Hair cortisol as a marker of hypothalamic-pituitary-adrenal Axis activity in female patients with major depressive disorder

Abstract

Hair cortisol is regarded as a promising marker of hypothalamic-pituitary-adrenal axis (HPAA) activity alterations due to stress, somatic and mental health conditions. Hair cortisol was previously reported to be elevated in patients with depression, however the data related to remission and recurrent depressive episodes are different. In this study, levels of hair cortisol were assessed in female patients with major depressive disorder (MDD) and the validity of hair cortisol as a marker of HPAA activity in this condition was evaluated. Hair cortisol was measured in 1 cm hair segments of 21 female patients with MDD and 22 female age-matched controls using enzyme-immunoassay analysis. Concurrently, serum cortisol was assessed and psychological status was evaluated using 17-item Hamilton Depression Rating Scale (HAMD-17), Beck Depression Inventory (BDI) and the Spielberger state trait anxiety inventory (STAI). The levels of hair cortisol were significantly lower in the MDD group, while serum cortisol levels were significantly higher in patients, as compared with controls. A significant negative correlation was found between HAMD-17 scores and hair cortisol. Decreased hair cortisol found in female patients with MDD as compared to controls suggests downregulation of HPAA activity during the preceding month. Further studies are needed to investigate the profiles of hair cortisol at different stages of depressive disorder to establish this parameter as a handy clinical tool.

Recurrence of Depression in Relation to History of Childhood Trauma and Hair Cortisol Concentration in a Community-Based Sample

“…The hypothesized peripheral hypocortisolism is in accordance with findings in animal models of early life stress [44], findings of reduced cortisol secretion in groups with history of early life stress [45, 46], reports of reduced adrenocortical activation during psychological stress [47-49] and pharmacological challenge [50]. Such mechanism could explain a more recent report of reduced hair cortisol in patients with depression [51] and the role in mediating the effects of childhood trauma on development of externalizing symptoms [52]. Such counter-regulatory changes at the peripheral level could further enhance the disinhibition of central CRH pathways interfering with the regulation of emotions and contributing to the occurrence and persistence of depressive symptoms [42].…”

Cortisol levels in fingernails, neurocognitive performance and clinical variables in euthymic bipolar I disorder

“…Further support for the elevation of cortisol over longer time frames comes from studies using hair specimens from depressed patients, which usually cover longer periods of around 3 months (Dettenborn et al, 2012;Herane Vives et al, 2015;Wei et al, 2015;Pochigaeva et al, 2017).…”

Short‐term and long‐term measures of cortisol in saliva and hair in atypical and non‐atypical depression

“…More recently, Pochigaeva et al. studied just female depressed patients and found HCC to be lower. As noted earlier, A‐MDE might be associated with a different pattern of HPA disturbance.…”

“…Decreased cortisol levels are also found in somatic symptom disorders such chronic fatigue syndrome (CFS) and fibromyalgia (; Roberts et al., 2004). Indeed, some authors have suggested that atypical depression may be better described as part of this group of disorders and that the profound fatigue seen in these states may be the factor most closely linked to reduced HPA activity across the different syndromes .…”