Weill Institute for Neurosciences, Department of Psychiatry, University of California, 401 Parnassus Avenue, San Francisco, CA, 94143, USA.
Department of Radiology and Biomedical Imaging, University of California, 505 Parnassus Avenue, San Francisco, CA, 94143, USA; Center for Imaging of Neurodegenerative Diseases, VA Medical Center, 4150 Clement St., San Francisco, CA 94121, USA.
Psychoneuroendocrinology. 2019 Nov;109:104386. doi: 10.1016/j.psyneuen.2019.104386. Epub 2019 Jul 26.
Studies testing the relationship between cortisol levels, depression, and antidepressant treatment response have yielded divergent results suggesting the possibility of moderators of a cortisol effect. Several studies indicate that age may moderate the relationship between cortisol and depression. In patients with Major Depressive Disorder (MDD), we studied the interactive effects of age and cortisol in association with MDD diagnostic status and mood and memory response to antidepressant treatment.
Serum cortisol levels in 66 unmedicated patients with MDD and 75 matched healthy controls (HC) were measured at baseline and retrospectively analyzed. Logistic regression was used to determine an association of age, cortisol and their interaction with MDD diagnosis in the pooled sample of MDD and HC participants. Thirty-four of the MDD participants (age range: 19-65 years; median: 36) underwent treatment with a selective serotonin reuptake inhibitor (SSRl) for 8 weeks. Clinician and self-ratings of depression symptoms, as well as tests of verbal and visual delayed recall were obtained at baseline and post treatment. Moderation analyses determined the effect of age on the relationship between baseline cortisol and treatment outcome.
Cortisol, moderated by age, was associated with MDD diagnosis (p < .05), treatment-associated reduction of depression symptoms (p < .001) and improvement of delayed recall (p < .001). Modeling the Cortisol × Age interaction suggested that for participants below the median age of our sample, lower cortisol levels were associated with a lower rate of MDD diagnosis and higher antidepressant effects. On the contrary, in those above the median sample age, lower cortisol was associated with a higher rate of MDD and less improvement in depression symptoms and memory performance.
Our results add to the body of literature suggesting that age might be an important factor in moderating the relationship between peripheral cortisol levels, depression, cognition, and prognosis. These results indicate that previous disparities in the literature linking peripheral cortisol levels with depression characteristics and treatment response may critically relate, at least in part, to the age of the participants studied.
测试皮质醇水平、抑郁和抗抑郁治疗反应之间关系的研究得出了不同的结果，这表明皮质醇效应可能存在调节因素。有几项研究表明，年龄可能会调节皮质醇与抑郁之间的关系。在患有重度抑郁症（MDD）的患者中，我们研究了年龄与皮质醇与 MDD 诊断状态以及抗抑郁治疗后情绪和记忆反应之间的相互作用。
测量了 66 名未接受药物治疗的 MDD 患者和 75 名匹配的健康对照组（HC）的血清皮质醇水平，并进行了回顾性分析。使用逻辑回归来确定年龄、皮质醇及其与 MDD 和 HC 参与者混合样本诊断的相互作用与 MDD 诊断之间的关联。34 名 MDD 参与者（年龄范围：19-65 岁；中位数：36 岁）接受选择性 5-羟色胺再摄取抑制剂（SSRl）治疗 8 周。在基线和治疗后获得了临床医生和自我评估的抑郁症状以及言语和视觉延迟回忆测试。进行了调节分析，以确定年龄对基线皮质醇与治疗结果之间关系的影响。
皮质醇，受年龄调节，与 MDD 诊断相关（p <.05），与治疗相关的抑郁症状减轻（p <.001）和延迟回忆改善（p <.001）相关。对皮质醇×年龄交互作用进行建模表明，对于低于我们样本中位数年龄的参与者，较低的皮质醇水平与较低的 MDD 诊断率和更高的抗抑郁效果相关。相反，在年龄高于样本中位数的参与者中，较低的皮质醇与较高的 MDD 发生率以及抑郁症状和记忆表现的改善较少相关。
我们的结果增加了文献中表明年龄可能是调节外周皮质醇水平、抑郁、认知和预后之间关系的重要因素的证据。这些结果表明，先前文献中将外周皮质醇水平与抑郁特征和治疗反应联系起来的差异可能至少部分与研究参与者的年龄有关。
