Dysregulated diurnal cortisol pattern is associated with glucocorticoid resistance in women with major depressive disorder.
Title | Dysregulated diurnal cortisol pattern is associated with glucocorticoid resistance in women with major depressive disorder. |
Publication Type | Journal Article |
Year of Publication | 2013 |
Authors | Jarcho MR, Slavich GM, Tylova-Stein H, Wolkowitz OM, Burke HM |
Journal | Biol Psychol |
Volume | 93 |
Issue | 1 |
Pagination | 150-8 |
Date Published | 2013 Apr |
ISSN | 1873-6246 |
Keywords | Adult, Circadian Rhythm, Depressive Disorder, Major, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System, Saliva, Stress, Psychological |
Abstract | Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis is believed to play a role in the pathophysiology of depression. To investigate mechanisms that may underlie this effect, we examined several indices of HPA axis function - specifically, diurnal cortisol slope, cortisol awakening response, and suppression of cortisol release following dexamethasone administration - in 26 pre-menopausal depressed women and 23 never depressed women who were matched for age and body mass index. Salivary cortisol samples were collected at waking, 30 min after waking, and at bedtime over three consecutive days. On the third day, immediately after the bedtime sample, participants ingested a 0.5mg dexamethasone tablet; they then collected cortisol samples at waking and 30 min after waking the following morning. As predicted, depressed women exhibited flatter diurnal cortisol rhythms and more impaired suppression of cortisol following dexamethasone administration than non-depressed women over the three sampling days. In addition, flatter diurnal cortisol slopes were associated with reduced cortisol response to dexamethasone treatment, both for all women and for depressed women when considered separately. Finally, greater self-reported depression severity was associated with flatter diurnal cortisol slopes and with less dexamethasone-related cortisol suppression for depressed women. Depression in women thus appears to be characterized by altered HPA axis functioning, as indexed by flatter diurnal cortisol slopes and an associated impaired sensitivity of cortisol to dexamethasone. Given that altered HPA axis functioning has been implicated in several somatic conditions, the present findings may be relevant for understanding the pathophysiology of both depression and depression-related physical disease. |
DOI | 10.1016/j.biopsycho.2013.01.018 |
Alternate Journal | Biol Psychol |
PubMed ID | 23410758 |
PubMed Central ID | PMC3687535 |
Grant List | 5K08MH75813-3 / MH / NIMH NIH HHS / United States K08 MH075813 / MH / NIMH NIH HHS / United States R01 MH083784 / MH / NIMH NIH HHS / United States T32 MH019925 / MH / NIMH NIH HHS / United States T32 MH19925 / MH / NIMH NIH HHS / United States UL1 RR024131 / RR / NCRR NIH HHS / United States UL1 RR024131 / RR / NCRR NIH HHS / United States |