Recurrence of Depression in Relation to History of Childhood Trauma and Hair Cortisol Concentration in a Community-Based Sample

Abstract

Background: Childhood trauma represents a risk factor for developing depression with increased rates of recurrence. Mechanisms involved include a disturbed regulation of the hypothalamic–pituitary–adrenal (HPA) axis. Hair cortisol concentration (HCC) is a measure of long-term HPA axis activity with less interference from circadian and confounding factors. However, no study has so far used HCC to investigate the role of childhood trauma in recurrent pattern of depressive symptoms. Methods: A community-based sample of 500 participants was recruited, and depression was assessed at 3 time points using the Revised Clinical Interview Schedule. The Childhood Trauma Questionnaire was administered to identify a history of childhood trauma. Hair samples were obtained from 144 participants for analysis of cortisol. Results: Patients with recurrent depression had higher rates of childhood trauma compared to participants with no depression. Participants with current-only depression had increased HCC compared to the no depression group, while this was absent in participants with recurrent depression. Within the depressed group (both current-only and recurrent depression), those with a history of childhood physical abuse had lower HCC when compared to those with no such history. Conclusions: Our findings show that retrospectively reported childhood trauma is associated with protracted trajectories of depression and a distinct pattern of long-term HPA axis activity.

Relationship of Hair Cortisol with History of Psychosis, Neuropsychological Performance and Functioning in Remitted Later-Life Major Depression

“…Generally, studies investigating HCC in current MDD have had mixed results, with findings that HCC is higher [42, 43] than, or the same [44-46], or lower [47] as healthy controls. Some of these studies reported on the influence of various additional clinical variables.…”

Childhood maltreatment and clinical severity of treatment‐resistant depression in a French cohort of outpatients (FACE‐DR): One‐year follow‐up

“…Childhood maltreatment significantly impacts the proinflammatory immune state (Baumeister et al, 2016; Müller et al, 2019). In addition, childhood maltreatment seems to play a key role in HPA function and dysfunction in adulthood (Duncko et al, 2019).…”

Evaluation of the HPA Axis’ Response to Pharmacological Challenges in Experimental and Clinical Early-Life Stress-Associated Depression

“…Recently, Spitzer et al (2018) determined that free salivary cortisol responses were not significantly different between women with or without major depression and with or without ELS history. Duncko et al (2019) found that within depressed patients, those with a history of ELS presented lower cortisol concentration when compared with those with no such history, although they have used hair cortisol, and not plasma cortisol, to assess it.…”

“…Particularly, early-life stress (ELS), such as childhood neglect; parental deprivation; lack of basic care; physical, sexual, and psychological violence (Heim et al, 2000;Cohen et al, 2001;Martins-Monteverde et al, 2019), have been shown as risk factors for depression in adulthood (Cohen et al, 2001;Heim and Nemeroff, 2001;Kendler et al, 2002). ELS can affect the clinical course and worsen the treatment outcome (Tunnard et al, 2014;Williams et al, 2016;Duncko et al, 2019) and can be related to disturbed development of brain structures during this neurodevelopmental window (Anisman et al, 1998;Andersen, 2003;Murmu et al, 2006;Lupien et al, 2009;Krugers et al, 2017).…”