Cortisol responses to daily events in major depressive disorder
Cortisol responses to daily events in major depressive disorder
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DOI：
10.1097/01.psy.0000088594.17747.2e
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发表时间：
2003-09-01
影响因子：
3.3
通讯作者：
Berkhof, J
中科院分区：
文献类型：
--
作者：
Peeters, F;Nicholson, NA;Berkhof, J
目的：下丘脑-垂体-肾上腺（HPA）轴对应激的异常反应被认为参与了重度抑郁症（MDD）的病理生理过程。本研究的目的是确定是否皮质醇反应的消极和积极的日常事件在抑郁症患者（N = 47）不同的反应，在健康的参与者（N = 39）。我们还研究了临床特征和可能的性别差异对皮质醇反应事件的影响。最后，情绪变化在调节皮质醇反应中的作用进行了评估。研究方法：采用经验抽样法（每天10次，连续6天，同时采集唾液样本，进行情绪和事件的自我报告）和多水平回归分析，探讨日常生活事件与唾液皮质醇水平的关系。结果：与健康的参与者相比，抑郁的参与者在负面事件后皮质醇没有增加。有情绪障碍家族史的抑郁参与者的反应甚至更迟钝。虽然负面事件对皮质醇反应的影响似乎是由情绪变化介导的，但在抑郁的参与者中，负面情绪与皮质醇水平的关系往往不那么密切。抑郁的女性对消极事件的皮质醇反应比抑郁的男性大。积极事件对两组的皮质醇水平没有影响。结论：这些结果表明，HPA轴的负性日常事件和情绪变化的反应是迟钝的MDD。未来的研究将需要解决这些异常是否在临床恢复后消失。
Objective: Abnormal responses of the hypothalamic-pituitary-adrenal (HPA) axis to stress are thought to be involved in the pathophysiology of major depressive disorder (MDD). The aim of the present study was to determine whether cortisol responses to negative and positive daily events in depressed participants (N = 47) differed from such responses in healthy participants (N = 39). We also examined the influence of clinical characteristics and possible gender differences in cortisol responses to events. Finally, the role of mood changes in mediating cortisol responses was assessed. Methods: Experience sampling methodology (self-reports of mood and events, with simultaneous saliva samples, 10 times each day for 6 consecutive days) and multilevel regression analysis were used to examine the relationship between events in daily life and salivary cortisol levels. Results: In contrast to healthy participants, depressed participants showed no increase in cortisol following negative events. Responses were even more blunted in depressed participants with a family history of mood disorders. Although the effects of negative events on cortisol responses appeared to be mediated by changes in mood, negative affect tended to be less closely associated with cortisol levels in depressed participants. Depressed women showed larger cortisol responses to negative events than depressed men. Positive events had no effect on cortisol levels in either group. Conclusions: These results suggest that responses of the HPA axis to negative daily events and mood changes are blunted in MDD. Future studies will need to address whether these abnormalities disappear after clinical recovery.