title: Depressive symptoms are associated with blunted cortisol stress responses in very low-income women.
abstract: OBJECTIVE
  The purpose of this study was to examine the association between depressive symptoms and salivary cortisol responses to stress in a high-risk population of very poor Mexican women.
  
  
  METHODS
  Adult women (N = 1109) between the ages of 18 and 44 years (mean age, 29) were identified in a house-to-house survey in low-income areas (income <20th percentile nationally) of urban Mexico. An interview containing the Spanish version of the Center for Epidemiologic Studies--Depression Scale (CES-D) was administered to all women. The naturalistic stressor was defined as the unexpected arrival of a team of researchers at the participants' homes followed by an in-depth interview and physical assessment, with saliva samples taken at time of arrival (baseline), 25 minutes, and 50 minutes after arrival.
  
  
  RESULTS
  The mean CES-D score was 19.42 (range, 0-53). Results of hierarchical linear modeling analyses revealed no effect of depressive symptoms on baseline salivary cortisol levels. However, a significant depressive symptom by time interaction revealed that women with elevations in depressive symptoms (CES-D scores = 35) failed to exhibit a cortisol response to the stressor. In contrast, in women with lower CES-D scores, cortisol levels significantly increased in response to the stressor.
  
  
  CONCLUSIONS
  Consistent with research on individuals with major depressive disorder, results of this study demonstrate that women with very high levels of depressive symptoms exhibit blunted cortisol responses to a naturalistic psychological stressor. Results also contribute to previous research by generalizing findings to a high risk, underserved population of women.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, CA 94143, USA. hburke@itsa.ucsf.edu
authors.forename: Heather M
authors.initials: HM
authors.lastname: Burke
authors.forename: Lia C
authors.initials: LC
authors.lastname: Fernald
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Gertler
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Adler
mesh_terms: D000293:Adolescent; D000328:Adult; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D016014:Linear Models; D008800:Mexico / Q000453:epidemiology; D011203:Poverty / Q000523:psychology / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012463:Saliva / Q000737:chemistry; D012737:Sex Factors; D013315:Stress, Psychological / Q000175:diagnosis* / Q000523:psychology
chemical_list: D006854:Hydrocortisone