title: Cortisol awakening response and subsequent depression: prospective longitudinal study.
abstract: BACKGROUND
  Some studies have found an association between elevated cortisol and subsequent depression, but findings are inconsistent. The cortisol awakening response may be a more stable measure of hypothalamic-pituitary-adrenal function and potentially of stress reactivity.
  
  
  OBJECTIVE
  To investigate whether salivary cortisol, particularly the cortisol awakening response, is associated with subsequent depression in a large population cohort.
  
  
  METHODS
  Young people (aged 15 years, n = 841) from the Avon Longitudinal Study of Parents and Children (ALSPAC) collected salivary cortisol at four time points for 3 school days. Logistic regression was used to calculate odds ratios for developing depression meeting ICD-10 criteria at 18 years.
  
  
  RESULTS
  We found no evidence for an association between salivary cortisol and subsequent depression. Odds ratios for the cortisol awakening response were 1.24 per standard deviation (95% CI 0.93-1.66, P = 0.14) before and 1.12 (95% CI 0.73-1.72, P = 0.61) after adjustment for confounding factors. There was no evidence that the other cortisol measures, including cortisol at each time point, diurnal drop and area under the curve, were associated with subsequent depression.
  
  
  CONCLUSIONS
  Our findings do not support the hypothesis that elevated salivary cortisol increases the short-term risk of subsequent depressive illness. The results suggest that if an association does exist, it is small and unlikely to be of clinical significance.
authors: Rebecca Carnegie, BSc, MBChB, Ricardo Araya, MRCPsych, PhD, Academic Unit of Psychiatry, School of Social and Community Medicine, University of Bristol, UK; Yoav Ben-Shlomo, BSc, MBBS, MSc, PhD, FFPH, School of Social and Community Medicine, University of Bristol, UK; Vivette Glover, MA, PhD, DSc, Institute of Reproductive and Developmental Biology, Imperial College London, UK; Thomas G. O'Connor, PhD, Wynne Center for Family Research, Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA; Kieran J. O'Donnell, PhD, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada; Rebecca Pearson, PhD, Academic Unit of Psychiatry, School of Social and Community Medicine, University of Bristol, UK; Glyn Lewis, PhD, Mental Health Sciences Unit, University College London, UK.
authors: Rebecca
authors: R
authors: Carnegie
authors: Ricardo
authors: R
authors: Araya
authors: Yoav
authors: Y
authors: Ben-Shlomo
authors: Vivette
authors: V
authors: Glover
authors: Thomas G
authors: TG
authors: O'Connor
authors: Kieran J
authors: KJ
authors: O'Donnell
authors: Rebecca
authors: R
authors: Pearson
authors: Glyn
authors: G
authors: Lewis
mesh_terms: D000293:Adolescent; D002940:Circadian Rhythm / Q000502:physiology; D015986:Confounding Factors, Epidemiologic; D003863:Depression / Q000453:epidemiology*; D004739:England / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D038801:International Classification of Diseases; D008297:Male; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D012463:Saliva / Q000737:chemistry; D012959:Socioeconomic Factors; D014851:Wakefulness / Q000502:physiology*
chemical_list: D006854:Hydrocortisone