Major depressive disorder, generalised anxiety disorder, and their comorbidity: associations with cortisol in the Vietnam Experience Study.
OBJECTIVE
The aim of these analyses was to examine the association of cortisol, dehydroepiandrosterone sulphate (DHEAS), and the cortisol:DHEAS ratio with the diagnoses of major depressive disorder (MDD), generalised anxiety disorder (GAD), and their comorbidity.


METHODS
This was a cross-sectional study.


METHODS
Participants were 4256 Vietnam era US army veterans. From military service files, telephone interviews, and a medical examination, occupational, socio-demographic, and health data were collected. One-year prevalence of MDD and GAD was determined through a diagnostic interview schedule based on the DSM-IV criteria. Contemporary morning fasted cortisol and DHEAS concentrations were determined. Analyses of covariance were run, first with adjustment for age and then additionally adjusting for a range of candidate confounders.


RESULTS
In fully adjusted analyses, there was evidence of lower basal cortisol levels in individuals with MDD and co-morbid MDD and GAD than those with GAD alone or no diagnosis.


CONCLUSIONS
This suggests that MDD and its comorbidity can also be characterised by low as well as high cortisol levels. A profitable line of future research might be to examine cortisol and DHEAS levels in more representative samples including older participants and women with and without MDD, GAD, and other psychiatric diagnoses.
School of Sport & Exercise Sciences, University of Birmingham, Birmingham, UK. A.C.Phillips@bham.ac.uk
Anna C
AC
Phillips
G David
GD
Batty
Catharine R
CR
Gale
Janet M
JM
Lord
Wiebke
W
Arlt
Douglas
D
Carroll
D000328:Adult; D000465:Algorithms; D001008:Anxiety Disorders / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism; D003130:Combat Disorders / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D047829:Vietnam Conflict
D006854:Hydrocortisone