Comparison of short-term (saliva) and long-term (hair) cortisol levels in out-patients with melancholic and non-melancholic major depression.
Depressive disorders
biomarkers
hair cortisol
melancholic
non-melancholic
Journal
BJPsych open
ISSN: 2056-4724
Titre abrégé: BJPsych Open
Pays: England
ID NLM: 101667931
Informations de publication
Date de publication:
23 Apr 2020
23 Apr 2020
Historique:
entrez:
24
4
2020
pubmed:
24
4
2020
medline:
24
4
2020
Statut:
epublish
Résumé
Major depressive episodes (MDEs) show diverse cortisol level alterations. Heterogeneity in symptom profiles, symptom severity and cortisol specimens may explain these heterogeneous results. Less severely ill out-patients with a non-melancholic MDE (NM-MDE) may have a variation in the rhythm of cortisol secretion rather than in its concentration. Cortisol measures were taken (a) over a short-term period (12 h) by measuring daily salivary output using the area under the curve with respect to the ground (AUCg) and (b) over a long-term period (3 months) in hair. Additionally, cortisol reactivity measures in saliva - the cortisol awakening response and the 30 min delta cortisol secretion after awakening (DELTA) - were investigated in 19 patients with a melancholic MDE (M-MDE) and 52 with a NM-MDE, and in 40 matched controls who were recruited from the UK and Chile. Depression severity scores were correlated with different cortisol measures. The NM-MDE group showed a decreased AUCg in comparison with controls (P = 0.02), but normal cortisol reactivity and long-term cortisol levels. The M-MDE group did not exhibit any significant cortisol alterations nor an association with depression severity scores. Higher Hamilton Rating Scale for Depression score was linked with decreased hair cortisol concentration (HCC, P = 0.05) and higher DELTA (P = 0.04) in NM-MDEs, whereas decreased HCC was the sole alteration associated with out-patients with severe M-MDEs. The contrasting short- and long-term cortisol output results are compatible with an alteration in the rhythm of cortisol secretion in NM-MDEs. This alteration may consist of large and/or intense episodes of hypercortisolaemia in moderate NM-MDEs and frequent, but brief and sharp early-morning DELTAs in its severe form. These changes may reflect the effects of environmental factors or episodes of nocturnal hypercortisolaemia that were not measured by the short-term samples used in this study.
Sections du résumé
BACKGROUND
BACKGROUND
Major depressive episodes (MDEs) show diverse cortisol level alterations. Heterogeneity in symptom profiles, symptom severity and cortisol specimens may explain these heterogeneous results. Less severely ill out-patients with a non-melancholic MDE (NM-MDE) may have a variation in the rhythm of cortisol secretion rather than in its concentration.
METHOD
METHODS
Cortisol measures were taken (a) over a short-term period (12 h) by measuring daily salivary output using the area under the curve with respect to the ground (AUCg) and (b) over a long-term period (3 months) in hair. Additionally, cortisol reactivity measures in saliva - the cortisol awakening response and the 30 min delta cortisol secretion after awakening (DELTA) - were investigated in 19 patients with a melancholic MDE (M-MDE) and 52 with a NM-MDE, and in 40 matched controls who were recruited from the UK and Chile. Depression severity scores were correlated with different cortisol measures.
RESULTS
RESULTS
The NM-MDE group showed a decreased AUCg in comparison with controls (P = 0.02), but normal cortisol reactivity and long-term cortisol levels. The M-MDE group did not exhibit any significant cortisol alterations nor an association with depression severity scores. Higher Hamilton Rating Scale for Depression score was linked with decreased hair cortisol concentration (HCC, P = 0.05) and higher DELTA (P = 0.04) in NM-MDEs, whereas decreased HCC was the sole alteration associated with out-patients with severe M-MDEs.
CONCLUSIONS
CONCLUSIONS
The contrasting short- and long-term cortisol output results are compatible with an alteration in the rhythm of cortisol secretion in NM-MDEs. This alteration may consist of large and/or intense episodes of hypercortisolaemia in moderate NM-MDEs and frequent, but brief and sharp early-morning DELTAs in its severe form. These changes may reflect the effects of environmental factors or episodes of nocturnal hypercortisolaemia that were not measured by the short-term samples used in this study.
