Short-term and long-term measures of cortisol in saliva and hair in atypical and non-atypical depression

A. Herane-Vives, V. de Angel, A. Papadopoulos, T. Wise, K. C. Chua, R. Strawbridge, D. Castillo, D. Arnone, A. H. Young, A. J. Cleare

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)216-230
Number of pages15
JournalActa Psychiatrica Scandinavica
Issue number3
Publication statusPublished - Mar 2018
Externally publishedYes


  • affective disorders
  • classification
  • cortisol
  • depression
  • diagnosis

ASJC Scopus subject areas

  • Psychiatry and Mental health


Dive into the research topics of 'Short-term and long-term measures of cortisol in saliva and hair in atypical and non-atypical depression'. Together they form a unique fingerprint.

Cite this