Cortisol and depressive symptoms in a population-based cohort of midlife women.

Departments of Internal Medicine and Psychiatry, Rush University Medical Center, Chicago, Illinois, USA.
Psychosomatic Medicine (Impact Factor: 4.09). 11/2010; 72(9):855-61. DOI: 10.1097/PSY.0b013e3181f4ab87
Source: PubMed

ABSTRACT To determine whether there is a relationship between depressive symptoms and cortisol assessed at first morning awakening, 6 PM, and 9 PM in a population-based sample of midlife women. If this relationship is not linear, we aim to test whether this relationship is nonlinear, only present in those with more severe depressive symptoms, better accounted for by diurnal slope, or only apparent under uncontaminated conditions.
We investigated the cross-sectional association between cortisol and depressive symptoms, assessed by the Center for Epidemiological Studies Depression scale (CES-D) in 408 midlife women (45.7% African Americans, 54.3% white; mean age, 50.4 years) participating in the Chicago site of the Study of Women's Health Across the Nation.
Diurnal cortisol slope is significantly flatter for women with higher CES-D scores than for less depressed women (p < .05 for the interaction). This relationship remains significant even after adjusting for age, smoking status, race, education, income, menopausal status, hormone replacement therapy, body mass index, medications, and wake time, as well as possibly contaminating factors, including physical activity, smoking, eating, or caffeine or alcohol consumption before saliva collection. Results using depression assessed categorically (CES-D cutoff ≥16) were similar to those using continuous depression in both unadjusted and adjusted analyses (p = .005 for the interaction of CES-D by time).
In this population-based sample of midlife women, greater depressive symptoms were associated with a significantly flatter diurnal cortisol slope than those with fewer symptoms, even after adjusting for covariates and possibly contaminating behaviors.


Available from: Elizabeth F Avery, May 30, 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: Research has revealed a well-established relationship of depressive symptoms and hopelessness with a variety of physical illnesses that are associated with a dysfunction of the hypothalamic-pituitary-adrenal-axis. The purpose of this study was to test if depressive symptoms mediate the relationship between hopelessness and cortisol, a measure of the hypothalamic-pituitary-adrenal-axis. Hopelessness, depressive symptoms, and diurnal cortisol rhythm were measured in 257 adults (128 women and 129 men; age range, 20-74 years) in this cross-sectional study. To test the hypothesis, two linear regression analyses and asymmetrical confidence intervals around the regression weights were conducted. A second set of analyses was calculated to be able to exclude the possibility of hopelessness as a mediator between depressive symptoms and cortisol. As predicted, after adjusting for age, gender, awakening time, and medication use, more hopelessness predicted more depressive symptoms and more depressive symptoms predicted a flatter diurnal cortisol rhythm. The 95 % confidence intervals revealed that the indirect relationship between hopelessness and diurnal cortisol rhythm was significant. The analyses with hopelessness as a potential mediator revealed that hopelessness does not mediate the association between depressive symptoms and cortisol. While the relationship between hopelessness and cortisol was mediated by depressive symptoms in this cross-sectional study, many other risk factors of depression have not been examined. Thus, future longitudinal studies should examine the relationships between those risk factors of depression and the hypothalamic-pituitary-adrenal-axis.
    International Journal of Behavioral Medicine 12/2014; 22(2). DOI:10.1007/s12529-014-9422-6 · 2.63 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Hypothalamic-pituitary-adrenal system dysfunction, serotonergic system alterations, and enhanced platelet activity may contribute to the increased cardiac risk in depression. This exploratory study examined associations between cortisol parameters, platelet serotonin (5-HT) content, and platelet activity markers in patients with newly diagnosed major depression (MD) and/or Type 2 diabetes (T2DM) compared with healthy controls. We compared cortisol awakening response (CAR), diurnal decrease in salivary cortisol concentrations (slope), platelet 5-HT, and platelet markers (CD40, CD40 ligand [CD40L], soluble CD40L, CD62P, β-thromboglobulin, and platelet factor-4) in 22 T2DM patients, 20 MD patients, 18 T2DM patients with MD, and 24 healthy controls. Platelet markers were elevated in MD (F(6,60) = 11.14, p < .001) and T2DM (F(6,60) = 13.07, p < .001). Subgroups did not differ in 5-HTor cortisol slope, whereas T2DMpatients without depression had significantly lower CAR than did healthy controls (F(1,61) = 7.46, p = .008). In healthy controls, cortisol slope correlated with platelet activity for CD40 (r = -0.43, p = .048) and 5-HTwas correlated with CD40L (r = 0.53, p = .007). In patients with both T2DMandMD, 5-HT and CD62P were correlated (r = 0.52, p = .033). Increased platelet activity in T2DM and MD may play a role in the association between diabetes, depression, and coronary artery disease. The present data suggest that group differences in cortisol or 5-HT as well as group-specific associations of cortisol or 5-HT with platelet markers might be of limited importance in the shared pathways of T2DM and depression in the pathophysiology of coronary artery disease.
    Psychosomatic Medicine 01/2015; 77(2). DOI:10.1097/PSY.0000000000000145 · 4.09 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Disturbances of the circadian rhythm of cortisol secretion are associated with depression, coronary calcification, and higher all-cause and cardiovascular mortality.The primary aim of this study was to test the associations between midnight salivary cortisol (MSC), depression and HbA1c, and control for behavioural, environmental and intra individual factors with possible impact on cortisol secretion, like smoking, physical inactivity, season, medication, diabetes duration, severe hypoglycemia episodes, age and gender in patients with type 1 diabetes. Secondary aims were to present MSC levels for a reference group of non-depressed type 1 diabetes patients with a healthy life style (physically active and non-smoking), and to explore seasonal variations.
    BMC Endocrine Disorders 09/2014; 14(1):75. DOI:10.1186/1472-6823-14-75 · 1.67 Impact Factor