The Cortisol Awakening Response predicts major depression: Predictive stability over a four year follow-up and effect of depression history

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Suzanne Vrshek-Schallhorn, Associate Professor and Undergraduate Program Director (Creator)
The University of North Carolina at Greensboro (UNCG )
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Abstract: Background The cortisol awakening response (CAR) has been shown to predict major depressive episodes (MDEs) over a 1-year period. It is unknown whether this effect: (a) is stable over longer periods of time; (b) is independent of prospective stressful life events; and (c) differentially predicts first onsets or recurrences of MDEs.Method A total of 270 older adolescents (mean age 17.06 years at cortisol measurement) from the larger prospective Northwestern-UCLA Youth Emotion Project completed baseline diagnostic and life stress interviews, questionnaires, and a 3-day cortisol sampling protocol measuring the CAR and diurnal rhythm, as well as up to four annual follow-up interviews of diagnoses and life stress.Results Non-proportional person-month survival analyses revealed that higher levels of the baseline CAR significantly predict MDEs for 2.5 years following cortisol measurement. However, the strength of prediction of depressive episodes significantly decays over time, with the CAR no longer significantly predicting MDEs after 2.5 years. Elevations in the CAR did not significantly increase vulnerability to prospective major stressful life events. They did, however, predict MDE recurrences more strongly than first onsets.Conclusions These results suggest that a high CAR represents a time-limited risk factor for onsets of MDEs, which increases risk for depression independently of future major stressful life events. Possible explanations for the stronger effect of the CAR for predicting MDE recurrences than first onsets are discussed.

Additional Information

Psychological Medicine, 43(03)
Language: English
Date: 2013
cortisol awakening response, diurnal rhythm, late adolescence, major depressive disorder, non-proportional hazards models, stressful life events

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