The cortisol awakening response at admission to hospital predicts depression severity after discharge in major depressive disorder patients—A replication study
The cortisol awakening response (CAR) is a non-invasive biomarker for hypothalamic-pituitary-adrenal axis (HPA) dysregulation, reflecting accumulated stress over time. In a previous study we reported that a blunted CAR before an inpatient treatment predicted self-reported depressive symptoms six wee...
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| Format: | Article |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2022.952903/full |
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| author | Sabrina Neyer Michael Witthöft Mark Cropley Markus Pawelzik Stefan Sütterlin Stefan Sütterlin Ricardo G. Lugo |
| author_facet | Sabrina Neyer Michael Witthöft Mark Cropley Markus Pawelzik Stefan Sütterlin Stefan Sütterlin Ricardo G. Lugo |
| author_sort | Sabrina Neyer |
| collection | DOAJ |
| description | The cortisol awakening response (CAR) is a non-invasive biomarker for hypothalamic-pituitary-adrenal axis (HPA) dysregulation, reflecting accumulated stress over time. In a previous study we reported that a blunted CAR before an inpatient treatment predicted self-reported depressive symptoms six weeks and six months after discharge [Eikeseth, F. F., Denninghaus, S., Cropley, M., Witthöft, M., Pawelzik, M., & Sütterlin, S. (2019). The cortisol awakening response at admission to hospital predicts depression severity after discharge in major depressive disorder (MDD) patients. Journal of Psychiatric Research, 111, 44-50)]. This replication study adopted an improved overall methodology with more stringent assessment protocols and monitoring. The longitudinal design included 122 inpatients from a psychosomatic hospital with a diagnosis of MDD displaying symptoms of moderate to severe major depression (n = 80 females). The CAR was measured at intake. Depression severity was assessed as Beck Depression Inventory II scores at intake, discharge, 6 weeks and 6 months following discharge. Results from the original study were replicated in terms of effect size but did not reach statistical significance (correlation between BDI-II 6 months after discharge and AUCg: r = −0.213; p = 0.054). The replication study yielded nearly identical correlation coefficients as in the original study (BDI-II 6 months and CAR, r = −0.223, p < 0.05). The replication of previously reported effect sizes with a concurrent lack of statistical significance in the more restrictive, larger and better controlled replication study may well inform research on psycho-endocrinological predictors for treatment success, but suggests a rather limited practical relevance for cortisol awakening response measures in this clinical context. |
| first_indexed | 2024-04-11T10:10:31Z |
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| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-04-11T10:10:31Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-5e8f9942043f46078d25fecacb04279a2022-12-22T04:30:07ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2022-10-011610.3389/fnins.2022.952903952903The cortisol awakening response at admission to hospital predicts depression severity after discharge in major depressive disorder patients—A replication studySabrina Neyer0Michael Witthöft1Mark Cropley2Markus Pawelzik3Stefan Sütterlin4Stefan Sütterlin5Ricardo G. Lugo6EOS-Klinik, Münster, GermanyDepartment for Clinical Psychology, Psychotherapy and Experimental Psychopathology, University of Mainz, Mainz, GermanySchool of Psychology, University of Surrey, Guildford, United KingdomEOS-Klinik, Münster, GermanyFaculty for Health and Welfare Sciences, Østfold University College, Østfold, NorwayHochschule Albstadt-Sigmaringen, Sigmaringen, GermanyFaculty for Health and Welfare Sciences, Østfold University College, Østfold, NorwayThe cortisol awakening response (CAR) is a non-invasive biomarker for hypothalamic-pituitary-adrenal axis (HPA) dysregulation, reflecting accumulated stress over time. In a previous study we reported that a blunted CAR before an inpatient treatment predicted self-reported depressive symptoms six weeks and six months after discharge [Eikeseth, F. F., Denninghaus, S., Cropley, M., Witthöft, M., Pawelzik, M., & Sütterlin, S. (2019). The cortisol awakening response at admission to hospital predicts depression severity after discharge in major depressive disorder (MDD) patients. Journal of Psychiatric Research, 111, 44-50)]. This replication study adopted an improved overall methodology with more stringent assessment protocols and monitoring. The longitudinal design included 122 inpatients from a psychosomatic hospital with a diagnosis of MDD displaying symptoms of moderate to severe major depression (n = 80 females). The CAR was measured at intake. Depression severity was assessed as Beck Depression Inventory II scores at intake, discharge, 6 weeks and 6 months following discharge. Results from the original study were replicated in terms of effect size but did not reach statistical significance (correlation between BDI-II 6 months after discharge and AUCg: r = −0.213; p = 0.054). The replication study yielded nearly identical correlation coefficients as in the original study (BDI-II 6 months and CAR, r = −0.223, p < 0.05). The replication of previously reported effect sizes with a concurrent lack of statistical significance in the more restrictive, larger and better controlled replication study may well inform research on psycho-endocrinological predictors for treatment success, but suggests a rather limited practical relevance for cortisol awakening response measures in this clinical context.https://www.frontiersin.org/articles/10.3389/fnins.2022.952903/fullcortisol awakening responsedepressionHPA axisbiomarkerfollow-upreplication study |
| spellingShingle | Sabrina Neyer Michael Witthöft Mark Cropley Markus Pawelzik Stefan Sütterlin Stefan Sütterlin Ricardo G. Lugo The cortisol awakening response at admission to hospital predicts depression severity after discharge in major depressive disorder patients—A replication study Frontiers in Neuroscience cortisol awakening response depression HPA axis biomarker follow-up replication study |
| title | The cortisol awakening response at admission to hospital predicts depression severity after discharge in major depressive disorder patients—A replication study |
| title_full | The cortisol awakening response at admission to hospital predicts depression severity after discharge in major depressive disorder patients—A replication study |
| title_fullStr | The cortisol awakening response at admission to hospital predicts depression severity after discharge in major depressive disorder patients—A replication study |
| title_full_unstemmed | The cortisol awakening response at admission to hospital predicts depression severity after discharge in major depressive disorder patients—A replication study |
| title_short | The cortisol awakening response at admission to hospital predicts depression severity after discharge in major depressive disorder patients—A replication study |
| title_sort | cortisol awakening response at admission to hospital predicts depression severity after discharge in major depressive disorder patients a replication study |
| topic | cortisol awakening response depression HPA axis biomarker follow-up replication study |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2022.952903/full |
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