Im. Goodyer et al., Psychosocial and endocrine features of chronic first-episode major depression in 8-16 year olds, BIOL PSYCHI, 50(5), 2001, pp. 351-357
Background: Psychoendocrine processes may have a role in explaining individ
ual differences in the outcome of major depression in 8-16-year-old school
children.
Methods: Salivary cortisol and dehydroepiandrosterone (DHEA) levels at 8:00
am and 8:00 pm, life events, and comorbidity were assessed at presentation
, 36, and 72 weeks in 47 (60%) of 78 clinically referred subjects with a fi
rst episode of major depression. Comparisons were made between chronic and
nonchronic major depression.
Results: Chronic depression was characterized by being older, cortisol hype
rsecretion at 8:00 Pm at all three assessments, increasing depression-depen
dent life events over the follow-up period, and comorbid obsessive-compulsi
ve disorder (OCD) at presentation and at 36 weeks. Chronicity may be best p
redicted by increasing depression-dependent events over the 72-week period.
Such events are more likely in cases with evening cortisol hypersecretion
at entry and persistent OCD. Variations in DHEA levels were not associated
with chronicity or increasing life events.
Conclusions: During adolescence, but not childhood, the persistence of majo
r depression may occur through an increase of risk for further and particul
ar types of depression-dependent undesirable life events (personal disappoi
ntments and/or dangers to the self), that are more likely in those subjects
with persisting cortisol hypersecretion and unresolved comorbid OCD. Biol
Psychiatry 2001; 50:351-357 (C) 2001 Society of Biological Psychiatry.