Afternoon plasma cortisol in relation to depression A replication study

The occurrence of alexithymic features (inability to verbalize emotions) and cortisol hypersecretion was investigated in 257 subjects drawn from a Finnish adult community sample. Seventy‐five were considered to have poor sleep, 154 were good sleepers and 28 intermediate sleepers. The quality of sleep was investigated with the help of a self‐report‐based questionnaire, and alexithymic features were assessed during a psychiatric interview. Cortisol hypersecretion was measured by the dexamethasone suppression test (DST). Alexithymic features were clearly related to self‐reported insomnia and especially to long sleep latency (SL). Age and sex covaried with the relation between alexithymic features and quality of sleep. However, independent of age and sex, subjects with alexithymic features reported significantly more insomnia, difficulty in maintaining sleep (DMS) and parasomnias than non‐alexithymics. Though the occurrence of DST non‐suppressors did not differ in the good and the poor sleepers, the post‐dexamethasone cortisol level positively associated with alexithymic features. The data support but do not definitely prove the arousal theory of functional (psychophysiological) insomnia, ie a tendency of internalize psychic conflicts and an inability to verbalize them may lead to increased arousal and subsequent insomnia.

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Functional insomnia in relation to alexithymic features and cortisol hypersecretion in a community sample

Hyyppä

Lindholm

Kronholm

et al. 1990

Stress Med.

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Cortisol and treatment of depression: predictive value of spontaneous and suppressed cortisol levels and course of spontaneous plasma cortisol

et al. 1989

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In 72 consecutive depressed hospitalized patients afternoon plasma cortisol was measured in three ways before treatment with antidepressants: 1) Spontaneous (n = 72), 2) 2h after oxazepam suppression (45 mg, n = 28; 60 mg, n = 37) and 3) 16 h after dexamethasone suppression (2 mg, n = 71). In addition, spontaneous cortisol was measured after 3 weeks' treatment (n = 55) and 5 weeks' treatment (n = 36). Both spontaneous and suppressed cortisol levels seemed to have a predictive value in the endogenously depressed patients: complete responders had significantly lower pretreatment cortisol levels compared to poor responders. However, other covarying factors such as distress and age may as well account for the differences in treatment effect. During treatment a significant decrease of spontaneous cortisol was found from about 400 nM in poor responders and 325 nM in complete responders to about 300 nM in all groups. There was a positive correlation between pre- and post-treatment cortisol levels and between pretreatment levels and per cent fall in spontaneous cortisol levels.

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Benzodiazepine-induced sedation and cortisol suppression

Christensen¹,

Lolk²,

Gram³

et al. 1992

Psychopharmacology

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The sedative and cortisol suppressing properties of oxazepam (45 and 60 mg) and nitrazepam (10 and 15 mg) were examined in eight healthy male subjects. The most clear differences between oxazepam and nitrazepam were those seen with respect to the time course and until maximal effect (Tmax) of the different measurements. Nitrazepam showed maximal sedation after 1 h, maximal benzodiazepine level (RRA), and reaction time prolongation after 2 h, and maximal cortisol suppression after 3 h. Oxazepam showed maximal sedation after 2 h, maximal benzodiazepine levels, reaction time prolongation and cortisol suppression after 3 h. After administration of oxazepam (both doses) a transient return to baseline levels of cortisol was demonstrated. Whereas the degree of sedation correlated significantly within drug groups with the concurrent benzodiazepine levels, the Tmax of sedation was recorded 1 h earlier than the peak blood concentration (RRA) for both nitrazepam and oxazepam. The time course for cortisol suppression for the two compounds differed clearly from the other measurements and was not related to the peak blood concentration.

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Afternoon plasma cortisol in relation to depression A replication study

Cited by 6 publications

References 27 publications

Functional insomnia in relation to alexithymic features and cortisol hypersecretion in a community sample

Functional insomnia in relation to alexithymic features and cortisol hypersecretion in a community sample

Cortisol and treatment of depression: predictive value of spontaneous and suppressed cortisol levels and course of spontaneous plasma cortisol

Benzodiazepine-induced sedation and cortisol suppression

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