Stress and serum cortisol levels in major depressive disorder: a cross-sectional study

Amanda G Bertollo; Roberta E Grolli; Marcos E Plissari; Vanessa A Gasparin; João Quevedo; Gislaine Z Réus; Margarete D Bagatini; Zuleide M Ignácio; Amanda G Bertollo; Roberta E Grolli; Marcos E Plissari; Vanessa A Gasparin; João Quevedo; Gislaine Z Réus; Margarete D Bagatini; Zuleide M Ignácio

doi:10.3934/Neuroscience.2020028

AIMS Neuroscience

2020, Volume 7, Issue 4: 459-469. doi: 10.3934/Neuroscience.2020028

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Research article Topical Sections

Stress and serum cortisol levels in major depressive disorder: a cross-sectional study

1.
Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Chapecó, SC, Brazil
2.
Santa Catarina State University, West Higher Education Center, Chapecó, SC, Brazil
3.
Laboratory of Translational Psychiatry, Graduate Program in Health Sciences, University of Southern Santa Catarina, Criciúma, SC, Brazil
4.
Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
5.
Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
6.
Neuroscience Graduate Program, Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
7.
Laboratory of Cell Culture, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Chapecó, SC, Brazil

Received: 29 August 2020 Accepted: 10 November 2020 Published: 13 November 2020

Major depressive disorder (MDD) is one of the disorders that most causes disability and affects about 265 million people worldwide, according to the World Health Organization (WHO). Chronic stress is one of the most prevalent factors that trigger MDD. Among the most relevant biological mechanisms that mediate stress and MDD are changes in the hypothalamic-pituitary-adrenal (HPA) axis function. Hypercortisolism is one of the relevant mechanisms involved in response to stress and is present in many people with MDD and in animals subjected to stress in the laboratory. This study aimed to investigate the levels of stress and cortisol in individuals diagnosed with MDD from the Basic Health Unit (BHU) in a small city in the western region of Santa Catarina, Brazil. Depression scores were assessed using Beck's inventory. For the investigation of stress, an adaptation with twenty-four questions of the Checklist-90-R manual was performed. The analysis of the cortisol levels in the individuals' serum was by the chemiluminescence method. Depression and stress scores were significantly higher in individuals with MDD than in control subjects (p < 0.001). Cortisol levels were also significantly higher in individuals with MDD (p < 0.05). Besides, depression scores were positively correlated with stress scores in individuals with MDD (Pearson's “r” = 0.70). Conclusion: Individuals with MDD had higher stress levels and cortisol than control subjects. The positive correlation between the levels of stress and depression in MDD individuals suggests that these conditions are related to a dysregulation of the HPA axis function.
- major depressive disorder,
- chronic stress,
- HPA axis,
- cortisol
Citation: Amanda G Bertollo, Roberta E Grolli, Marcos E Plissari, Vanessa A Gasparin, João Quevedo, Gislaine Z Réus, Margarete D Bagatini, Zuleide M Ignácio. Stress and serum cortisol levels in major depressive disorder: a cross-sectional study[J]. AIMS Neuroscience, 2020, 7(4): 459-469. doi: 10.3934/Neuroscience.2020028

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Abstract

Major depressive disorder (MDD) is one of the disorders that most causes disability and affects about 265 million people worldwide, according to the World Health Organization (WHO). Chronic stress is one of the most prevalent factors that trigger MDD. Among the most relevant biological mechanisms that mediate stress and MDD are changes in the hypothalamic-pituitary-adrenal (HPA) axis function. Hypercortisolism is one of the relevant mechanisms involved in response to stress and is present in many people with MDD and in animals subjected to stress in the laboratory. This study aimed to investigate the levels of stress and cortisol in individuals diagnosed with MDD from the Basic Health Unit (BHU) in a small city in the western region of Santa Catarina, Brazil. Depression scores were assessed using Beck's inventory. For the investigation of stress, an adaptation with twenty-four questions of the Checklist-90-R manual was performed. The analysis of the cortisol levels in the individuals' serum was by the chemiluminescence method. Depression and stress scores were significantly higher in individuals with MDD than in control subjects (p < 0.001). Cortisol levels were also significantly higher in individuals with MDD (p < 0.05). Besides, depression scores were positively correlated with stress scores in individuals with MDD (Pearson's “r” = 0.70). Conclusion: Individuals with MDD had higher stress levels and cortisol than control subjects. The positive correlation between the levels of stress and depression in MDD individuals suggests that these conditions are related to a dysregulation of the HPA axis function.

