THE RELATIONSHIP BETWEEN LONGITUDINAL CLINICAL COURSE AND SLEEP AND CORTISOL CHANGES IN ADOLESCENT DEPRESSION

This study examined the relationship between longitudinal clinical cou rse and sleep and cortisol findings in adolescent unipolar major depre ssive disorder (MDD), Subjects were 28 adolescents (15.4 +/- 1.3 years ) systematically diagnosed with unipolar MDD and 35 group-matched norm al controls who participated ill EEG sleep and neuroendocrine studies. Follow-up clinical assessments were conducted 7.0 +/- 0.5 years later in 94% of the original cohort, Although initial group comparisons fai led to shaw significant differences in biologic measures, analyses inc orporating clinical follow-up reveal that changes in sleep and cortiso l measures are associated with differential longitudinal course, Norma l controls who would develop depression after the biologic studies had shown significantly higher density of rapid eye movements (REM) and a trend for reduced REM latency compared to controls with no psychiatri c disorder at follow-up. Depressed subjects with a recurrent unipolar course showed a trend towards elevated plasma cortisol near sleep onse t compared to MDD subjects with no further episodes during the follow- up interval.