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Recent life events, cortisol, dehydroepiandrosterone and the onset of major depression in high-risk adolescents

Developmental Psychiatry Section, Department of Psychiatry, Cambridge Clinical School, University of Cambridge, and Lifespan Healthcare Trust, England

J. HERBERT, PhD

Neuroendocrine Laboratory, Department of Anatomy, University of Cambridge

P. M. E. ALTHAM, PhD

Statistical Laboratory, University of Cambridge

Correspondence: Professor Ian M. Goodyer, Department of Child and Adolescent Psychiatry, University of Cambridge, Section of Developmental Psychiatry, Douglas House, 18B Trumpington Road, Cambridge CB2 4AH, UK

Declaration of interest Funding from the Wellcome Trust.

See editorial, pp. 482-483, this issue.

Background It is not clear whether cortisol or dehydroepiandrosterone (DHEA) hypersecretion increases the risk for major depression in the presence of undesirable life events.

Aims To determine whether there is a specific pattern of psychoendocrine factors that predicts the onset of major depressive disorder.

Method 180 adolescents (73 boys, 107 girls) at high risk for psychopathology were assessed for cortisol, DHEA, depressive symptoms, life events and psychiatric disorder at entry and 12 months later.

Results Major depression was predicted for both genders by the additive effects of: higher depressive symptoms; personal disappointments and losses only in the month before onset; one or more daily levels of cortisol at 08.00 h or DHEA at 20.00 h greater than the 80th percentile of the daily mean.

Conclusions A subgroup of adolescents may carry a physiological risk for major depression which may be either of genetic and/or earlier psychosocial origin.

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