Identifiants
pubmed: 32321622
doi: 10.1192/bjo.2020.8
pii: S2056472420000083
pmc: PMC7189571
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e41Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Références
Arch Gen Psychiatry. 1970 Oct;23(4):289-98
pubmed: 4918519
Acta Psychiatr Scand. 2012 Jun;125(6):478-91
pubmed: 22211368
Physiol Behav. 2011 Aug 3;104(2):348-53
pubmed: 21397617
Br J Psychiatry. 1978 Nov;133:429-35
pubmed: 728692
Anal Bioanal Chem. 2012 May;403(3):769-76
pubmed: 22451175
Arch Gen Psychiatry. 2009 Jun;66(6):617-26
pubmed: 19487626
Am J Psychiatry. 1983 Jan;140(1):88-91
pubmed: 6847992
Brain Behav Immun. 2012 Oct;26(7):1019-29
pubmed: 22366690
J Affect Disord. 2015 Apr 1;175:299-302
pubmed: 25661395
J Affect Disord. 1989 Mar-Jun;16(2-3):189-95
pubmed: 2522118
Stress. 2012 May;15(3):348-53
pubmed: 22043813
J Clin Endocrinol Metab. 2001 Aug;86(8):3787-94
pubmed: 11502812
Br J Psychiatry. 1989 Sep;155:294-304
pubmed: 2692760
Metab Brain Dis. 2017 Apr;32(2):577-583
pubmed: 28064407
Ann N Y Acad Sci. 2009 Oct;1179:144-52
pubmed: 19906237
Stress. 2012 Nov;15(6):578-88
pubmed: 22356099
Acta Psychiatr Scand. 2018 Mar;137(3):216-230
pubmed: 29397570
J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57
pubmed: 9881538
J Affect Disord. 2013 Sep 5;150(2):384-8
pubmed: 23759278
J Affect Disord. 1980 Jun;2(2):95-109
pubmed: 6448888
Endocrinology. 1999 Sep;140(9):4359-66
pubmed: 10465310
Psychiatry Res. 2004 Apr 15;126(1):1-13
pubmed: 15081622
Acta Psychiatr Scand Suppl. 2007;(433):90-103
pubmed: 17280575
Mol Psychiatry. 2013 Jun;18(6):632-4
pubmed: 23698316
Psychoneuroendocrinology. 2010 Jul;35(6):921-31
pubmed: 20079576
Am J Psychiatry. 1994 Apr;151(4):489-98
pubmed: 8147445
J Psychiatr Res. 2015 Nov;70:38-49
pubmed: 26424422
Br J Soc Clin Psychol. 1967 Dec;6(4):278-96
pubmed: 6080235
World J Biol Psychiatry. 2018 Dec;19(8):633-644
pubmed: 28345388
Int Arch Occup Environ Health. 2012 Nov;85(8):849-52
pubmed: 22183048
Am J Psychiatry. 2002 Sep;159(9):1470-9
pubmed: 12202264
Psychoneuroendocrinology. 2015 Apr;54:24-30
pubmed: 25662340
Br J Psychiatry. 1965 Aug;111:659-74
pubmed: 14337413
Br J Psychiatry. 2004 Feb;184:136-41
pubmed: 14754825
Schizophr Res. 2019 Nov;213:65-71
pubmed: 30660575
Psychosom Med. 2003 Jan-Feb;65(1):92-9
pubmed: 12554820
Arch Gen Psychiatry. 1999 May;56(5):431-7
pubmed: 10232298
Psychoneuroendocrinology. 2016 Jul;69:26-34
pubmed: 27017430
J Behav Med. 1981 Mar;4(1):1-39
pubmed: 7288876
Clin Chem Lab Med. 2011 Sep 09;49(12):2013-9
pubmed: 21902574
Psychosom Med. 2011 Feb-Mar;73(2):114-26
pubmed: 21257974
Am J Psychiatry. 1985 Sep;142(9):1017-31
pubmed: 2862799
Psychoneuroendocrinology. 2019 Jan;99:183-190
pubmed: 30248494
Am J Psychiatry. 1994 Aug;151(8):1132-6
pubmed: 8037246
Biol Psychiatry. 2005 Dec 15;58(12):963-8
pubmed: 16005439
Mol Psychiatry. 2013 Jun;18(6):692-9
pubmed: 23089630
Acta Psychiatr Scand. 1998 Dec;98(6):432-6
pubmed: 9879783
Psychopharmacology (Berl). 2005 Oct;182(1):54-7
pubmed: 15991000
Neuropsychiatr Dis Treat. 2016 Feb 05;12:279-85
pubmed: 26917961
Psychoneuroendocrinology. 2012 May;37(5):589-601
pubmed: 21974976
Psychoneuroendocrinology. 2018 Feb;88:17-23
pubmed: 29153629
Clin Invest Med. 2007;30(5):E183-91
pubmed: 17892760
J Psychosom Res. 1997 Sep;43(3):279-92
pubmed: 9304554
Psychother Psychosom. 2003 Mar-Apr;72(2):61-70
pubmed: 12601223