A two-year follow-up study of salivary cortisol concentration and the risk of depression

Matias Brødsgaard Grynderup; Henrik Albert Kolstad; Sigurd Mikkelsen; Johan Hviid Andersen; Jens Peter Bonde; Henriette Nørmølle Buttenschøn; Anette Kærgaard; Linda Kærlev; Reiner Rugulies; Jane Frølund Thomsen; Marianne Agergaard Vammen; Ole Mors; Åse Marie Hansen

doi:10.1016/j.psyneuen.2013.03.013

A two-year follow-up study of salivary cortisol concentration and the risk of depression

Matias Brødsgaard Grynderup, Henrik Albert Kolstad, Sigurd Mikkelsen, Johan Hviid Andersen, Jens Peter Bonde, Henriette Nørmølle Buttenschøn, Anette Kærgaard, Linda Kærlev, Reiner Rugulies, Jane Frølund Thomsen, Marianne Agergaard Vammen, Ole Mors, Åse Marie Hansen

22 Citations (Scopus)

Abstract

Stress is a suspected cause of depression. High cortisol concentration, a biomarker of an activated stress response, has been found in depressed patients. The aim of this study was to determine if a high level of salivary cortisol is a risk factor of depression. In 2007, we enrolled 4467 public employees. Morning and evening salivary cortisol concentration were measured for each participant. Participants reporting high levels of depressive, burnout, or stress symptoms, assessed by questionnaires were assigned to a psychiatric interview. In this interview 98 participants were diagnosed with depression and subsequently excluded. Two years later in 2009, 2920 participants who had provided at least one valid saliva cortisol measurement at baseline participated at follow up. The psychiatric interviews were repeated and 62 cases of newly onset depression were diagnosed. Odds ratios of depression were estimated for every 1.0nmol/l increase in morning, evening, and daily mean cortisol concentration, as well as for the difference between morning and evening cortisol concentration. The risk of depression decreased by increasing daily mean cortisol concentration and by increasing difference between morning and evening concentrations, while morning and evening cortisol concentrations were not significantly associated with depression. The adjusted odds ratios for 1.0nmol/l increase in morning, evening, and daily mean cortisol concentration were 0.69 (95% CI: 0.45, 1.05), 0.87 (95% CI: 0.59, 1.28), and 0.53 (95% CI: 0.32, 0.90), respectively. The adjusted odds ratio for 1.0nmol/l increase in difference between morning and evening concentration were 0.64 (95% CI: 0.45, 0.90). This study did not support the hypothesis that high salivary cortisol concentration is a risk factor of depression, but indicate that low mean salivary cortisol concentration and a small difference between morning and evening cortisol concentration may be risk factors of depression.

Original language	English
Journal	Psychoneuroendocrinology
Volume	38
Issue number	10
Pages (from-to)	2042-2050
ISSN	0306-4530
DOIs	https://doi.org/10.1016/j.psyneuen.2013.03.013
Publication status	Published - Oct 2013

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Grynderup, M. B., Kolstad, H. A., Mikkelsen, S., Andersen, J. H., Bonde, J. P., Buttenschøn, H. N., Kærgaard, A., Kærlev, L., Rugulies, R., Thomsen, J. F., Vammen, M. A., Mors, O., & Hansen, Å. M. (2013). A two-year follow-up study of salivary cortisol concentration and the risk of depression. Psychoneuroendocrinology, 38(10), 2042-2050. https://doi.org/10.1016/j.psyneuen.2013.03.013

Grynderup, MB, Kolstad, HA, Mikkelsen, S, Andersen, JH, Bonde, JP, Buttenschøn, HN, Kærgaard, A, Kærlev, L, Rugulies, R, Thomsen, JF, Vammen, MA, Mors, O & Hansen, ÅM 2013, 'A two-year follow-up study of salivary cortisol concentration and the risk of depression', Psychoneuroendocrinology, vol. 38, no. 10, pp. 2042-2050. https://doi.org/10.1016/j.psyneuen.2013.03.013

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title = "A two-year follow-up study of salivary cortisol concentration and the risk of depression",

abstract = "Stress is a suspected cause of depression. High cortisol concentration, a biomarker of an activated stress response, has been found in depressed patients. The aim of this study was to determine if a high level of salivary cortisol is a risk factor of depression. In 2007, we enrolled 4467 public employees. Morning and evening salivary cortisol concentration were measured for each participant. Participants reporting high levels of depressive, burnout, or stress symptoms, assessed by questionnaires were assigned to a psychiatric interview. In this interview 98 participants were diagnosed with depression and subsequently excluded. Two years later in 2009, 2920 participants who had provided at least one valid saliva cortisol measurement at baseline participated at follow up. The psychiatric interviews were repeated and 62 cases of newly onset depression were diagnosed. Odds ratios of depression were estimated for every 1.0nmol/l increase in morning, evening, and daily mean cortisol concentration, as well as for the difference between morning and evening cortisol concentration. The risk of depression decreased by increasing daily mean cortisol concentration and by increasing difference between morning and evening concentrations, while morning and evening cortisol concentrations were not significantly associated with depression. The adjusted odds ratios for 1.0nmol/l increase in morning, evening, and daily mean cortisol concentration were 0.69 (95% CI: 0.45, 1.05), 0.87 (95% CI: 0.59, 1.28), and 0.53 (95% CI: 0.32, 0.90), respectively. The adjusted odds ratio for 1.0nmol/l increase in difference between morning and evening concentration were 0.64 (95% CI: 0.45, 0.90). This study did not support the hypothesis that high salivary cortisol concentration is a risk factor of depression, but indicate that low mean salivary cortisol concentration and a small difference between morning and evening cortisol concentration may be risk factors of depression.",

