Herane-Vives Andrés, Arnone Danilo, de Angel Valeria, Papadopoulos Andrew, Wise Toby, Alameda Luis, Chua Kia-Chong, Young Allan H, Cleare Anthony J
Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 103 Denmark Hill, London, SE5 8AF, UK.
Neuroscience and Mental Health Group, Institute of Cognitive Neuroscience, University College London, London, UK.
Int J Bipolar Disord. 2020 Mar 5;8(1):15. doi: 10.1186/s40345-020-0180-x.
Differentiating between unipolar and bipolar depression can be clinically challenging, especially at first presentation. Patterns of cortisol secretion could aid diagnostic discrimination in affective disorders although there has been little comparative research to date. In this study, we investigated acute (saliva) and chronic (hair) cortisol levels concurrently in unmedicated unipolar and bipolar disorders by using conventional diagnostic criteria and self-report measures.
Patients with unipolar and bipolar major depression and healthy controls were recruited and assessed. Cortisol levels were extracted from saliva and hair specimens. Depressive features were investigated according to diagnostic groups and with a continuous self-report measure of bipolarity using the Hypomania Checklist (HCL-33).
Whilst a trend towards a reduction in the total daily salivary cortisol output-area under the curve with respect to the ground (AUCg)-was detected in depressive disorders across diagnosis, the self-administrated bipolarity index suggested that an increase in bipolarity symptoms predicted lower cortisol levels using AUCg. Chronic cortisol measurement did not discriminate unipolar from bipolar depression.
Results suggested that whilst a low total daily salivary cortisol output (AUCg) might be associated with depressive symptoms, a self-reported measure of bipolarity predicts lower daily cortisol output.
区分单相抑郁和双相抑郁在临床上具有挑战性，尤其是在首次就诊时。尽管迄今为止比较研究较少，但皮质醇分泌模式可能有助于情感障碍的诊断鉴别。在本研究中，我们通过使用传统诊断标准和自我报告测量方法，同时调查了未用药的单相和双相情感障碍患者的急性（唾液）和慢性（毛发）皮质醇水平。
招募并评估了单相和双相重度抑郁患者及健康对照。从唾液和毛发样本中提取皮质醇水平。根据诊断组并使用轻躁狂检查表（HCL - 33）对双相性进行连续自我报告测量来调查抑郁特征。
虽然在所有诊断的抑郁症患者中均检测到相对于基线的总日唾液皮质醇输出曲线下面积（AUCg）有降低趋势，但自我管理的双相性指数表明，双相性症状增加预示着使用AUCg时皮质醇水平较低。慢性皮质醇测量无法区分单相抑郁和双相抑郁。
结果表明，虽然每日唾液皮质醇总输出量低（AUCg）可能与抑郁症状有关，但双相性的自我报告测量预示着每日皮质醇输出量较低。