Abbreviation BHU: Basic health unit; HPA: Hypothalamic-Pituitary-Adrenal axis; MDD: Major depressive disorder; WHO: World Health Organization;
Acknowledgments

The Translational Psychiatry Program (USA) is funded by the Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth). Laboratory of Translational Psychiatry (Brazil) is one of the members of the Center of Excellence in Applied Neurosciences of Santa Catarina (NENASC). Its research is supported by grants from CNPq (JQ, GZR, ZMI, and MDB), FAPESC (JQ, GZR, ZMI, and MDB), Instituto Cérebro e Mente (JQ and GZR), UFFS (MDB and ZMI), and UNESC (JQ and GZR). JQ is a 1A CNPq Research Fellow. ZR assisted in writing and revised the manuscript. All authors read and approved the manuscript.

Author contributions

VAG and ZMI applied the questionnaires; MGB made the blood collections. AGB, MEP and MGB prepared the samples and tabulated the data. GZR did the statistical analysis. ZMI and AGB wrote the manuscript. JQ and G.

Conflict of interest

The authors declare no conflict of interest.

References

[1]	World Health Organization The Global Burden of Disease: 2004, 2008. Available from: https://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/.
[2]	World Health Organization Depression: Fact sheet. World Health Organization, 2020. Available from: https://www.who.int/news-room/fact-sheets/detail/depression.
[3]	Chapman DP, Whitfield CL, Felitti VJ, et al. (2004) Adverse childhood experiences and the risk of depressive disorders in adulthood. J Affect Disord 82: 217-225. doi: 10.1016/j.jad.2003.12.013
[4]	Ignácio ZM, Réus GZ, Abelaira HM, et al. (2017) Quetiapine treatment reverses depressive-like behavior and reduces DNA methyltransferase activity induced by maternal deprivation. Behav Brain Res 320: 225-232. doi: 10.1016/j.bbr.2016.11.044
[5]	Vranceanu AM, Hobfoll SE, Johnson RJ (2007) Child multi-type maltreatment and associated depression and PTSD symptoms: The role of social support and stress. Child Abuse Negl 31: 71-84. doi: 10.1016/j.chiabu.2006.04.010
[6]	Ignácio ZM, Réus GZ, Abelaira HM, et al. (2014) Epigenetic and epistatic interactions between serotonin transporter and brain-derived neurotrophic factor genetic polymorphism: insights in depression. Neuroscience 275: 455-468. doi: 10.1016/j.neuroscience.2014.06.036
[7]	Hasin DS, Sarvet AL, Meyers JL, et al. (2018) Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States. JAMA Psychiatry 75: 336-346. doi: 10.1001/jamapsychiatry.2017.4602
[8]	Constance H (2005) Stress and Depression. Rev Clin Psychol 1: 293-319. doi: 10.1146/annurev.clinpsy.1.102803.143938
[9]	Gold PW, Machado-Vieira R, Pavlatou MG (2015) Clinical and biochemical manifestations of depression: relation to the neurobiology of stress. Neural Plast 2015: 581976.
[10]	Lima-Ojeda JM, Rupprecht R, Baghai TC (2018) Neurobiology of depression: A neurodevelopmental approach. World J Biol Psychiatry 19: 349-359. doi: 10.1080/15622975.2017.1289240
[11]	Vythilingam M, Heim C, Newport J, et al. (2002) Childhood trauma associated with smaller hippocampal volume in women with major depression. Am J Psychiatry 159: 2072-2080. doi: 10.1176/appi.ajp.159.12.2072
