Age effects on cortisol levels in depressed patients with and without comorbid post-traumatic stress disorder, and healthy volunteers.
BACKGROUND
Post-traumatic stress disorder (PTSD) and major depression are frequently comorbid. Age and major depression are associated with higher cortisol levels and dexamethasone resistance, whereas PTSD is associated with lower cortisol and dexamethasone supersensitivity. Therefore, we examined the effect of age on the hypothalamic-pituitary-adrenal (HPA) system in depressed patients with and without PTSD.


METHODS
Thirty-one depressed patients without PTSD, 12 depressed patients with PTSD, and 23 healthy volunteers were studied on 2 days. Subjects received single-blind placebo on day 1 and fenfluramine on day 2. Cortisol levels were drawn before challenge and for 5 h thereafter.


RESULTS
Cortisol levels increase with age in depressed patients without PTSD but not in depressed patients with PTSD or in healthy volunteers. Number of previous major depressive episodes was a predictor of the cortisol response to fenfluramine administration in depressed patients without PTSD.


CONCLUSIONS
The results of our study highlight the importance of considering age in psychobiology. Further research is needed to fully delineate the role of age in abnormalities of the HPA axis found in major depression and PTSD.
Division of Neuroscience, Department of Psychiatry, Columbia University, 1051 Riverside Drive, Suite 2917, Box 42, New York, NY 10032, USA. LS2003@columbia.edu
Leo
L
Sher
Maria A
MA
Oquendo
Hanga C
HC
Galfalvy
Thomas B
TB
Cooper
J John
JJ
Mann
D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000150:complications* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology*
D006854:Hydrocortisone