The self-perceived symptom distress and health-related conditions associated with morning to evening diurnal cortisol patterns in outpatients with major depressive disorder
The self-perceived symptom distress and health-related conditions associated with morning to evening diurnal cortisol patterns in outpatients with major depressive disorder
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DOI：
10.1016/j.psyneuen.2009.08.019
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发表时间：
2010-05-01
影响因子：
3.7
通讯作者：
Wang, Kuo-Chang
中科院分区：
文献类型：
--
作者：
Hsiao, Fei-Hsiu;Yang, Tsung-Tsair;Wang, Kuo-Chang
目的：本研究对126例门诊抑郁症（MDD）患者的皮质醇昼夜节律进行了研究，以探讨其与精神疾病家族史、自感抑郁和焦虑、自感健康状况及健康行为的关系。症状困扰，健康相关的条件，健康的行为和唾液皮质醇的客观措施的自我报告唤醒后，唤醒后45分钟，并在1200，1700和2100小时收集在受试者的家中。个体生长曲线模型被用来管理数据和分析重复观察的自我报告数据与昼夜皮质醇patterns.Results：MDD门诊患者，平坦的昼夜皮质醇模式更有可能发现在受试者的精神疾病家族史比那些没有。患者报告的总睡眠时间较短，抑郁程度较严重，痛苦程度较高，与昼夜皮质醇模式较平坦呈正相关。少于5个小时的睡眠比超过7个小时的睡眠更可能与平坦的昼夜皮质醇模式相关。严重程度的抑郁症更可能与平坦的昼夜皮质醇模式比中度和轻度抑郁症。较高的焦虑水平，较好的睡眠质量和较高水平的体力活动的患者报告与陡峭的昼夜皮质醇模式呈正相关。与MOD门诊患者不同，健康受试者中与昼夜皮质醇模式相关的唯一特征是总睡眠时间。这些结果表明，自我感觉良好的睡眠质量，总睡眠时间为7小时或更长，自我-在重性抑郁症门诊患者中，在家庭环境中感知到的较高水平的体力活动可能与积极的应激内分泌结果呈正相关，disorder.皇冠版权所有（C）2009由爱思唯尔有限公司出版。保留所有权利。
Objective: This study was an examination of 126 major depressive disorder (MDD) outpatients' morning to evening diurnal cortisol patterns to determine their association with family histories of mental illness, self-perceived depressive and anxiety distress, self-perceived health-related conditions, and healthy behaviors.Methods: 126 MDD outpatients and 106 healthy subjects were recruited. Self-reports of symptom distress, health-related conditions, and healthy behaviors and objective measures of salivary cortisol upon awakening, 45 min after awakening, and at 1200, 1700, and 2100 h were collected at subjects' homes. The individual growth curve model was used to manage data and to analyze repeated observations of self-report data associated with diurnal cortisol patterns.Results: For MDD outpatients, flatter diurnal cortisol patterns were more likely found in subjects with family histories of mental illness than in those without. Patient-reported shorter total sleep hours, more severe levels of depression and higher suffering levels were positively associated with flatter diurnal cortisol patterns. Less than 5 sleep hours was more likely associated with flatter diurnal cortisol patterns than above 7 sleep hours. Severe levels of depression were more likely related to flatter diurnal cortisol patterns than moderate and mild levels of depression. Higher anxiety levels, better sleep quality and higher levels of physical activity reported by patients were positively associated with steeper diurnal cortisol patterns. Unlike the MOD outpatients, the only trait associated with diurnal cortisol patterns in healthy subjects was total sleep hours.Conclusions: These results suggested that self-perceived good sleep quality, total hours slept of 7 or greater, and self-perceived higher levels of physical activity in the home environment could be positively related to positive stress endocrine outcomes seen as steep diurnal cortisol patterns in outpatients with major depressive disorder. Crown Copyright (C) 2009 Published by Elsevier Ltd. All rights reserved.