author = "Grynderup, {Matias Br{\o}dsgaard} and Kolstad, {Henrik Albert} and Sigurd Mikkelsen and Andersen, {Johan Hviid} and Bonde, {Jens Peter} and Buttensch{\o}n, {Henriette N{\o}rm{\o}lle} and Anette K{\ae}rgaard and Linda K{\ae}rlev and Reiner Rugulies and Thomsen, {Jane Fr{\o}lund} and Vammen, {Marianne Agergaard} and Ole Mors and Hansen, {{\AA}se Marie}",

year = "2013",

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doi = "10.1016/j.psyneuen.2013.03.013",

language = "English",

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pages = "2042--2050",

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T1 - A two-year follow-up study of salivary cortisol concentration and the risk of depression

AU - Grynderup, Matias Brødsgaard

AU - Kolstad, Henrik Albert

AU - Mikkelsen, Sigurd

AU - Andersen, Johan Hviid

AU - Bonde, Jens Peter

AU - Buttenschøn, Henriette Nørmølle

AU - Kærgaard, Anette

AU - Kærlev, Linda

AU - Rugulies, Reiner

AU - Thomsen, Jane Frølund

AU - Vammen, Marianne Agergaard

AU - Mors, Ole

AU - Hansen, Åse Marie

PY - 2013/10

Y1 - 2013/10

N2 - Stress is a suspected cause of depression. High cortisol concentration, a biomarker of an activated stress response, has been found in depressed patients. The aim of this study was to determine if a high level of salivary cortisol is a risk factor of depression. In 2007, we enrolled 4467 public employees. Morning and evening salivary cortisol concentration were measured for each participant. Participants reporting high levels of depressive, burnout, or stress symptoms, assessed by questionnaires were assigned to a psychiatric interview. In this interview 98 participants were diagnosed with depression and subsequently excluded. Two years later in 2009, 2920 participants who had provided at least one valid saliva cortisol measurement at baseline participated at follow up. The psychiatric interviews were repeated and 62 cases of newly onset depression were diagnosed. Odds ratios of depression were estimated for every 1.0nmol/l increase in morning, evening, and daily mean cortisol concentration, as well as for the difference between morning and evening cortisol concentration. The risk of depression decreased by increasing daily mean cortisol concentration and by increasing difference between morning and evening concentrations, while morning and evening cortisol concentrations were not significantly associated with depression. The adjusted odds ratios for 1.0nmol/l increase in morning, evening, and daily mean cortisol concentration were 0.69 (95% CI: 0.45, 1.05), 0.87 (95% CI: 0.59, 1.28), and 0.53 (95% CI: 0.32, 0.90), respectively. The adjusted odds ratio for 1.0nmol/l increase in difference between morning and evening concentration were 0.64 (95% CI: 0.45, 0.90). This study did not support the hypothesis that high salivary cortisol concentration is a risk factor of depression, but indicate that low mean salivary cortisol concentration and a small difference between morning and evening cortisol concentration may be risk factors of depression.

AB - Stress is a suspected cause of depression. High cortisol concentration, a biomarker of an activated stress response, has been found in depressed patients. The aim of this study was to determine if a high level of salivary cortisol is a risk factor of depression. In 2007, we enrolled 4467 public employees. Morning and evening salivary cortisol concentration were measured for each participant. Participants reporting high levels of depressive, burnout, or stress symptoms, assessed by questionnaires were assigned to a psychiatric interview. In this interview 98 participants were diagnosed with depression and subsequently excluded. Two years later in 2009, 2920 participants who had provided at least one valid saliva cortisol measurement at baseline participated at follow up. The psychiatric interviews were repeated and 62 cases of newly onset depression were diagnosed. Odds ratios of depression were estimated for every 1.0nmol/l increase in morning, evening, and daily mean cortisol concentration, as well as for the difference between morning and evening cortisol concentration. The risk of depression decreased by increasing daily mean cortisol concentration and by increasing difference between morning and evening concentrations, while morning and evening cortisol concentrations were not significantly associated with depression. The adjusted odds ratios for 1.0nmol/l increase in morning, evening, and daily mean cortisol concentration were 0.69 (95% CI: 0.45, 1.05), 0.87 (95% CI: 0.59, 1.28), and 0.53 (95% CI: 0.32, 0.90), respectively. The adjusted odds ratio for 1.0nmol/l increase in difference between morning and evening concentration were 0.64 (95% CI: 0.45, 0.90). This study did not support the hypothesis that high salivary cortisol concentration is a risk factor of depression, but indicate that low mean salivary cortisol concentration and a small difference between morning and evening cortisol concentration may be risk factors of depression.

U2 - 10.1016/j.psyneuen.2013.03.013

DO - 10.1016/j.psyneuen.2013.03.013

M3 - Journal article

C2 - 23597874

SN - 0306-4530

VL - 38

SP - 2042

EP - 2050

JO - Psychoneuroendocrinology

JF - Psychoneuroendocrinology

IS - 10

ER -

A two-year follow-up study of salivary cortisol concentration and the risk of depression

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