title: Associations between DSM-IV diagnosis, psychiatric symptoms and morning cortisol levels in a community sample of adolescents.
abstract: OBJECTIVE
  Dysfunction of the hypothalamic-pituitary-adrenocortical axis (HPA-axis) is implicated in a variety of psychiatric and emotional disorders. In this study, we explore the association between HPA-axis functioning, as measured by morning cortisol, and common psychiatric disorders and symptoms among a community sample of adolescents.
  
  
  METHODS
  Data from a cross-sectional school-based survey of 501 school pupils, aged 15, were used to establish the strength of association between salivary morning cortisol and both diagnosis of psychiatric disorders and a number of psychiatric symptoms, as measured via a computerised psychiatric interview. Analysis, conducted separately by gender, used multiple regressions, adjusting for relevant confounders.
  
  
  RESULTS
  With one exception (a positive association between conduct disorder symptoms and cortisol among females) there was no association between morning cortisol and psychiatric diagnosis or symptoms. However, there was a significant two-way interaction between gender and conduct symptoms, with females showing a positive and males a negative association between cortisol and conduct symptoms. A further three-way interaction showed that while the association between cortisol and conduct symptoms was negative among males with a few mood disorder symptoms, among females with many mood symptoms it was positive.
  
  
  CONCLUSIONS
  Except in relation to conduct symptoms, dysregulation of morning cortisol levels seems unrelated to any psychiatric disorder or symptoms. However, the relationship between cortisol and conduct symptoms is moderated by both gender and mood symptoms. Findings are compatible with the recent work suggesting research should concentrate on the moderated associations between gender, internalising and externalising symptoms and cortisol, rather than any simple relationship.
authors.affiliation: MRC Social and Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow, G12 8RZ, UK. robert@sphsu.mrc.ac.uk
authors.forename: Robert
authors.initials: R
authors.lastname: Young
authors.forename: Helen
authors.initials: H
authors.lastname: Sweeting
authors.forename: Patrick
authors.initials: P
authors.lastname: West
mesh_terms: D000293:Adolescent; D019955:Conduct Disorder / Q000175:diagnosis* / Q000453:epidemiology; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism; D007406:Interview, Psychological; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis* / Q000453:epidemiology; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D000297:Psychology, Adolescent; D012463:Saliva / Q000378:metabolism; D012565:Schizophrenic Psychology; D012574:Schools; D012606:Scotland / Q000453:epidemiology; D017678:Sex Distribution; D013315:Stress, Psychological / Q000523:psychology*; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data
chemical_list: D006854:Hydrocortisone