Background
Changes in the hypothalamic–pituitary–adrenal (HPA) axis, as evidenced by patterns
of cortisol secretion, have been of interest in understanding depression and anxiety
disorders across the life span. Previous studies of pediatric depression have pointed
to the period around sleep onset as a key time point for observing alterations in
cortisol secretion associated with affective disorders. Evidence also indicates that
pubertal development may influence the expression of HPA dysregulation. We hypothesized
that adolescents with depression and youth with anxiety disorders exhibit elevated
peri-sleep-onset cortisol.
Methods
Plasma cortisol was sampled every 20 min around sleep onset from children and adolescents
with major depressive disorder (n = 116), anxiety disorders (n = 32), or no history of psychiatric disorder (control; n = 76). Sleep onset was determined by polysomnography. Classification of participants
as children or adolescents was based on Tanner staging of pubertal maturation.
Results
Children with anxiety disorders had higher peri-sleep-onset cortisol than children
with depression or control children. Adolescents with depression had marginally higher
peri-sleep-onset cortisol than control adolescents and significantly higher peri-sleep-onset
cortisol than children with depression.
Conclusions
Depression and anxiety are associated with altered cortisol secretion around sleep
onset, and these changes appear to be influenced by pubertal maturation.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Biological PsychiatryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Diagnostic and Statistical Manual for Mental Disorders (DSM-III-R), 3rd rev. ed. American Psychiatric Association, Washington, DC1987
- Puberty and depression.Psychol Medicine. 1998; 28: 51-61
- Corticotropin-releasing hormone challenge in prepubertal major depression.Biol Psychiatry. 1996; 39: 267-277
- Dexamethasone suppression test in children with major depressive disorder.J Am Acad Child Adolesc Psychiatry. 1992; 31: 291-297
- Auditory arousal thresholds during sleep in hyperkinetic children.Sleep. 1985; 8: 332-341
- Diurnal salivary cortisol in pediatric posttraumatic stress disorder.Soc Biol Psychiatry. 2002; 51: 575-582
- Adolescent sleep patterns. Cambridge University Press, New York2002
- Psychobiological mechanisms of resilience and vulnerability.Am J Psychiatry. 2004; 161: 195-216
- An epidemiological study of disorders in late childhood and adolescence—IAge- and gender-specific prevalence.J Child Psychol Psychiatry. 1993; 34: 851-867
- Development and natural history of mood disorders.Biol Psychiatry. 2002; 52: 529-542
- Cortisol secretion in adolescents with major depressive disorder.Acta Psychiatr Scand. 1989; 80: 18-26
- Sleep onset abnormalities in depressed adolescents.Biol Psychiatry. 1996; 39: 400-410
- 24-hour cortisol measures in adolescents with major depression.Biol Psychiatry. 1991; 30: 25-36
- A.E. Bennett Research Award. Developmental traumatology. Part I: Biological stress systems.Biol Psychiatry. 1999; 45: 1259-1270
- Twenty-four-hour cortisol secretion patterns in prepubertal children with anxiety or depressive disorders.Biol Psychiatry. 2004; 56: 198-204
- Environmental enrichment reverses the effects of maternal separation on stress reactivity.J Neurosci. 2002; 22: 7840-7843
- Ages of onset of psychiatric disorders in a community population of older adolescents.J Am Acad Child Adolesc Psychiatry. 1994; 33: 706-717
- Pituitary-adrenal function in adolescent psychiatric patients.J Affect Disord. 2000; 59: 71-76
- Psychosocial and endocrine features of chronic first-episode major depression in 8-16 year olds.Soc Biol Psychiatry. 2001; 50: 351-357
- Experience effects on brain development.J Child Psychol Psychiatry. 2003; 44: 33-63
- Cortisol secretion in exogenous depression. I. Basal plasma levels.Arch Gen Psychiatry. 1985; 42: 904-908
- A rating scale for depression.J Neurol Neurosurg Psychiatry. 1960; 23: 56-62
- The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders.Psychoneuroendocrinology. 2000; 25: 1-35
- Nonhuman primate model of alcohol abuse.Proc Natl Acad Sci U S A. 1991; 88: 7261-7265
- Four factor index of social status. Yale University Sociology Department, New Haven, CT1975
- Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL).J Am Acad Child Adolesc Psychiatry. 1997; 36: 980-988
- Epidemiology of DSM-III-R major depression and minor depression among adolescents and young adults in the national comorbidity survey.Depress Anxiety. 1998; 7: 3-14
- Depressive disorders in childhood. IV. A longitudinal study of comorbidity with and risk for anxiety disorders.Arch Gen Psychiatry. 1989; 46: 776-782
- Nocturnal cortisol, thyroid stimulating hormone, and growth hormone secretory profiles in depressed adolescents.J Am Acad Child Adolesc Psychiatry. 1991; 30: 407-414
- Child’s stress hormone levels correlate with mother’s socioeconomic status and depressive state.Biol Psychiatry. 2000; 48: 976-980
- Growth and physiological development during adolescence.Annu Rev Med. 1968; 19: 283-300
- Mood disorders and allostatic load.Biol Psychiatry. 2003; 54: 200-207
- DSM-III disorders from age 11 to age 15 years.J Am Acad Child Adolesc Psychiatry. 1992; 31: 50-59
- The development of individual differences in behavioral and endocrine responses to stress.Annu Rev Neurosci. 2001; 24: 1161-1192
- Retrospective assessment of prepubertal major depression with the Kiddie-SADS-e.J Am Acad Child Psychiatry. 1982; 21: 392-397
- Pathophysiology of childhood anxiety disorders.Biol Psychiatry. 1999; 46: 1555-1566
- Cortisol secretion in prepubertal children with major depressive disorder. Episode and recovery.Arch Gen Psychiatry. 1989; 46: 801-809
- The relationship between longitudinal clinical course and sleep and cortisol changes in adolescent depression.Biol Psychiatry. 1996; 40: 474-484
- The neuroendocrinology of posttraumatic stress disorder.CNS Spectr. 2003; 8 (665–667): 651-656
- Comorbidity of unipolar depression: II. Comorbidity with other mental disorders in adolescents and adults.J Abnorm Psychol. 1991; 100: 214-222
- Neuroendocrine aspects of primary endogenous depression. I. Cortisol secretory dynamics in patients and matched controls.Arch Gen Psychiatry. 1987; 44: 328-336
- Estrogen mediates sex differences in stress-induced prefrontal cortex dysfunction.Mol Psychiatry. 2003; 9: 531-538
- Panic induced by carbon dioxide inhalation and lack of hypothalamic-pituitary-adrenal axis activation.Psychiatry Res. 1999; 86: 93-98
- Organizers and genes. Cambridge University Press, Cambridge1940
- The strategy of the genes. Allen and Unwin, London1957
Williamson DE, Forbes EE, Dahl RE, Ryan ND (in press): Examining the relation between depression and anxiety: evidence from a family-genetic study. Child Adolesc Psychiatr Clin N Am.
- Hamilton depression scores can be extracted from the K-SADS-P in adolescents.J Child Adolesc Psychopharmacol. 1992; 2: 175-181
- Increased evening activation of the hypothalamic–pituitary–adrenal axis in depressed patients.Arch Gen Psychiatry. 1994; 51: 701-707
- Mineralocorticoid receptor function in major depression.Arch Gen Psychiatry. 2003; 60: 24-28
Article info
Publication history
Published online: August 22, 2005
Accepted:
June 2,
2005
Received in revised form:
May 12,
2005
Received:
January 3,
2005
Identification
Copyright
© 2005 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.