Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Affective Disorders Unit and Laboratory, South London and Maudsley NHS Foundation Trust, London, UK.
Psychol Med. 2023 Oct;53(13):6397-6402. doi: 10.1017/S0033291723000053. Epub 2023 Feb 16.
Enhanced post-awakening cortisol may serve as a biological marker for individuals with major depressive disorder. However, studies comparing post-awakening cortisol between patients with major depressive disorder (MDD) and healthy controls have produced conflicting findings. The aim of this study was to investigate whether this inconsistency could be due to the effects of childhood trauma.
A total of = 112 patients with MDD and healthy controls were divided into four groups according to the presence of childhood trauma. Saliva samples were collected at awakening and 15, 30, 45, and 60 min later. The total cortisol output and the cortisol awakening response (CAR) were calculated.
The total post-awakening cortisol output was significantly higher in patients with MDD as compared to healthy controls, but only in those individuals reporting childhood trauma. The four groups did not differ regarding the CAR.
Elevated post-awakening cortisol in MDD may be confined to those with a history of early life stress. Tailoring and/or augmenting of currently available treatments may be required to meet the specific needs of this population.
觉醒后皮质醇水平升高可能是重性抑郁障碍患者的生物标志物。然而，比较重性抑郁障碍（MDD）患者和健康对照组觉醒后皮质醇的研究结果存在矛盾。本研究旨在探讨这种不一致是否可能是由于童年创伤的影响。
共纳入 112 例 MDD 患者和健康对照者，根据是否存在童年创伤分为四组。在觉醒后 15、30、45 和 60 分钟采集唾液样本。计算总皮质醇分泌量和皮质醇觉醒反应（CAR）。
与健康对照组相比，MDD 患者觉醒后的总皮质醇分泌量明显升高，但仅在报告有童年创伤的患者中升高。四组之间 CAR 无差异。
MDD 患者觉醒后皮质醇升高可能仅限于有早期生活压力史的患者。可能需要调整和/或增强现有的治疗方法，以满足该人群的特定需求。
