title: Predicting mental disorders from hypothalamic-pituitary-adrenal axis functioning: a 3-year follow-up in the TRAILS study.
abstract: BACKGROUND
  Hypothalamic-pituitary-adrenal axis functioning, with cortisol as its major output hormone, has been presumed to play a key role in the development of psychopathology. Predicting affective disorders from diurnal cortisol levels has been inconclusive, whereas the predictive value of stress-induced cortisol concentrations has not been studied before. The aim of this study was to predict mental disorders over a 3-year follow-up from awakening and stress-induced cortisol concentrations.
  
  
  METHODS
  Data were used from 561 TRAILS (TRacking Adolescents' Individual Lives Survey) participants, a prospective cohort study of Dutch adolescents. Saliva samples were collected at awakening and half an hour later and during a social stress test at age 16. Mental disorders were assessed 3 years later with the Composite International Diagnostic Interview (CIDI).
  
  
  RESULTS
  A lower cortisol awakening response (CAR) marginally significantly predicted new disorders [odds ratio (OR) 0.77, p = 0.06]. A flat recovery slope predicted disorders with a first onset after the experimental session (OR 1.27, p = 0.04). Recovery revealed smaller, non-significant ORs when predicting new onset affective or anxiety disorders, major depressive disorder, or dependence disorders in three separate models, corrected for all other new onsets.
  
  
  CONCLUSIONS
  Our results suggest that delayed recovery and possibly reduced CAR are indicators of a more general risk status and may be part of a common pathway to psychopathology. Delayed recovery suggests that individuals at risk for mental disorders perceived the social stress test as less controllable and less predictable.
authors: University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation,Groningen,The Netherlands.
authors: E
authors: E
authors: Nederhof
authors: Department of Child and Adolescent Psychiatry,Erasmus University Medical Center,Rotterdam,The Netherlands.
authors: F V A
authors: FV
authors: van Oort
authors: University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation,Groningen,The Netherlands.
authors: E M C
authors: EM
authors: Bouma
authors: University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation,Groningen,The Netherlands.
authors: O M
authors: OM
authors: Laceulle
authors: University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation,Groningen,The Netherlands.
authors: A J
authors: AJ
authors: Oldehinkel
authors: University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation,Groningen,The Netherlands.
authors: J
authors: J
authors: Ormel
mesh_terms: D001008:Anxiety Disorders / Q000175:diagnosis*; D002648:Child; D003865:Major Depressive Disorder / Q000175:diagnosis*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D016015:Logistic Models; D008297:Male; D009426:Netherlands; D009483:Neuropsychological Tests; D010913:Pituitary-Adrenal System / Q000502:physiology*; D011379:Prognosis; D011446:Prospective Studies; D012424:Rural Population; D012463:Saliva / Q000737:chemistry; D019966:Substance-Related Disorders / Q000175:diagnosis*; D014505:Urban Population
chemical_list: D006854:Hydrocortisone
keywords: Depression; general psychopathology; longitudinal; phobia; prospective; psychiatric diagnosis; public speaking task; social stress test; substance dependence