Colich Natalie L, Kircanski Katharina, Foland-Ross Lara C, Gotlib Ian H
Department of Psychology, Stanford University, USA.
Department of Psychology, Stanford University, USA.
Psychoneuroendocrinology. 2015 May;55:94-101. doi: 10.1016/j.psyneuen.2015.02.004. Epub 2015 Feb 16.
Both elevated and blunted levels of cortisol secretion during childhood and adolescence have been linked to the subsequent onset of major depressive disorder (MDD). These mixed findings may be due to developmental changes in HPA-axis functioning, which have not been previously assessed in the context of risk. In the present study, therefore, we examined whether pubertal development moderated the influence of cortisol secretion on the subsequent development of MDD. Eighty-nine never-disordered girls ages 9-15 years, many of whom were at high risk for depression by virtue of having a maternal history of the disorder, completed a laboratory stress task. To index cortisol reactivity, salivary cortisol samples were collected at baseline and 15 min following the onset of the stressor. Girls' levels of pubertal development were measured using Tanner staging. All participants were followed through age 18 in order to assess the subsequent development of MDD. Pubertal stage moderated the effects of cortisol stress reactivity on the development of MDD. Specifically, the onset of MDD was predicted by cortisol hyporeactivity in girls who were earlier in pubertal development (Tanner stage ≤ 2), but by cortisol hyperreactivity in girls who were later in pubertal development (Tanner stage ≥ 3.5).
These findings demonstrate that girls' cortisol stress reactivity predicts the subsequent onset of MDD, and further, that the nature of this effect depends on the girls' level of pubertal development. Results are discussed in the context of clarifying previous findings, and directions for future research are offered.
儿童期和青少年期皮质醇分泌水平升高和降低均与随后发生的重度抑郁症(MDD)有关。这些相互矛盾的研究结果可能是由于下丘脑-垂体-肾上腺(HPA)轴功能的发育变化,而此前尚未在风险背景下对此进行评估。因此,在本研究中,我们考察了青春期发育是否会调节皮质醇分泌对MDD后续发展的影响。89名年龄在9至15岁、此前无精神障碍的女孩完成了一项实验室应激任务,其中许多人因母亲有抑郁症病史而具有较高的抑郁风险。为了测定皮质醇反应性,在基线和应激源开始后15分钟采集唾液皮质醇样本。使用坦纳分期法测量女孩的青春期发育水平。对所有参与者随访至18岁,以评估MDD的后续发展情况。青春期阶段调节了皮质醇应激反应性对MDD发展的影响。具体而言,青春期发育较早(坦纳分期≤2期)的女孩中,MDD的发病可由皮质醇低反应性预测,而青春期发育较晚(坦纳分期≥3.5期)的女孩中,则由皮质醇高反应性预测。
这些研究结果表明,女孩的皮质醇应激反应性可预测MDD的后续发病,而且,这种效应的性质取决于女孩的青春期发育水平。我们在澄清先前研究结果的背景下对结果进行了讨论,并提供了未来研究的方向。