Elsevier

Journal of Affective Disorders

Volume 299, 15 February 2022, Pages 559-567
Journal of Affective Disorders

Association of childhood maltreatment and cortisol with the severity and stability of depression symptoms

https://doi.org/10.1016/j.jad.2021.12.036Get rights and content
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open access

Highlights

  • Latent class analysis based on the mean and variance of depression symptoms over ten years

  • Childhood maltreatment and blunted morning cortisol contribute to a worse depression course

  • Low morning cortisol may indicate problems with energy levels and sleep, not clinical depression

  • Childhood maltreatment and cortisol appear to relate independently to depression symptoms

Abstract

Background

Little is known about patterns of depression symptoms over time in older adults. This study aims to assess the association of childhood maltreatment and cortisol levels with latent classes of depression symptoms over ten years in older adults.

Methods

A total of 752 participants (mean age 61.7±9.5, female 18%) in the Second Manifestations of ARTerial disease-Memory, depression and aging (SMART-Medea) study provided up to twenty measures of depression symptoms over ten years based on the Patient Health Questionnaire-9 (PHQ-9). At baseline, salivary cortisol was measured, and childhood maltreatment was assessed. Responses to the PHQ-9 were indicators in a latent class analysis. Multinomial regression determined associations between class membership and cortisol and maltreatment, adjusting for age, sex, and education.

Results

Four distinct classes were identified; never depressed (n=275, 37%), energy/sleep difficulties (n=237, 32%), mild depression symptoms (n=152, 20%) and fluctuating severe depression (n=88, 12%). Childhood maltreatment was associated with mild depression symptoms (OR=1.95, 95% CI: 1.17-3.25) and fluctuating severe depression (OR=3.50, 95% CI: 1.99-6.15). Blunted morning cortisol was associated with energy/sleep difficulties (OR=0.98, 95% CI: 0.95-1.00) and fluctuating severe depression (OR=0.96, 95% CI: 0.92-0.99). There was no evidence for interaction between maltreatment and cortisol.

Limitations

There is limited generalizability due to the cohort consisting of participants with atherosclerosis and being mostly male. This study utilizes retrospective self-reporting of childhood maltreatment.

Conclusion

Childhood maltreatment and blunted morning cortisol independently contribute to a worse depression course. Blunted morning cortisol may contribute to sub-clinical depression symptoms, specifically difficulties with energy levels and sleep.

Keywords

Depression symptoms
Cortisol
Childhood maltreatment
Age
Latent class analysis

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