title: Peri-sleep-onset cortisol levels in children and adolescents with affective disorders.
abstract: BACKGROUND
  Changes in the hypothalamic-pituitary-adrenal (HPA) axis, as evidenced by patterns of cortisol secretion, have been of interest in understanding depression and anxiety disorders across the life span. Previous studies of pediatric depression have pointed to the period around sleep onset as a key time point for observing alterations in cortisol secretion associated with affective disorders. Evidence also indicates that pubertal development may influence the expression of HPA dysregulation. We hypothesized that adolescents with depression and youth with anxiety disorders exhibit elevated peri-sleep-onset cortisol.
  
  
  METHODS
  Plasma cortisol was sampled every 20 min around sleep onset from children and adolescents with major depressive disorder (n = 116), anxiety disorders (n = 32), or no history of psychiatric disorder (control; n = 76). Sleep onset was determined by polysomnography. Classification of participants as children or adolescents was based on Tanner staging of pubertal maturation.
  
  
  RESULTS
  Children with anxiety disorders had higher peri-sleep-onset cortisol than children with depression or control children. Adolescents with depression had marginally higher peri-sleep-onset cortisol than control adolescents and significantly higher peri-sleep-onset cortisol than children with depression.
  
  
  CONCLUSIONS
  Depression and anxiety are associated with altered cortisol secretion around sleep onset, and these changes appear to be influenced by pubertal maturation.
authors.affiliation: Department of Psychiatry, University of Pittsburgh, PA 15213, USA. forbese@upmc.edu
authors.forename: Erika E
authors.initials: EE
authors.lastname: Forbes
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Williamson
authors.forename: Neal D
authors.initials: ND
authors.lastname: Ryan
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.forename: David A
authors.initials: DA
authors.lastname: Axelson
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Dahl
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000704:Analysis of Variance; D001007:Anxiety / Q000097:blood / Q000503:physiopathology; D002648:Child; D003863:Depression / Q000097:blood / Q000503:physiopathology; D004569:Electroencephalography / Q000379:methods; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D019964:Mood Disorders / Q000097:blood / Q000145:classification / Q000503:physiopathology*; D017286:Polysomnography / Q000379:methods; D011863:Radioimmunoassay / Q000379:methods; D012890:Sleep / Q000502:physiology*; D013997:Time Factors
chemical_list: D006854:Hydrocortisone