title: Sex differences in hormonal responses to a social stressor in chronic major depression.
abstract: BACKGROUND
  Acute depression has been associated with increased hypothalamic-pituitary-adrenal (HPA) reactivity. While chronicity of depressive illness influences symptoms, course and outcome, its effect on the HPA axis has not been extensively evaluated. The current study evaluated cortisol stress responses to a social challenge in chronic major depressive disorder (CMDD).
  
  
  METHODS
  Cortisol stress responses to the Trier Social Stress Test (TSST) were compared in 26 participants with CMDD and 28 healthy controls using repeated measures analysis of variance (RANOVA). In addition, group differences in area under the curve (AUC) and peak percentage change in cortisol were examined.
  
  
  RESULTS
  The RANOVA indicated a significant sex by condition interaction in cortisol responses to the social challenge. Post-hoc testing of pair-wise group differences revealed that in females, CMDD subjects had greater cortisol levels in response to the TSST than did controls. Similarly, AUC was greater in females with CMDD than in female controls. Neither of these differences was significant in males. However, male CMDD subjects exhibited a significantly decreased peak percentage change in cortisol in response to the TSST than did male controls.
  
  
  CONCLUSIONS
  Males and females with CMDD exhibited unique differences in cortisol responses to the social challenge relative to controls. In females, CMDD subjects had greater overall secretion of cortisol whereas in males, CMDD subjects had a blunted peak response to the social stressor. Sex differences are an important consideration in future work in this population.
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Ontario, Canada. kevin_chopra@camh.net
authors.forename: Kevin K
authors.initials: KK
authors.lastname: Chopra
authors.forename: Arun
authors.initials: A
authors.lastname: Ravindran
authors.forename: Sidney H
authors.initials: SH
authors.lastname: Kennedy
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Mackenzie
authors.forename: Stephen
authors.initials: S
authors.lastname: Matthews
authors.forename: Hymie
authors.initials: H
authors.lastname: Anisman
authors.forename: R Michael
authors.initials: RM
authors.lastname: Bagby
authors.forename: Peter
authors.initials: P
authors.lastname: Farvolden
authors.forename: Robert D
authors.initials: RD
authors.lastname: Levitan
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002908:Chronic Disease / Q000523:psychology; D003865:Major Depressive Disorder / Q000378:metabolism* / Q000523:psychology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008297:Male; D012463:Saliva / Q000378:metabolism; D012727:Sex Characteristics; D013315:Stress, Psychological / Q000378:metabolism*; D013997:Time Factors
chemical_list: D006854:Hydrocortisone