[12]	Aan Het Rot M, Mathews SJ, Charney DS (2009) Neurobiological mechanisms in major depressive disorder. CMAJ 180: 305-313. doi: 10.1503/cmaj.080697
[13]	Ignácio ZM, Da Silva RS, Plissari ME, et al. (2019) Physical Exercise and Neuroinflammation in Major Depressive Disorder. Mol Neurobiol 56: 8323-8335. doi: 10.1007/s12035-019-01670-1
[14]	Ignácio ZM, Réus GZ, Quevedo J, et al. (2017) Maternal Deprivation. Reference Module in Neuroscience and Biobehavioral Psychology. Elsevier Available from: https://doi.org/10.1016/B978-0-12-809324-5.00352-7.
[15]	Saraceno B, Levav I, Kohn R (2005) The public mental health significance of research on socioeconomic factors in schizophrenia and major depression. World Psychiatry 4: 181-185.
[16]	Lorant V, Deliege D, Eaton W, et al. (2003) Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol 157: 98-112. doi: 10.1093/aje/kwf182
[17]	Husain N, Creed F, Tomenson B (2002) Depression and social stress in Pakistan. Psychol Med 30: 395-402. doi: 10.1017/S0033291700001707
[18]	Probst JC, Laditka S, Moore CG, et al. (2005) Depression in rural populations: Prevalence, effects on life quality and treatment-seeking behavior. South Carolina Rural Health Res Cent. 1-64.
[19]	Sidlauskaitė-Stripeikienė I, Zemaitienė N, Klumbienė J (2010) Associations between depressiveness and psychosocial factors in Lithuanian rural population. Medicina 46: 693-699. doi: 10.3390/medicina46100098
[20]	(2010) SEBRAESanta Catarina em Números: Nova Erechim. Florianópolis: Sebrae/SC: 113.
[21]	Derogatis LR (1994) SCL-90-R: symptom checklist-90-R: administration, scoring & procedures manual Minneapolis: National Computer Systems, 123.
[22]	Lipp MEN, Guevara AJH (1994) Validação empírica do Inventário de Sintomas de Stress. Estud de Psicologia 11: 43-49.
[23]	Henna E, Zilberman ML (2016) Instrumentos de Avaliação de Aspectos Adicionais Relacionados à Saúde Mental. Instrumentos de Avaliação em Saúde Mental Porto Alegre: Editora Artmed, 432-435.
[24]	Gorestein C, Andrade LHSG (1998) Inventário de depressão de Beck: propriedades psicométricas da versão em português. Rev de Psiquiatr Clín 25: 245-250.
[25]	Kominami G, Fujisaka I, Yamauchi A, et al. (1980) A sensitive enzime immunoassay for plasma cortisol. Clin Chim Acta 103: 381-391. doi: 10.1016/0009-8981(80)90158-8
[26]	Holder G (2006) Measurement of Glucocorticoids in Biological Fluids. Methods in Molecular Biology: Hormone Assays in Biological Fluids Totowa: Humana Press, 141-157. doi: 10.1385/1-59259-986-9:141
[27]	Richter P, Werner J, Heerlein A, et al. (1998) On the validity of the Beck Depression Inventory. A review. Psychopathology 31: 160-168. doi: 10.1159/000066239
[28]	Tolahunase MR, Sagar R, Faiq M, et al. (2018) Yoga- and meditation-based lifestyle intervention increases neuroplasticity and reduces severity of major depressive disorder: A randomized controlled trial. Restor Neurol Neurosci 36: 423-442.
