Saliva cortisol and male depressive syndrome in a community study. The Sudurnesjamenn study

The degree and direction of hypothalamic-pituitary-adrenal (HPA) dysfunction to male mental health is unclear.

The aim of the study was to investigate the relationship between cortisol and male mental health.

In this community study, 534 males were screened, using the Beck Depression Inventory (BDI), Gotland Male Depression Scale (GMDS) and a general health questionnaire. Those with signs of depression (n = 65) and controls (n = 69) were evaluated in a psychiatric examination according to the DSM-IV criteria for depressive disorder (DD). In a sub-sample (n = 51) saliva cortisol was measured five times on a single day.

Evening cortisol was significantly higher in untreated individuals with DD. Significantly higher evening cortisol (at 22 h) correlated also with a history of physical disorder, a history of any mental disorder and MADRS score ≥ 20 (Montgomery-Åsberg Depression Rating Scale). High cortisol, measured as AUC (area under curve), correlated with a high MADRS score but not with any other health variable tested. Morning cortisol did not correlate with any health variable; however, cortisol awakening response (CAR) could not be investigated. The BDI and GMDS scores did not correlate with cortisol measurements.

Evening saliva cortisol measurement seems most informative, as it correlates with male depressive syndrome in our study but replications with larger studies are needed.