The cortisol awakening response predicts major depression: predictive stability over a 4-year follow-up and effect of depression history

Abstract

Background The cortisol awakening response (CAR) has been shown to predict major depressive episodes (MDEs) over a 1-year period. It is unknown whether this effect: (a) is stable over longer periods of time; (b) is independent of prospective stressful life events; and (c) differentially predicts first onsets or recurrences of MDEs. Method A total of 270 older adolescents (mean age 17.06 years at cortisol measurement) from the larger prospective Northwestern-UCLA Youth Emotion Project completed baseline diagnostic and life stress interviews, questionnaires, and a 3-day cortisol sampling protocol measuring the CAR and diurnal rhythm, as well as up to four annual follow-up interviews of diagnoses and life stress. Results Non-proportional person-month survival analyses revealed that higher levels of the baseline CAR significantly predict MDEs for 2.5 years following cortisol measurement. However, the strength of prediction of depressive episodes significantly decays over time, with the CAR no longer significantly predicting MDEs after 2.5 years. Elevations in the CAR did not significantly increase vulnerability to prospective major stressful life events. They did, however, predict MDE recurrences more strongly than first onsets. Conclusions These results suggest that a high CAR represents a time-limited risk factor for onsets of MDEs, which increases risk for depression independently of future major stressful life events. Possible explanations for the stronger effect of the CAR for predicting MDE recurrences than first onsets are discussed.

Low levels of morning salivary α-amylase activity predict higher number of depressive symptoms in a community sample of children

“…Nevertheless, the relationship was weaker than previously assumed and, in analyses of the clinical subsample, the association was found to be stronger among male participants. A similar conclusion was reached by Vrshek-Schallhorn et al (2013) and Nelemans et al (2014). Finally, Keenan et al (2013) studied the specific association between the cortisol response to a laboratory stressor and depressive symptomatology in a cohort of 232 girls at 10 years and 12 years of age and their mothers.…”

Stress, Sleep, and Performance on Standardized Tests: Understudied Pathways to the Achievement Gap

“…Frequently experiencing large CARs may indicate the individual faces excessive perceived demands-or insufficient perceived resources to meet those demands Vrshek-Schallhorn et al, 2012).…”

Increased Cortisol Levels in Depression: A Comparative Study Evaluating the Correlation of Hypercortisolemia with Prosocial Coping Mechanisms

“…Follow up studies on a longer period in patients who experienced at least one depressive episode have shown that the risk of recurrence was higher in those with higher levels of cortisol [28,29].…”