Mannie Zola N, Harmer Catherine J, Cowen Philip J
Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford OX3 7JX, UK.
Am J Psychiatry. 2007 Apr;164(4):617-21. doi: 10.1176/ajp.2007.164.4.617.
Cortisol hypersecretion is one of the most reliable biological abnormalities in major depression, but it is uncertain if it represents an illness marker or a trait vulnerability to mood disorder. The present study sought to answer this question by measuring waking salivary cortisol levels in young people at familial risk of depression but with no personal history of mood disorder.
The authors studied 49 young people who had not been depressed themselves but who had a parent with a history of major depression (FH+) and a comparison group of 55 participants who had no personal history of depression and no reported depression in a first-degree relative. The authors measured the amount of cortisol secreted in saliva during the first 30 minutes after awakening on a workday and on a nonworkday.
The amount of cortisol secreted by the FH+ subjects was greater than that of the comparison subjects on both workdays (mean=698 nmol x minutes/liter, SD=243, versus mean=550, SD=225) and nonworkdays (mean=633 nmol x minutes/liter, SD=216, versus mean=492, SD=166). The increase in cortisol secretion was not accounted for by differences in parental attachment, life events, personality, or current mental state.
Hypersecretion of cortisol can be detected in asymptomatic individuals at genetic risk of depression and may represent an illness endophenotype. Further studies will be needed to find out if increased waking salivary cortisol levels can predict individual risk of illness and whether the increased cortisol secretion has implications for general health and cognitive function.
皮质醇分泌过多是重度抑郁症最可靠的生物学异常之一,但尚不确定它是疾病标志物还是情绪障碍的特质易感性。本研究旨在通过测量有抑郁症家族风险但无情绪障碍个人史的年轻人清醒时唾液皮质醇水平来回答这个问题。
作者研究了49名自身未患抑郁症但其父母有重度抑郁症病史的年轻人(FH+),以及55名无抑郁症个人史且一级亲属中无抑郁症报告的参与者组成的对照组。作者测量了工作日和非工作日醒来后前30分钟唾液中分泌的皮质醇量。
FH+组受试者在工作日(均值=698纳摩尔×分钟/升,标准差=243,对照组均值=550,标准差=225)和非工作日(均值=633纳摩尔×分钟/升,标准差=216,对照组均值=492,标准差=166)分泌的皮质醇量均高于对照组。皮质醇分泌增加不能用亲子依恋、生活事件、人格或当前精神状态的差异来解释。
在有抑郁症遗传风险的无症状个体中可检测到皮质醇分泌过多,这可能代表一种疾病内表型。需要进一步研究以确定清醒时唾液皮质醇水平升高是否能预测个体患病风险,以及皮质醇分泌增加是否对总体健康和认知功能有影响。