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The British Journal of Psychiatry (2000) 177: 505-510
© 2000 The Royal College of Psychiatrists

Morning cortisol as a risk factor for subsequent major depressive disorder in adult women{dagger}

T.O. HARRIS, MA, S. BORSANYI, BSc, S. MESSARI, MSc, K. STANFORD, BSc and G.W. BROWN, PhD

Socio-medical Research Centre, Academic Department of Psychiatry, St Thomas' Hospital, Guy's, King's and St Thomas' Schools of Medicine, London

S.E. CLEARY, BSc, H.M. SHIERS, AIST and J. HERBERT, MB

Department of Anatomy, University of Cambridge

Correspondence: Professor Joe Herbert, Department of Anatomy, University of Cambridge, Downing Street, Cambridge CB2 3BY, UK

Declaration of interest Supported by the Medical Research Council.

{dagger} See editorial, pp. 482-483, this issue.

Background Whether individual differences in cortisol contribute to subsequent major depressive disorder (MDD) is unknown.

Aims To determine whether premorbid levels of salivary cortisol and dehydroepiandrosterone (DHEA) were associated with subsequent MDD and how these related to psychosocial factors known to increase the risk for MDD.

Method Adult women (n=116) were recruited from general practices. None was currently depressed; 83 were ‘psychosocially vulnerable’ to MDD, 33 were not. Salivary steroids (cortisol and DHEA at 08.00 h and 20.00 h), recent life events, current mood and social support were assessed at entry. Onset of MDD was recorded during 13 months' follow-up.

Results There were no associations between salivary cortisol or DHEA and recent life events or vulnerability. Twentyeight onsets of MDD occurred during the follow-up period. This was associated with: severe adverse life events and difficulties during the follow-up period; mean morning cortisol levels at entry; and the presence of any of three vulnerability factors.

Conclusions Individual differences in morning salivary cortisol levels may represent an independent risk factor for subsequent MDD. The origin of these differences in cortisol is not yet understood.




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