Stress reactivity and its effects on subsequent food intake in depressed and healthy women with and without adverse childhood experiences.
BACKGROUND
Adverse childhood experiences (ACE) increase the risk to develop major depressive disorder (MDD) and obesity or metabolic syndrome in adulthood. In addition, ACE may be associated with an exaggerated endocrine response to stress, which, in turn, may lead to enhanced food intake resulting in obesity and metabolic problems.


METHODS
We systematically examined the stress response and consecutive food intake in 32 women with MDD and ACE as determined by a clinical interview (Early Trauma Inventory), 52 women with MDD without ACE, 22 women with ACE but no current or lifetime MDD and 37 healthy women without either MDD or ACE. All participants underwent a psychosocial stress test (Trier Social Stress Test, TSST) and a control condition (Placebo-TSST) before they were offered a buffet of snacks. Participants were not aware that the primary outcome variable was the amount of consumed kilocalories (kcal).


RESULTS
The four groups did not differ in demographic variables. Stress resulted in higher cortisol release and higher blood pressure compared to the control condition. Patients with MDD without ACE had a significantly lower cortisol response to stress compared to controls. Across groups, we found higher kcal intake after stress compared to the control condition. Comparing high and low cortisol responders to stress, higher kcal intake after stress was only seen in those with low cortisol release.


CONCLUSIONS
This study provides evidence that blunted rather than enhanced cortisol release to stress might lead to increased food intake, independent from MDD and ACE.
Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany. Electronic address: katja.wingenfeld@charite.de.
Katja
K
Wingenfeld
Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Linn K
LK
Kuehl
Asklepios Fachklinikum Tiefenbrunn, Rosdorf, Germany.
Anita
A
Boeker
Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Katharina
K
Schultebraucks
Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Kristin
K
Ritter
Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Julian
J
Hellmann-Regen
Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Christian
C
Otte
Asklepios Fachklinikum Tiefenbrunn, Rosdorf, Germany.
Carsten
C
Spitzer
D000328:Adult; D003863:Depression / Q000378:metabolism; D003865:Major Depressive Disorder / Q000378:metabolism; D004435:Eating / Q000502:physiology / Q000523:psychology*; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008016:Life Change Events; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D012463:Saliva; D013315:Stress, Psychological / Q000378:metabolism / Q000523:psychology
D006854:Hydrocortisone
Adverse childhood experiences; Cortisol; Depression; Eating behavior; Stress