Effects of Early and Recent Adverse Experiences on Adrenal Response to Psychosocial Stress in Depressed Adolescents

doi:10.1016/j.biopsych.2008.05.012

Biological Psychiatry

Volume 64, Issue 6, 15 September 2008, Pages 521-526

https://doi.org/10.1016/j.biopsych.2008.05.012 Get rights and content

Background

As observed in depressed adults, there is considerable variability in the degree and direction of hypothalamic-pituitary-adrenal (HPA) dysfunction in depressed adolescents. The variability in HPA findings may be attributed to experiential factors.

Methods

A modified version of a standard psychosocial stressor used in adults, the Trier Social Stress Test (TSST), was administered to 30 adolescents with major depressive disorder and 25 healthy adolescent volunteers. Cortisol concentrations were measured in saliva samples collected before and after the stressor. Information was also gathered on early and recent adverse experiences with standard interviews.

Results

Participants from both groups had increased cortisol secretion in response to TSST. Compared with control subjects, depressed subjects showed more elevated and prolonged cortisol secretion in response to TSST. The combination of early-life adversity and high levels of chronic stress during adolescence was the most powerful predictor of enhanced adrenal response to the TSST.

Conclusions

These results support previous findings on the role of experiential factors on HPA response to stress and in the development of mood disorders. Dissection of the heterogeneous pathophysiology of adolescent depression will assist in developing more specific interventions for different subgroups of patients.

Section snippets

Participants

With approval from the institutional review board, 30 adolescents with depression and 25 control subjects were recruited. The depressed adolescents met criteria for major depressive disorder (MDD), with a minimum duration of 4 weeks and a score of 15 on the first 17-items of the Hamilton Depression Rating Scale (HDRS) (27). Adolescents with a current or prior history of mania, hypomania, substance use disorder symptoms, schizophrenia, schizoaffective disorder, or autism were excluded from the

Demographic and Clinical Characteristics of the Sample

Demographic and clinical features are outlined in Table 1. The groups did not differ significantly with respect to age, sex, and race/ethnicity. Depressed adolescents scored significantly higher on the BDI and HDRS, but lower on CGAS, than control subjects. Participants with depression scored significantly higher on early-life adversity and recent chronic stress. However, they did not differ significantly on the number of negative life events or magnitude of stress.

Baseline Cortisol Secretion and Cortisol Response to Psychosocial Stress

Serial cortisol secretory

Discussion

Depressed adolescents manifested higher and more prolonged adrenal response to a psychosocial stressor than healthy volunteers. The results suggest that in adolescents, as in children and adults, experiential factors influence HPA regulation (16, 17, 18). The HPA response to the stressor was highest in those who had a combination of early-life adversity and high levels of chronic stress during adolescence (17, 23).

Consistent with findings in humans, animal research has demonstrated that

References (50)

F. Holsboer
Stress, hypercortisolism and corticosteroid receptors in depression: Implications for therapy
J Affect Disord
(2001)
J. Kaufman et al.
Are child-, adolescent-, and adult-onset depression one and the same disorder?
Biol Psychiatry
(2001)
J. Kaufman et al.
The corticotrophin-releasing hormone challenge in depressed abused, depressed nonabused, and normal control children
Biol Psychiatry
(1997)
D.J. Newport et al.
Pituitary-adrenal responses to standard and low-dose dexamethasone suppression tests in adult survivors of child abuse
Biol Psychiatry
(2004)
H.M. Burke et al.
Depression and cortisol responses to psychological stress: A meta-analysis
Psychoneuroendocrinol
(2005)
J. Kaufman et al.
Schedule for Affective Disorders and Schizophrenia for School-aged Children-Present and Lifetime version (K-SADS-PL): Initial reliability and validity data
J Am Acad Child Adolesc Psychiatry
(1997)
K.A. Dienes et al.
The stress sensitization hypothesis: Understanding the course of bipolar disorder
J Affect Disord
(2006)
S.J. Crowley et al.
Sleep, circadian rhythms, and delayed phase in adolescence
Sleep Med
(2007)
R.E. Poland et al.
Saliva cortisol levels following dexamethasone administration in endogenously depressed patients
Life Sci
(1982)
C.O. Ladd et al.
Long-term behavioral and neuroendocrine adaptations to adverse early experience
Prog Brain Res
(2000)

