@article{f1bf1e68ea134bb3a965c99d6df12051,
title = "Short-term and long-term measures of cortisol in saliva and hair in atypical and non-atypical depression",
abstract = "Background: Atypical depression may show lowered rather than raised short-term cortisol levels. Atypical major depressive episodes (A-MDE) may also be more closely linked to environmental factors and show overlap with somatic symptom disorders. Hair specimens allow measuring long-term cortisol levels. Methods: Twenty-seven A-MDE and 44 NA-MDE patients and 40 matched controls were tested. Measures of hair cortisol concentration [HCC] covering the previous 3 months and short-term cortisol parameters (six saliva specimens to assess the cortisol awakening response [CAR] and total daily cortisol output calculated as the area under the curve [AUCg]) were taken alongside measures of environmental factors and clinical variables. Results: There were no differences in HCC between the three groups (P = 0.8), and no difference in the CAR (P = 0.95). However, A-MDE showed lowered short-term cortisol output (AUCg) compared to controls (P = 0.04). A-MDE patients also reported a higher number of daily hassles, and higher levels of fatigue and impaired concentration than NA-MDE. Conclusions: Normal long-term (HCC) and reduced short-term (AUCg) cortisol levels in A-MDE could suggest a disrupted long-term cortisol rhythm, perhaps affected by environmental factors or by certain symptoms, such as mid-nocturnal insomnia. However, other underlying explanations for these findings should also be investigated in the future.",
keywords = "affective disorders, classification, cortisol, depression, diagnosis",
author = "A. Herane-Vives and {de Angel}, V. and A. Papadopoulos and T. Wise and Chua, {K. C.} and R. Strawbridge and D. Castillo and D. Arnone and Young, {A. H.} and Cleare, {A. J.}",
note = "Funding Information: This research was funded by departmental funds generated by AJC, AHV and AHY and start up funds from the Academy of Medical Sciences to DA (Ref. AMS-SGCL8). AHV was supported by a Chilean Bicentennial Fund Scholarship from the Bicentennial Fund for Human Capital Development (Becas Chile) and by the Psychiatric Research Trust. AJC, TW and AHY are supported by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. This study represents independent research part funded by the NIHR/Wellcome Trust, King's Clinical Research Facility and the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NHS. The authors would like to thank the staff of the NIHR/Wellcome Trust Clinical Research Facility at King's College Hospital and the Cl{\'i}nica Psiqu{\'i}atrica Universitaria and Oficina de Apoyo a la Investigacion Cl{\'i}nica (OAIC) of University of Chile for their support in the conduct of the study. We are grateful to Mrs Irene Papadopoulos for performing the saliva cortisol Immunoassays and Miss Carolina Afandi for her technical assistance. We thank the Mental Health Research Network for contributing to this study and all participants in this study for their support. The funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication. Funding Information: This research was funded by departmental funds generated by AJC, AHV and AHY and start up funds from the Academy of Medical Sciences to DA (Ref. AMS-SGCL8). AHV was supported by a Chilean Bicentennial Fund Scholarship from the Bicentennial Fund for Human Capital Development (Becas Chile) and by the Psychiatric Research Trust. AJC, TW and AHY are supported by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King{\textquoteright}s College London. This study represents independent research part funded by the NIHR/Wellcome Trust, King{\textquoteright}s Clinical Research Facility and the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King{\textquoteright}s College London. The views expressed are those of the author(s) and not necessarily those of the NHS. The authors would like to thank the staff of the NIHR/Wellcome Trust Clinical Research Facility at King{\textquoteright}s College Hospital and the Cl{\'i}nica Psiqu{\'i}atrica Universitaria and Oficina de Apoyo a la Investigacion Cl{\'i}nica (OAIC) of University of Chile for their support in the conduct of the study. We are grateful to Mrs Irene Papadopoulos for performing the saliva cortisol Immunoassays and Miss Carolina Afandi for her technical assistance. We thank the Mental Health Research Network for contributing to this study and all participants in this study for their support. The funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication. Publisher Copyright: {\textcopyright} 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd",
year = "2018",
month = mar,
doi = "10.1111/acps.12852",
language = "English",
volume = "137",
pages = "216--230",
journal = "Acta Psychiatrica Scandinavica",
issn = "0001-690X",
publisher = "Wiley-Blackwell",
number = "3",
}