[29]	Kazemi A, Noorbala AA, Azam K, et al. (2018) Effect of probiotic and prebiotic vs placebo on psychological outcomes in patients with major depressive disorder: A randomized clinical trial. Clin Nutr 38: 522-528. doi: 10.1016/j.clnu.2018.04.010
[30]	DiNapoli EA, Pierpaoli CM, Shah A, et al. (2017) Effects of Home-Delivered Cognitive Behavioral Therapy (CBT) for Depression on Anxiety Symptoms among Rural, Ethnically Diverse Older Adults. Clin Gerontol 40: 181-190. doi: 10.1080/07317115.2017.1288670
[31]	Simpkin AL, Khan A, West DC, et al. (2018) Stress From Uncertainty and Resilience Among Depressed and Burned Out Residents: A Cross-Sectional Study. Acad Pediatr 18: 698-704. doi: 10.1016/j.acap.2018.03.002
[32]	Hill MN, Hellemans KG, Verma P, et al. (2012) Neurobiology of chronic mild stress: parallels to major depression. Neurosci Biobehav Rev 36: 2085-2117. doi: 10.1016/j.neubiorev.2012.07.001
[33]	Hodes GE, Kana V, Menard C, et al. (2015) Neuroimmune mechanisms of depression. Nat Neurosci 18: 1386-1393. doi: 10.1038/nn.4113
[34]	Dean J, Keshavan M (2017) The neurobiology of depression: An integrated view. Asian J Psychiatr 27: 101-111. doi: 10.1016/j.ajp.2017.01.025
[35]	Kennis M, Gerritsen L, Van Dalen M, et al. (2020) Prospective biomarkers of major depressive disorder: a systematic review and meta-analysis. Mol Psychiatry 25: 321-338. doi: 10.1038/s41380-019-0585-z
[36]	Padgett DA, Glaser R (2003) How stress influences the immune response. Trends Immunol 24: 444-448. doi: 10.1016/S1471-4906(03)00173-X
[37]	Slavich GM, Irwin MR (2014) From stress to inflammation and major depressive disorder: A social signal transduction theory of depression. Psychol Bull 140: 774-815. doi: 10.1037/a0035302
[38]	Jia Y, Liu L, Sheng C, et al. (2019) Increased Serum Levels of Cortisol and Inflammatory Cytokines in People With Depression. J Nerv Ment Dis 207: 271-276. doi: 10.1097/NMD.0000000000000957
[39]	Rohleder N (2012) Acute and chronic stress induced changes in sensitivity of peripheral inflammatory pathways to the signals of multiple stress systems—2011 Curt Richter award winner. Psychoneuroendocrinology 37: 307-316. doi: 10.1016/j.psyneuen.2011.12.015
[40]	Burke HM, Davis MC, Otte C, et al. (2005) Depression and cortisol responses to psychological stress: A meta-analysis. Psychoneuroendocrinology 30: 846-856. doi: 10.1016/j.psyneuen.2005.02.010
[41]	Fiksdal A, Hanlin L, Kuras Y, et al. (2019) Associations Between Symptoms of Depression and Anxiety and Cortisol Responses to and Recovery from Acute Stress. Psychoneuroendocrinology 102: 44-52. doi: 10.1016/j.psyneuen.2018.11.035
[42]	Chen L, Deng H, Cui H, et al. (2018) Inflammatory responses and inflammation-associated diseases in organs. Oncotarget 9: 7204-7218. doi: 10.18632/oncotarget.23208
[43]	Chan KL, Cathomas F, Russo SJ (2019) Central and Peripheral Inflammation Link Metabolic Syndrome and Major Depressive Disorder. Physiol Bethesda 34: 123-133. doi: 10.1152/physiol.00047.2018
[44]	Brydon L, Edwards S, Mohamed-Ali V, et al. (2004) Socioeconomic status and stress-induced increases in interleukin-6. Brain Behav Immun 18: 281-290. doi: 10.1016/j.bbi.2003.09.011

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