Elevated morning cortisol is a stratified population-level biomarker for major depression in boys only with high depressive symptoms

Summary & key facts

The researchers repeatedly measured early-morning cortisol and self-reported depressive symptoms in a population of adolescents. Using a statistical method to find subgroups, they identified a high-risk group (17% of the sample) with both high depressive symptoms and elevated morning cortisol. Membership in this group was linked to worse autobiographical memory in both sexes and to the highest chance of having major depression in boys only. The authors say this biobehavioral pattern could act as a population-level biomarker for depression in adolescent boys, but the findings do not prove cause-and-effect and apply to groups rather than individual diagnoses.

Key facts:

• About 1 in 6 people will experience major depressive disorder at some point, according to the paper's background statement.
• The study used repeated measurements of self-reported current depressive symptoms and early-morning cortisol in adolescents to identify subgroups over time.
• A latent class analysis (a statistical method that finds distinct subgroups) identified a high-risk class that made up 17% of the sample and was marked by both high depressive symptoms and elevated morning cortisol.
• Being in that high-risk class was associated with increased problems recalling autobiographical memories in both boys and girls.
• Membership in the high-risk class was linked to the greatest likelihood of experiencing major depression, but this increased risk was observed in boys only, not girls.
• The authors describe the combined pattern of high depressive symptoms plus elevated morning cortisol as a possible population-level biomarker for major depression in adolescent boys, while noting the findings do not establish causation and

Abstract

Major depressive disorder (MD) is a debilitating public mental health problem with severe societal and personal costs attached. Around one in six people will suffer from this complex disorder at some point in their lives, which has shown considerable etiological and clinical heterogeneity. Overall there remain no validated biomarkers in the youth population at large that can aid the detection of at-risk groups for depression in general and for boys and young men in particular. Using repeated measurements of two well-known correlates of MD (self-reported current depressive symptoms and early-morning cortisol), we undertook a population-based investigation to ascertain subtypes of adolescents that represent separate longitudinal phenotypes. Subsequently, we tested for differential risks for MD and other mental illnesses and cognitive differences between subtypes. Through the use of latent class analysis, we revealed a high-risk subtype (17% of the sample) demarcated by both high depressive symptoms and elevated cortisol levels. Membership of this class of individuals was associated with increased levels of impaired autobiographical memory recall in both sexes and the greatest likelihood of experiencing MD in boys only. These previously unidentified findings demonstrate at the population level a class of adolescents with a common physiological biomarker specifically for MD in boys and for a mnemonic vulnerability in both sexes. We suggest that the biobehavioral combination of high depressive symptoms and elevated morning cortisol is particularly hazardous for adolescent boys.

Topics

Child and Adolescent Psychosocial and Emotional Development Stress Responses and Cortisol Tryptophan and brain disorders

Categories

Behavioral Neuroscience Life Sciences Neuroscience

Tags

Biochemistry Biology Biomarker Clinical psychology Clinical significance Cortisol awakening response Depression (economics) Economics Environmental health Hydrocortisone Internal medicine Macroeconomics Medicine Mood Morning Population Psychiatry Psychology Psychosocial Subclinical infection