title: Depressive symptoms and cortisol variability prior to surgery for suspected endometrial cancer.
abstract: Endometrial cancer (EC) is the most common type of gynecologic cancer affecting women; however, very little research has examined relationships between psychological factors and hypothalamic-pituitary-adrenal (HPA) axis dysregulation in this population. The current study examined relations between depressive/anxious symptoms and salivary cortisol diurnal rhythm and variability in women undergoing surgery for suspected endometrial cancer. Depressive and anxious symptoms were measured prior to surgery using the Structured Interview Guide for the Hamilton Depression Inventory (SIGH-AD). Saliva was collected four times a day for the 3 days prior to surgery and then assayed by ELISA to obtain cortisol concentrations. Cortisol slopes and intraindividual variability were then calculated across subjects. Relations between depressive/anxious symptoms and cortisol indices were examined using multilevel modeling and linear regression analyses. Participants were 82 women with nonmetastatic endometrial cancer. Anxious symptoms were not associated with either cortisol slope or intraindividual variability, and depressive symptoms were unrelated to cortisol slope. However, after controlling for presence of poorer prognosis cancer subtypes, greater depressive symptoms (excluding symptoms possibly/definitely due to health/treatment factors) in the week preceding surgery were significantly related to greater cortisol intraindividual variability (β=.214; p<.05). These results suggest that depressive symptoms prior to surgery for suspected endometrial cancer are related to greater cortisol intraindividual variability, which is suggestive of more erratic HPA axis arousal. Future research should examine whether mood symptoms may be associated with compromised health outcomes via erratic HPA axis arousal in this population.
authors: Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610-0165, United States.
authors: Timothy S
authors: TS
authors: Sannes
authors: Sally E
authors: SE
authors: Jensen
authors: Stacy M
authors: SM
authors: Dodd
authors: Shawn M
authors: SM
authors: Kneipp
authors: Stephanie
authors: S
authors: Garey Smith
authors: Seema M
authors: SM
authors: Patidar
authors: Michael M
authors: MM
authors: Marsiske
authors: Susan M
authors: SM
authors: Lutgendorf
authors: Linda S
authors: LS
authors: Morgan
authors: Deidre B
authors: DB
authors: Pereira
mesh_terms: D001007:Anxiety / Q000150:complications / Q000175:diagnosis / Q000378:metabolism; D002940:Circadian Rhythm / Q000502:physiology; D003863:Depression / Q000150:complications / Q000378:metabolism*; D016889:Endometrial Neoplasms / Q000150:complications / Q000378:metabolism* / Q000523:psychology* / Q000601:surgery; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism; D007206:Individuality; D008875:Middle Aged; D015233:Models, Statistical; D010913:Pituitary-Adrenal System / Q000378:metabolism; D012463:Saliva / Q000378:metabolism; D063189:Symptom Assessment
chemical_list: D006854:Hydrocortisone