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Predicting mental disorders from hypothalamic-pituitary-adrenal axis functioning: a 3-year follow-up in the TRAILS study

Published online by Cambridge University Press:  19 March 2015

E. Nederhof ,
F. V. A. van Oort ,
E. M. C. Bouma ,
O. M. Laceulle ,
A. J. Oldehinkel  and
J. Ormel
E. Nederhof*
Affiliation:
University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands
F. V. A. van Oort
Affiliation:
Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
E. M. C. Bouma
Affiliation:
University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands
O. M. Laceulle
Affiliation:
University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands
A. J. Oldehinkel
Affiliation:
University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands
J. Ormel
Affiliation:
University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands
*
*Address for correspondence: Dr E. Nederhof, Ph.D., Interdisciplinary Center Psychopathology and Emotion Regulation, University Center for Psychiatry, University Medical Center Groningen, University of Groningen, CC72, PO Box 30001, 9700RB Groningen, The Netherlands. (Email: e.nederhof@umcg.nl)
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Abstract

Background

Hypothalamic-pituitary-adrenal axis functioning, with cortisol as its major output hormone, has been presumed to play a key role in the development of psychopathology. Predicting affective disorders from diurnal cortisol levels has been inconclusive, whereas the predictive value of stress-induced cortisol concentrations has not been studied before. The aim of this study was to predict mental disorders over a 3-year follow-up from awakening and stress-induced cortisol concentrations.

Method

Data were used from 561 TRAILS (TRacking Adolescents’ Individual Lives Survey) participants, a prospective cohort study of Dutch adolescents. Saliva samples were collected at awakening and half an hour later and during a social stress test at age 16. Mental disorders were assessed 3 years later with the Composite International Diagnostic Interview (CIDI).

Results

A lower cortisol awakening response (CAR) marginally significantly predicted new disorders [odds ratio (OR) 0.77, p = 0.06]. A flat recovery slope predicted disorders with a first onset after the experimental session (OR 1.27, p = 0.04). Recovery revealed smaller, non-significant ORs when predicting new onset affective or anxiety disorders, major depressive disorder, or dependence disorders in three separate models, corrected for all other new onsets.

Conclusions

Our results suggest that delayed recovery and possibly reduced CAR are indicators of a more general risk status and may be part of a common pathway to psychopathology. Delayed recovery suggests that individuals at risk for mental disorders perceived the social stress test as less controllable and less predictable.

Keywords

Depressiongeneral psychopathologylongitudinalphobiaprospectivepsychiatric diagnosispublic speaking tasksocial stress testsubstance dependence
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 11 , August 2015 , pp. 2403 - 2412
Copyright
Copyright © Cambridge University Press 2015 

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