.017 · Cited by 855 · see citing works
Self-citationHair 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
Minireview: Hair cortisol: A novel biomarker of hypothalamic-pituitary-adrenocortical activity
Meyer, J. S., & Novak, M. A. (2012) · Endocrinology · doi:10.1210/en.2012-1226 · Cited by 457 · see citing works
Stress and Obesity: Are There More Susceptible Individuals?
van der Valk, E. S., Savas, M., & van Rossum, E. F. C. (2018) · Current Obesity Reports · doi:10.1007/s13679-018-0306-y · Cited by 402 · 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
Self-citationClinical applications of cortisol measurements in hair
Wester, V. L., & van Rossum, E. F. C. (2015) · European Journal of Endocrinology · doi:10.1530/eje-15-0313 · Cited by 210 · see citing works
Wosu, A. C., Valdimarsdóttir, U., Shields, A. E., Williams, D. R., & Williams, M. A. (2013) · Annals of Epidemiology · doi:10.1016/j.annepidem.2013.09.006 · Cited by 199 · see citing works
Assessing cortisol from hair samples in a large observational cohort: the Whitehall II study
Abell, J. G., Stalder, T., Ferrie, J. E., Shipley, M. J., Kirschbaum, C., Kivimäki, M., & Kumari, M. (2016) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2016.07.214 · Cited by 175 · see citing works
Self-citationMayer, 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
The relationship between cortisol, stress and psychiatric illness: New insights using hair analysis
Herane Vives, A., De Angel, V., Papadopoulos, A., Strawbridge, R., Wise, T., Young, A. H., Arnone, D., & Cleare, A. J. (2015) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2015.08.007 · Cited by 129 · see citing works
Hair cortisol concentrations in mental disorders: A systematic review
Koumantarou Malisiova, E., Mourikis, I., Darviri, C., Nicolaides, N. C., Zervas, I. M., Papageorgiou, C., & Chrousos, G. P. (2021) · Physiology & Behavior · doi:10.1016/j.physbeh.2020.113244 · Cited by 99 · 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
Self-citationMeditation interventions efficiently reduce cortisol levels of at-risk samples: A meta-analysis
Koncz, A., Demetrovics, Z., & Takacs, Z. K. (2021) · Health Psychology Review · doi:10.1080/17437199.2020.1760727 · Cited by 94 · see citing works
Schalinski, I., Elbert, T., Steudte-Schmiedgen, S., & Kirschbaum, C. (2015) · PLOS ONE · doi:10.1371/journal.pone.0136921 · Cited by 88 · see citing works
Self-citationEmotional and psychological trauma in refugees arriving in Germany in 2015
Ullmann, E., Barthel, A., Taché, S., Bornstein, A., Licinio, J., & Bornstein, S. R. (2015) · Molecular Psychiatry · doi:10.1038/mp.2015.164 · Cited by 74 · see citing works
Elevated fingernail cortisol levels in major depressive episodes
Herane-Vives, A., Fischer, S., de Angel, V., Wise, T., Cheung, E., Chua, K.-C., Arnone, D., Young, A. H., & Cleare, A. J. (2018) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2017.10.026 · Cited by 46 · see citing works
Scalp hair cortisol for diagnosis of Cushing's syndrome
Wester, V. L., Reincke, M., Koper, J. W., van den Akker, E. L. T., Manenschijn, L., Berr, C. M., Fazel, J., de Rijke, Y. B., Feelders, R. A., & van Rossum, E. F. C. (2017) · European Journal of Endocrinology · doi:10.1530/eje-16-0873 · Cited by 39 · see citing works
The Association between Hair Cortisol and Self-Reported Symptoms of Depression in Pregnant Women
Wikenius, E., Moe, V., Kjellevold, M., Smith, L., Lyle, R., Waagbø, R., Page, C. M., & Myhre, A. M. (2016) · PLOS ONE · doi:10.1371/journal.pone.0161804 · Cited by 36 · see citing works
Izawa, S., Sugaya, N., Ogawa, N., Shirotsuki, K., & Nomura, S. (2021) · Stress · doi:10.1080/10253890.2021.1895113 · Cited by 29 · see citing works
- Authors
- Dettenborn, L., Muhtz, C., Skoluda, N., Stalder, T., Steudte, S., Hinkelmann, K., Kirschbaum, C., & Otte, C.
- Affiliations
- Technische Universität Dresden (DE)
- University Medical Center Hamburg-Eppendorf (DE)
- Corresponding author
- Dettenborn, Lucia
- Venue
- Stress
- Publisher
- Informa UK Limited
- Published
- 2011-11
- Volume
- 15
- Issue
- 3
- Pages
- 348-353
- ISSN
- 1025-3890 (ISSN-L)
- 1607-8888
- OpenAlex
- W1747999473
- Cited by
- 181
- References
- 43
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 8 · 2023: 10 · 2022: 11 · 2021: 16 · 2020: 21 · 2019: 10 · 2018: 13 · 2017: 17 · 2016: 18 · 2015: 18 · 2014: 8 · 2013: 7 · 2012: 8
- FWCI
- 2.89
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Stress (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Deutsche Forschungsgemeinschaft
- Servier
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Keywords
- depression, hair cortisol, hypercortisolism, hypothalamic-pituitary-adrenal axis, antidepressants, chronic stress
- MeSH terms
- Adult, Analysis of Variance, Depression, Female, Hair, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Inpatients, Male, Middle Aged, Pituitary-Adrenal System, Psychiatric Status Rating Scales, Recurrence, Smoking
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
