Cortisol response to psychosocial stress during a depressive episode and remission

Abstract

This study compared cortisol responses to a standardized psychosocial stressor during a major depressive episode (MDE) and again during remission in adolescents and young adults. Twenty-six individuals with no personal or family history of a major psychiatric disorder (NC) and 24 individuals with a diagnosis of major depressive disorder (MDD) at Time 1 participated in the study. The MDD group showed robust cortisol responses during their index episode and after recovery. In contrast, the NC group showed habituation to the repeated psychosocial stressor, as evident in a flatter cortisol response profile at Time 2. Within the MDD group, net peak cortisol during the first stress test was positively associated with the duration of the index MDE and negatively associated with the total duration of all MDEs. Whereas summary indices of cortisol responses were relatively stable across repeated stress tasks within the MDD group, this was not the case for NC. Results demonstrate that cortisol responses fail to habituate to repeated psychosocial stress during recovery from an MDE and could reflect a trait-like marker of risk for recurrence.

Figure 1

Mean cortisol levels (± standard error of the mean) to repeated standardized laboratory stressors (TSST) for normal controls (NC, n = 26). Pre-stress 1 = 30 minutes prior to TSST (1.5 hours acclimation); pre-stress 2 = immediately prior to TSST (2 hours acclimation).

Figure 2

Mean cortisol levels (± standard error of the mean) to repeated standardized laboratory stressors (TSST) for individuals with major depression at Time 1 (MDD, n = 24). Pre-stress 1 = 30 minutes prior to TSST (1.5 hours acclimation); pre-stress 2 = immediately prior to TSST (2 hours acclimation). All individuals with MDD had recovered from their index episode prior to the second TSST.

Figure 3

Interaction of group status (MDD, NC), TSST session (First, Second), and cortisol sampling time predicting instantaneous rate of change in cortisol levels at the start of sampling. *p = .002.