MRC Social and Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow, G12 8RZ, UK.
Soc Psychiatry Psychiatr Epidemiol. 2012 May;47(5):723-33. doi: 10.1007/s00127-011-0374-8. Epub 2011 Apr 8.
Dysfunction of the hypothalamic-pituitary-adrenocortical axis (HPA-axis) is implicated in a variety of psychiatric and emotional disorders. In this study, we explore the association between HPA-axis functioning, as measured by morning cortisol, and common psychiatric disorders and symptoms among a community sample of adolescents.
Data from a cross-sectional school-based survey of 501 school pupils, aged 15, were used to establish the strength of association between salivary morning cortisol and both diagnosis of psychiatric disorders and a number of psychiatric symptoms, as measured via a computerised psychiatric interview. Analysis, conducted separately by gender, used multiple regressions, adjusting for relevant confounders.
With one exception (a positive association between conduct disorder symptoms and cortisol among females) there was no association between morning cortisol and psychiatric diagnosis or symptoms. However, there was a significant two-way interaction between gender and conduct symptoms, with females showing a positive and males a negative association between cortisol and conduct symptoms. A further three-way interaction showed that while the association between cortisol and conduct symptoms was negative among males with a few mood disorder symptoms, among females with many mood symptoms it was positive.
Except in relation to conduct symptoms, dysregulation of morning cortisol levels seems unrelated to any psychiatric disorder or symptoms. However, the relationship between cortisol and conduct symptoms is moderated by both gender and mood symptoms. Findings are compatible with the recent work suggesting research should concentrate on the moderated associations between gender, internalising and externalising symptoms and cortisol, rather than any simple relationship.
下丘脑-垂体-肾上腺轴（HPA 轴）功能障碍与多种精神和情绪障碍有关。本研究旨在探讨社区青少年样本中 HPA 轴功能（通过清晨皮质醇测量）与常见精神障碍和症状之间的关联。
使用横断面基于学校的 501 名 15 岁学生的调查数据，建立唾液清晨皮质醇与精神障碍诊断和计算机化精神访谈测量的多种精神症状之间的关联强度。按性别分别进行分析，使用多元回归，调整相关混杂因素。
除了一个例外（女性行为障碍症状与皮质醇之间呈正相关），清晨皮质醇与精神诊断或症状之间没有关联。然而，性别与行为症状之间存在显著的双向交互作用，女性表现出皮质醇与行为症状之间的正相关，而男性则表现出负相关。进一步的三向交互作用表明，虽然皮质醇与行为症状之间的关联在男性中具有少量情绪障碍症状时呈负相关，但在女性中具有许多情绪症状时呈正相关。
除了与行为症状有关外，清晨皮质醇水平的失调似乎与任何精神障碍或症状无关。然而，皮质醇与行为症状之间的关系受到性别和情绪症状的调节。这些发现与最近的研究工作一致，该研究工作表明，研究应集中于性别、内化和外化症状与皮质醇之间的调节关联，而不是任何简单的关系。
