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Cortisol levels in typical and non-typical major depressive episodes, using hair and saliva specimens

Andrés Herane1, 2*, Toby Wise1, Valeria De Angel3, Danilo Arnone1, Dimosthenis Tsapekos1, Andrew Papadopoulos1, Allan Young1 and Anthony Cleare1
  • 1 King's College School, Psychological Medicine, United Kingdom
  • 2 Universidad Catolica del Norte, Departamento de Clinicas, Chile
  • 3 Universidad de Chile, Facultad de Medicina, Chile

Background: There is little consensus in relation to the cortisol concentration variations in Major Depressive Episode (MDE). Variables, such as the heterogeneity in this syndrome, different degrees of severity or the use of different cortisol specimens may explain this lack of agreement. Furthermore, less severe outpatients with non-typical features of MDE (NT-MDE) may have a variation in the rhythm of cortisol secretion, rather than in its concentration. Methods: Cortisol measures over short-term (12 hours), as a measure of the area under the curve with respect to the ground (AUCg) and over long-term (three months) in hair (HCC), in addition to cortisol reactivity measures, such as the cortisol awakening response (CAR) and the peak of cortisol secretion after awakening were investigated in 52 NT-MDE and 19 typical depressed subjects (T-MDE) who were age- and gender- matched with 40 controls. Depression severity scores, using the 17-item Hamilton Depression scale (HAMD-17) were correlated with aforementioned cortisol measures to investigated the influence of depression severity in the level of this hormone. Results: NT-MDE presented a decreased AUCg in comparison to controls (p=0.01), but with normal cortisol reactivity and long-term secretion levels. Increases in HAMD-17 scores were associated with an increase in early morning peaks of cortisol and short-term cortisol secretion levels. However, the same scores were linked with decreased long-term cortisol secretion levels. Conclusion: The contrasting results that the two secretion measures showed suggested an alteration in the rhythm of cortisol secretion in NT-MDE. Different associations between depression severity and cortisol measures suggests that this clinical illness variable may become a stressor, and imply a pathological body cortisol distribution in MDE outpatients, such as those seen in disorders featured by an abnormal stress response. Cortisol distribution differences also suggest that fatigue is a consequence of chronic vasoconstriction in locomotor muscles in MDE patients. Lactate levels may be potential biomarker of this symptom.

Acknowledgements

This research was funded by departmental funds generated by AJC, AHY and AHV and start-up funds from the Academy of Medical Sciences to DA (Ref. AMS-SGCL8). AHV was supported by a Chilean Bicentennial Fund Scholarship from the Bicentennial Fund for Human Capital Development (Becas Chile) and by the Psychiatric Research Trust. SF was funded by the Swiss National Science Foundation. AJC, TW and AHY are supported by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Tru

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Keywords: hair cortisol, typical depression, non-typical depression, Saliva cortisol, severity of illness

Conference: ISAD LONDON 2017: Perspectives on Mood and Anxiety Disorders: Looking to the future, London, United Kingdom, 6 Jul - 7 Jul, 2017.

Presentation Type: Poster

Topic: Diagnosis / Classification

Citation: Herane A, Wise T, De Angel V, Arnone D, Tsapekos D, Papadopoulos A, Young A and Cleare A (2019). Cortisol levels in typical and non-typical major depressive episodes, using hair and saliva specimens. Front. Psychiatry. Conference Abstract: ISAD LONDON 2017: Perspectives on Mood and Anxiety Disorders: Looking to the future. doi: 10.3389/conf.fpsyt.2017.48.00022

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Received: 26 May 2017; Published Online: 25 Jan 2019.

* Correspondence: Dr. Andrés Herane, King's College School, Psychological Medicine, London, United Kingdom, andres.herane@kcl.ac.uk