S. Levine

Developmental determinants of sensitivity and resistance to stress

Psychoneuroendocrinology

(2005)

F. Holsboer et al.

Central CRH system in depression and anxiety—evidence from clinical studies with CRH₁ receptor antagonists

Eur J Pharmacology

(2008)

R.S. Duman et al.

Neural plasticity to stress and antidepressant treatment

Biol Psychiatry

(1999)

U. Rao et al.

Effect of bupropion on nocturnal urinary free cortisol and its association with antidepressant response

J Psychiatr Res

(2005)

D.L. Evans et al.

Mood disorders and medical illness: A major public health problem

Biol Psychiatry

(2003)

A.D. Lopez et al.

The Global Burden of Disease and Risk Factors

(2006)

B.L. Hankin et al.

Development of depression from preadolescence to young adulthood: Emerging gender differences in a 10-year longitudinal study

J Abnorm Psychology

(1998)

R.C. Kessler et al.

Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey replication

Arch Gen Psychiatry

(2005)

U. Rao

Development and natural history of pediatric depression: Treatment implications

Clinical Neuropsychiatry

(2006)

P. McCrone et al.

The Maudsley long-term follow-up of child and adolescent depression: Predicting costs in adulthood

Eur Child Adolesc Psychiatry

(2005)

M.M. Weissman et al.

Offspring of depressed parents: 20 years later

Am J Psychiatry

(2006)

G.W. Brown et al.

Social origins of depression: A reply

Psychol Med

(1978)

K.S. Kendler et al.

Causal relationship between stressful life events and the onset of major depression

Am J Psychiatry

(1999)

S.M. Monroe et al.

The social environment and depression: Focusing on severe life stress

C. Hammen et al.

Intergenerational transmission of depression: test of an interpersonal stress model in a community sample

J Consult Clin Psychology

(2004)

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Research ReportEffects of Early and Recent Adverse Experiences on Adrenal Response to Psychosocial Stress in Depressed Adolescents

Background

Methods

Results

Conclusions

Section snippets

Participants

Demographic and Clinical Characteristics of the Sample

Baseline Cortisol Secretion and Cortisol Response to Psychosocial Stress

Discussion

J Affect Disord

Biol Psychiatry

Biol Psychiatry

Biol Psychiatry

Psychoneuroendocrinol

J Am Acad Child Adolesc Psychiatry

J Affect Disord

Sleep Med

Life Sci

Prog Brain Res

Psychoneuroendocrinology

Eur J Pharmacology

Biol Psychiatry

J Psychiatr Res

Biol Psychiatry

The Global Burden of Disease and Risk Factors

Development of depression from preadolescence to young adulthood: Emerging gender differences in a 10-year longitudinal study

J Abnorm Psychology

Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey replication

Arch Gen Psychiatry

Development and natural history of pediatric depression: Treatment implications

Clinical Neuropsychiatry

The Maudsley long-term follow-up of child and adolescent depression: Predicting costs in adulthood

Eur Child Adolesc Psychiatry

Offspring of depressed parents: 20 years later

Am J Psychiatry

Social origins of depression: A reply

Psychol Med

Causal relationship between stressful life events and the onset of major depression

Am J Psychiatry

The social environment and depression: Focusing on severe life stress

Intergenerational transmission of depression: test of an interpersonal stress model in a community sample

J Consult Clin Psychology

Research Report
Effects of Early and Recent Adverse Experiences on Adrenal Response to Psychosocial Stress in Depressed Adolescents