Study Reveals Higher Cortisol Levels in Individuals with Major Depressive Disorder and Childhood Trauma
A study published in Psychological Medicine compared individuals with major depressive disorder to healthy controls and found that those with depression exhibited higher cortisol levels after awakening than their healthy counterparts. Notably, this increase was only observed in individuals with depression who had also experienced childhood trauma.
The Role of Cortisol and Its Impact on Health
Cortisol is a steroid hormone produced by the adrenal glands, which are located on top of each kidney. It plays a vital role in the body’s response to stress. When a person experiences stress, cortisol levels increase, leading to elevated blood sugar levels, suppressed immune system, and metabolism of fats, proteins, and carbohydrates. However, prolonged or chronic elevation of cortisol levels can have adverse effects on health, including contributing to obesity, cardiovascular disease, and immune system dysfunction.
Cortisol as a Biomarker for Major Depressive Disorder
Cortisol is considered one of the most promising biomarkers for major depressive disorder. This mental health condition is characterized by persistent and severe feelings of sadness, hopelessness, and a loss of interest or pleasure in most activities. Studies have shown that individuals suffering from major depressive disorder often have consistently elevated levels of cortisol in their blood.
Furthermore, when these individuals are injected with dexamethasone, a synthetic analogue to cortisol, their cortisol levels do not decrease as much as expected. Elevated cortisol levels are also found in individuals who do not respond well to psychotherapy, indicating limited improvement in symptoms.
Investigating the Impact of Childhood Trauma on Cortisol Regulation
The study’s lead author, Shabaz Sendi, and his team aimed to determine if childhood trauma could alter the endocrine system’s function, specifically the regulation of cortisol in individuals with major depressive disorder. Building on prior research, they hypothesized that post-awakening cortisol levels would be highest in individuals with both major depressive disorder and childhood trauma, and lowest in healthy individuals without any childhood trauma.
The study involved four groups: 43 healthy participants without childhood trauma, 26 healthy participants with childhood trauma, 15 patients with major depressive disorder without childhood trauma, and 28 patients with both major depressive disorder and childhood trauma. The participants underwent evaluations either in an inpatient clinic or at their homes. They completed depression assessments using the Hamilton Depression Rating Scale (HAM-D 21) and a questionnaire to determine the presence or absence of childhood trauma (Childhood Trauma Questionnaire, CTQ). Additionally, they provided five saliva samples to measure cortisol levels, with the first sample taken immediately upon waking and the subsequent four at 15-minute intervals.
Study Findings
The study found no correlation between demographic factors such as age, gender, and body mass index with cortisol levels. The average waking time was consistent across the four groups.
Patients with major depressive disorder and a history of childhood trauma had higher baseline cortisol levels compared to healthy individuals, both with and without childhood trauma. However, when the researchers controlled for the participants’ sex, the only significant difference in cortisol levels that remained was between individuals suffering from major depressive disorder who also had a history of childhood trauma and the group of healthy individuals without childhood trauma.
The study authors concluded, “In summary, the present study showed that the total amount of cortisol released after awakening was increased in patients with major depressive disorder, although only when they had a history of childhood trauma. This finding resonates well with the notion that at least some neurobiological signatures of major depressive disorder may in fact be attributable to early life stress. They may also imply that this group of patients is characterized by yet to be determined (epi)genetic alterations, which render them non-resilient to childhood trauma.”
Implications and Limitations
This study contributes to the scientific understanding of the links between early experiences and cortisol production in adulthood. However, it is important to note that the study sample was small, and the study design does not allow for any cause-and-effect inferences to be derived from the findings.
The study, “Childhood trauma associated with increased post-awakening cortisol in major depressive disorder,” was authored by Shabaz Sendi, Susanne Fischer, Andrew Papadopoulos, Lucia Poon, Lena J. Rane, Abebaw Fekadu, Valeria Mondelli, and Anthony J. Cleare.
SDGs, Targets, and Indicators
| SDGs | Targets | Indicators |
|---|---|---|
| SDG 3: Good Health and Well-being | Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being | Indicator 3.4.1: Mortality rate attributed to cardiovascular disease, cancer, diabetes, or chronic respiratory disease |
| SDG 5: Gender Equality | Target 5.2: Eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation | Indicator 5.2.1: Proportion of ever-partnered women and girls subjected to physical, sexual, or psychological violence by a current or former intimate partner in the previous 12 months |
| SDG 10: Reduced Inequalities | Target 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status | Indicator 10.2.1: Proportion of people living below 50 percent of median income, by age, sex, and persons with disabilities |
| SDG 16: Peace, Justice, and Strong Institutions | Target 16.2: End abuse, exploitation, trafficking, and all forms of violence against and torture of children | Indicator 16.2.3: Proportion of young women and men aged 18-29 years who experienced sexual violence by age 18 |
1. Which SDGs are addressed or connected to the issues highlighted in the article?
- SDG 3: Good Health and Well-being
- SDG 5: Gender Equality
- SDG 10: Reduced Inequalities
- SDG 16: Peace, Justice, and Strong Institutions
2. What specific targets under those SDGs can be identified based on the article’s content?
- Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
- Target 5.2: Eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation
- Target 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status
- Target 16.2: End abuse, exploitation, trafficking, and all forms of violence against and torture of children
3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?
- Indicator 3.4.1: Mortality rate attributed to cardiovascular disease, cancer, diabetes, or chronic respiratory disease
- Indicator 5.2.1: Proportion of ever-partnered women and girls subjected to physical, sexual, or psychological violence by a current or former intimate partner in the previous 12 months
- Indicator 10.2.1: Proportion of people living below 50 percent of median income, by age, sex, and persons with disabilities
- Indicator 16.2.3: Proportion of young women and men aged 18-29 years who experienced sexual violence by age 18
4. SDGs, Targets and Indicators
| SDGs | Targets | Indicators |
|---|---|---|
| SDG 3: Good Health and Well-being | Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being | Indicator 3.4.1: Mortality rate attributed to cardiovascular disease, cancer, diabetes, or chronic respiratory disease |
| SDG 5: Gender Equality | Target 5.2: Eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation | Indicator 5.2.1: Proportion of ever-partnered women and girls subjected to physical, sexual, or psychological violence by a current or former intimate partner in the previous 12 months |
| SDG 10: Reduced Inequalities | Target 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status | Indicator 10.2.1: Proportion of people living below 50 percent of median income, by age, sex, and persons with disabilities |
| SDG 16: Peace, Justice, and Strong Institutions | Target 16.2: End abuse, exploitation, trafficking, and all forms of violence against and torture of children | Indicator 16.2.3: Proportion of young women and men aged 18-29 years who experienced sexual violence by age 18 |
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Source: psypost.org
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