title: Associations between psychiatric symptoms and cortisol levels in Nicaraguan young school-age children.
abstract: The regulation of the Hypothalamus-Pituitary-Adrenal axis (HPA-axis) with its end product cortisol seems to be affected in several psychiatric disorders. Although findings are not conclusive, internalizing symptoms have primarily been associated with higher diurnal cortisol levels and externalizing symptoms with lower cortisol levels. In this study on nine-year-olds in Nicaragua (n=111), we investigated associations between child psychiatric symptoms, using the Child Behavior Check List (CBCL), and saliva cortisol levels collected in the morning and afternoon, also adjusting for potential confounders. In line with previous findings, internalizing symptoms were significantly associated with higher morning, but not afternoon cortisol levels. Surprisingly, externalizing symptoms were also significantly associated with higher morning cortisol levels. Possibly, this association between externalizing symptoms and cortisol levels may be characteristic of early ages, representing a higher exposure to external stressors. The study highlights the need for prospective studies, following the development of the HPA-axis and its association with psychiatric symptoms.
authors.affiliation: Department of Neuroscience, Child and Adolescent Psychiatry Unit, Uppsala University, Uppsala, Sweden; Department of Women's and Children's Health, Pediatric Neuropsychiatry Unit, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden. Electronic address: johan.isaksson@neuro.uu.se.
authors.forename: Johan
authors.initials: J
authors.lastname: Isaksson
authors.affiliation: Department of Women's and Children's health/Obstetrics & Gynecology, Uppsala University, Uppsala, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Högberg
authors.affiliation: Center for Research and Interventions in Health, León, Nicaragua.
authors.forename: Eliette
authors.initials: E
authors.lastname: Valladares
authors.affiliation: Department of Neuroscience, Child and Adolescent Psychiatry Unit, Uppsala University, Uppsala, Sweden.
authors.forename: Frank
authors.initials: F
authors.lastname: Lindblad
mesh_terms: D002648:Child; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008297:Male; D001523:Mental Disorders / Q000503:physiopathology*; D009527:Nicaragua; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012463:Saliva / Q000737:chemistry
chemical_list: D006854:Hydrocortisone
keywords: Child behavior check list; Cortisol; HPA-axis; Psychiatric symptoms