DHEAS and cortisol/DHEAS-ratio in recurrent depression: State, or trait predicting 10-year recurrence?

Area of Science:

• Endocrinology
• Neuroscience
• Psychiatry

Background:

• Major depressive disorder (MDD) is linked to altered dehydroepiandrosterone-sulphate (DHEAS) and cortisol levels, but whether these are state-dependent or trait-like vulnerability markers is unclear.
• Previous research shows conflicting findings regarding DHEAS and cortisol in MDD, necessitating longitudinal studies to clarify their role.

Purpose of the Study:

• To investigate if low dehydroepiandrosterone-sulphate (DHEAS) and high cortisol/DHEAS-ratio in recurrent MDD represent a trait or a state-dependent effect.
• To examine the association of these hormonal profiles with previous depressive episodes, prospective recurrence, and the impact of cognitive therapy.

Main Methods:

• Cross-sectional comparison of salivary DHEAS and cortisol/DHEAS-ratio in remitted recurrent MDD patients and controls at study entry.
• Longitudinal assessment of these hormonal measures after an 8-week cognitive therapy trial and over a 2-year follow-up, with 10-year clinical symptom monitoring.

Main Results:

• Remitted MDD patients exhibited altered diurnal DHEAS decline and cortisol/DHEAS-ratio profiles compared to controls.
• No significant state-effect was observed for DHEAS or cortisol/DHEAS-ratio, nor association with the number of previous episodes.
• A higher morning cortisol/DHEAS-ratio predicted shorter time to recurrence, independent of cognitive therapy effects.

Conclusions:

• Altered diurnal profiles of DHEAS and cortisol/DHEAS-ratio in MDD appear to be stable traits, not state-dependent effects, suggesting they are endophenotypic vulnerability markers.
• These hormonal profiles may predict future recurrence of depression, offering potential targets for preventative strategies.
• Cognitive therapy did not influence DHEAS or cortisol/DHEAS-ratio levels, indicating their independence from treatment effects on mood.