Basal cortisol levels in relation to dimensions and DSM-IV categories of depression and anxiety.
The Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV classification may fail to adequately distinguish neuroendocrine factors involved in the etiology of depressive and anxiety disorders. Continuous phenotypic dimensions may correlate better with underlying neuroendocrine dysregulations. We compared the categorical DSM-IV diagnoses with a dimensional approach in the same group of outpatients with depressive (n=36), anxiety (n=18), and comorbid depressive and anxiety (n=19) disorders, who were free of psychotropic medication, and in 36 healthy controls. The Mood and Anxiety Symptom Questionnaire (MASQ) was used to measure the three dimensions of the tripartite model, i.e., anhedonic depression, anxious arousal, and general distress. The salivary cortisol awakening response (CAR) (0, 30, 45, and 60 min after awakening), and diurnal cortisol decline (11:00 h, 15:00 h, 19:00 h, and 23:00 h) were analyzed for linear and nonlinear associations. The CAR showed statistically significant nonlinear relationships with two MASQ dimensions, i.e., anhedonic depression and general distress, but no differences between DSM-IV categories. The diurnal cortisol decline was linearly related to the MASQ dimensions anhedonic depression and general distress and significantly higher AUC(diurnal) levels and a steeper slope were found in depressive patients compared to controls using DSM-IV categories. The present study shows that linear and nonlinear associations with salivary cortisol are detected when using phenotypic dimensions and may be complementary to phenotypic DSM-IV categories when doing neuroendocrine research.
Department of Psychiatry, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. G.Veen@lumc.nl
Gerthe
G
Veen
Irene M
IM
van Vliet
Roel H
RH
DeRijk
Erik J
EJ
Giltay
Johannes
J
van Pelt
Frans G
FG
Zitman
D000328:Adult; D000704:Analysis of Variance; D001007:Anxiety / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology*; D019540:Area Under Curve; D002940:Circadian Rhythm / Q000502:physiology; D003863:Depression / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011581:Psychological Tests; D012463:Saliva / Q000737:chemistry*; D011795:Surveys and Questionnaires; D055815:Young Adult
D006854:Hydrocortisone