Cortisol levels can serve as differentiating marker for depressed patients

Depression is associated with hyperactivity of the hypothalamo-pituitary adrenal axis. Cortisol has been suggested to be a biological marker of stress and anxiety. A recent meta-analysis by Sahu et al, published in Indian Journal of Psychiatry, compared serum or plasma cortisol levels between depressive patients and healthy controls and concluded that cortisol levels are significantly higher in depressed patients.

Depression is a common and morbid psychiatric illness and is a leading cause of disability. Cortisol is a steroid hormone of glucocorticoid class and its plays an important role in the development and expression of behavioral changes in human. Depression is well-recognized to be associated with hypercortisolemia as a result of hyperfunctioning of hypothalamo-pituitary-adrenal axis. Serum or plasma cortisol levels have been previously studied in depressive patients but reported contradictory results.

In this analysis, the data was collected from various database sites retrospectively from January 2021 to January 1990. Out of 1926 studies identified in the databases, 17 studies were selected and entered in the meta-analysis with 1400 population were pooled (743 for depressive and 657 for control).

The pooled SMD of the serum or plasma cortisol levels in depressive patients compared with controls was 1.18, (95% CI: 0.84, 1.52; P < 0.00001) with I2 = 85% (Ph < 0.00001). The findings revealed that the Asian, European, American, South American, and Egyptian population had higher serum or plasma cortisol levels in depressive patients as compared with the controls. The differences were significant when the samples were processed by ELISA and various other methods.

Based on the findings of this meta-analysis, it can be concluded that serum or plasma cortisol level can differentiate depressed patients from nondepressed controls, it is a good indicator to differentiate between depressive patients and controls. The findings are consistent with previous studies reporting the relationship of depression with the functioning of the HPA axis.

Source: Indian Journal of Psychiatry: doi: 10.4103/indianjpsychiatry.indianjpsychiatry_561_21