title: Pre-treatment waking cortisol response and vulnerability to interferon α induced depression.
abstract: Depressive disorder is a common consequence of interferon α treatment. An understanding of the aetiological processes involved is evolving. HPA axis abnormalities are clearly described in community depressive disorder and represent vulnerability to depression development. We explored whether pre-treatment HPA axis abnormalities influence depression emergence during interferon α treatment. We examined waking HPA axis response via salivary cortisol sampling in 44 non-depressed, chronic hepatitis C infected patients due to commence standard interferon α treatment. Hamilton depression scales and the structured clinical interview for DSM-IV major depressive disorder status were administered monthly during treatment. Major depressive disorder developed in 26 of 44 subjects during interferon-α treatment. The pre-treatment waking cortisol response over 1h was significantly greater in the subsequent switch to depression group (F=4.23, p=0.046). The waking cortisol response pre-treatment with interferon α appears greater in those subsequently switching to depressive disorder during treatment. This waking response may join other vulnerability factors for depression emergence in this group. This model could prove a valuable tool in understanding non-iatrogenic depressive disorder in the general population and notably the role of cytokines.
authors.affiliation: Brighton and Sussex Medical School, Brighton, UK.
authors.forename: Jessica
authors.initials: J
authors.lastname: Eccles
authors.forename: Camille
authors.initials: C
authors.lastname: Lallemant
authors.forename: Farrah
authors.initials: F
authors.lastname: Mushtaq
authors.forename: Matthew
authors.initials: M
authors.lastname: Greenwood
authors.forename: Majella
authors.initials: M
authors.lastname: Keller
authors.forename: Bruno
authors.initials: B
authors.lastname: Golding
authors.forename: Jeremy
authors.initials: J
authors.lastname: Tibble
authors.forename: Inam
authors.initials: I
authors.lastname: Haq
authors.forename: Richard
authors.initials: R
authors.lastname: Whale
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003863:Depression / Q000139:chemically induced / Q000378:metabolism* / Q000503:physiopathology*; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy / Q000378:metabolism*; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D011446:Prospective Studies; D012463:Saliva / Q000737:chemistry / Q000502:physiology; D013315:Stress, Psychological / Q000503:physiopathology; D016896:Treatment Outcome; D014851:Wakefulness / Q000502:physiology*
chemical_list: D016898:Interferon-alpha; D006854:Hydrocortisone