Exploring the Pathophysiology of Chronic Depression: The Interplay between Depression, Cortisol Responses, and Personality

Chronic major depressive disorder (CMDD) is a common and debilitating illness. Its pathophysiology needs further elucidation, before more effective targeted treatments can be developed for this condition. To gain a better understanding of the psychobiology of CMDD, three interconnected studies were conducted that examined the interplay between chronic depression, cortisol responses, and personality. Study 1 examined cortisol responses to the Trier Social Stress Test (TSST) in CMDD participants (n=29) as compared to healthy controls (n=28). It was hypothesized that cortisol responses would be greater in the CMDD population. Results indicated that females with CMDD had increased cortisol output compared to female controls, a pattern consistent with the hypothesis. However, males with CMDD had decreased cortisol responses compared to male controls. These results suggest that cortisol responses to social stress are altered in those with CMDD; however, females and males experience fundamentally different changes. Study 2 examined moderating effects of personality on cortisol responses to the TSST in those with CMDD (n=51) as compared to healthy controls (n=57). It was hypothesized that higher neuroticism and/or lower extraversion would be associated with increased cortisol responses in CMDD participants. As hypothesized, lower extraversion was associated with increased cortisol reactivity in those with CMDD but not in healthy controls. However, no association was found between neuroticism and cortisol responses. These findings could support the notion that lower extraversion is a vulnerability marker for chronic depression and thus a possible target for treatment. Study 3, evaluated the cortisol awakening response (CAR) in CMDD participants (n=27) compared to healthy controls (n=30). It was hypothesized that such awakening responses would be more pronounced in the depressed population compared to controls. Contrary to expectation, no differences were found between the groups. However, lower extraversion was associated with a lower CAR in both CMDD and healthy controls, a finding that was not anticipated a priori. These interconnected studies suggest that examining relationships between depression, cortisol responses, and personality, can assist with identifying distinct psychobiological profiles in those with chronic depression. It is proposed that this strategy will improve the likelihood of developing more targeted treatments for this population.

Department dc:contributor.department

Medical Science

Year dc:date.issued

2013

Author dc:creator

• Chopra, Kevin

Advisor dc:contributor.advisor

• Levitan, Robert

• cortisol
• chronic depression
• social stress
• personality
• neuroticism
• extraversion
• hypothalamic-pituitary-adrenal

Language dc:language.iso

en_ca

Handle dc:identifier.uri

http://hdl.handle.net/1807/35793

OAI identifier oai:identifier

oai:utoronto.scholaris.ca:1807/35793