title: Efficacy of psychotherapy on diurnal cortisol patterns and suicidal ideation in adjustment disorder with depressed mood.
abstract: OBJECTIVE
  The aims were to examine the effects of psychotherapy on depressive and anxiety symptoms, the occurrence of suicidal ideations and diurnal cortisol patterns in patients with adjustment disorder (AD) with depressed mood.
  
  
  METHODS
  Participants recruited from an outpatient department of psychiatry at a general hospital were randomly assigned to one of two groups: 34 in psychotherapy group and 37 in control group. The control group consisted of one-session psychoeducation. Psychotherapy included the eight-weekly body-mind-spirit (BMS) group psychotherapy. Measures included Beck Depression Inventory-II and State Trait Anxiety Inventory. Salivary cortisol samples were collected from the patients at their homes on awakening; 30 and 45 min after awakening; and at 1200, 1700 and 2100 h. Measurements were taken at baseline and at months 2 (end of intervention), 5, 8 and 14.
  
  
  RESULTS
  There was no differential change over time between the BMS and control groups in self-reported depression or anxiety symptoms. However, suicidal ideation appeared to be reduced in the psychotherapy group. Changes in diurnal cortisol patterns were also significantly different in group × time interactions, in favor of BMS group.
  
  
  CONCLUSIONS
  Psychotherapy likely provides improvements in psychobiological stress responses and decreases the occurrence of suicidal ideation in patients with AD.
authors.affiliation: Department of Nursing, College of Medicine National Taiwan University, Taipei, Taiwan. Electronic address: hsiaofei@ntu.edu.tw.
authors.forename: Fei-Hsiu
authors.initials: FH
authors.lastname: Hsiao
authors.affiliation: School of Nursing, Chang-Gung University, Taiwan.
authors.forename: Yu-Ming
authors.initials: YM
authors.lastname: Lai
authors.affiliation: School of Nursing, Chang-Gung University, Taiwan.
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Chen
authors.affiliation: Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Tsung-Tsair
authors.initials: TT
authors.lastname: Yang
authors.affiliation: Department of Psychiatry, National Taiwan University Hospital and Medical College, National Taiwan University.
authors.forename: Shih-Cheng
authors.initials: SC
authors.lastname: Liao
authors.affiliation: Department of Social Work and Social Administration, Centre on Behavioral Health, The University of Hong Kong, Hong Kong.
authors.forename: Rainbow T H
authors.initials: RT
authors.lastname: Ho
authors.affiliation: Department of Social Work and Social Administration, Centre on Behavioral Health, The University of Hong Kong, Hong Kong.
authors.forename: Siu-Man
authors.initials: SM
authors.lastname: Ng
authors.affiliation: Department of Social Work and Social Administration, Centre on Behavioral Health, The University of Hong Kong, Hong Kong.
authors.forename: Cecilia L W
authors.initials: CL
authors.lastname: Chan
authors.affiliation: School of Medicine, Fu-Jen Catholic University, No 510 Chung-Cheng Road, Hsin-Chuang Dist, New Taipei City 24205, Taiwan. Electronic address: 039666@mail.fju.edu.tw.
authors.forename: Guey-Mei
authors.initials: GM
authors.lastname: Jow
mesh_terms: D000275:Adjustment Disorders / Q000378:metabolism / Q000523:psychology / Q000628:therapy*; D000328:Adult; D001007:Anxiety / Q000378:metabolism / Q000523:psychology / Q000628:therapy*; D002940:Circadian Rhythm; D003863:Depression / Q000378:metabolism / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D026441:Mind-Body Therapies / Q000379:methods*; D011615:Psychotherapy, Group / Q000379:methods*; D012463:Saliva / Q000737:chemistry; D059020:Suicidal Ideation; D016896:Treatment Outcome
chemical_list: D006854:Hydrocortisone
keywords: Adjustment disorder; Cortisol; Depression; Psychotherapy; Suicide