a GGZ inGeest/Department of Psychiatry and EMGO + Institute for Health and Care Research , VU University Medical Centre , Amsterdam , The Netherlands.
World J Biol Psychiatry. 2018 Sep;19(6):440-449. doi: 10.1080/15622975.2016.1274829. Epub 2017 Jan 25.
Childhood abuse has been associated with depression in later life. This may be related to hypothalamic-pituitary-adrenal (HPA) axis functioning. Therefore we aimed to examine the impact of childhood abuse and its interaction with depression on cortisol levels in older adults.
Data from 418 participants (mean age 70.8 years) in the Netherlands Study of Depression in Older Persons (NESDO) were used; 187 participants experienced childhood abuse; 309 participants had a diagnosis of depression. Diurnal cortisol levels were determined using six saliva samples from every participant. Multiple regression analyses were performed.
Significant negative associations between childhood abuse and morning cortisol levels were found. In nondepressed persons, both psychological and sexual abuse were associated with greater dynamics of the HPA axis in response to awakening.
Childhood abuse is associated with lower basal cortisol levels at awakening irrespective of major depressive disorder (MDD). Higher reactivity of the HPA axis during the hour after awakening was found in nondepressed participants only, which might suggest that late-life depression modifies the effect of childhood abuse on the HPA axis. Older adults with a history of childhood abuse may be more negatively affected by stress or stressful events and this is reflected in dysregulation of the HPA axis.
儿童期虐待与晚年抑郁有关。这可能与下丘脑-垂体-肾上腺（HPA）轴的功能有关。因此，我们旨在研究儿童期虐待及其与抑郁对老年人皮质醇水平的交互作用。
使用荷兰老年人抑郁研究（NESDO）中 418 名参与者（平均年龄 70.8 岁）的数据；187 名参与者经历过儿童期虐待；309 名参与者被诊断为抑郁症。每位参与者采集 6 份唾液样本，以确定日间皮质醇水平。进行了多元回归分析。
发现儿童期虐待与早晨皮质醇水平呈显著负相关。在非抑郁者中，心理和性虐待均与 HPA 轴对觉醒的反应性更大有关。
无论是否患有重度抑郁症（MDD），儿童期虐待均与觉醒时皮质醇基础水平降低有关。仅在非抑郁的参与者中发现 HPA 轴在觉醒后 1 小时内的反应性更高，这可能表明晚年抑郁会改变 HPA 轴对儿童期虐待的影响。有儿童期虐待史的老年患者可能会受到压力或压力事件的负面影响更大，这反映在 HPA 轴失调中。
