The ratio of morning cortisol to CRP prospectively predicts first-onset depression in at-risk adolescents

E R Landau; M B Raniti; M Blake; J M Waloszek; L Blake; J G Simmons; O Schwartz; G Murray; J Trinder; N B Allen; M L Byrne

doi:10.1016/j.socscimed.2021.114098

The ratio of morning cortisol to CRP prospectively predicts first-onset depression in at-risk adolescents

Soc Sci Med. 2021 Jul:281:114098. doi: 10.1016/j.socscimed.2021.114098. Epub 2021 Jun 4.

Authors

E R Landau¹, M B Raniti², M Blake³, J M Waloszek⁴, L Blake³, J G Simmons⁵, O Schwartz⁶, G Murray⁷, J Trinder¹, N B Allen⁸, M L Byrne⁹

Affiliations

¹ Melbourne School of Psychological Sciences, 12th floor Redmond Barry Building, The University of Melbourne, Melbourne, Victoria, 3010 Australia.
² Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, 3052 Australia; Department of Paediatrics, Melbourne Medical School, University of Melbourne, Parkville, Victoria, 3010, Australia.
³ Melbourne School of Psychological Sciences, 12th floor Redmond Barry Building, The University of Melbourne, Melbourne, Victoria, 3010 Australia; Eucalyptus Psychology, 146 Cardigan Rd, Mooroolbark, Vic, 3138, Australia.
⁴ Melbourne School of Psychological Sciences, 12th floor Redmond Barry Building, The University of Melbourne, Melbourne, Victoria, 3010 Australia; Department of Psychological Sciences, Swinburne University of Technology, John St, Hawthorn 3122 Australia.
⁵ Melbourne School of Psychological Sciences, 12th floor Redmond Barry Building, The University of Melbourne, Melbourne, Victoria, 3010 Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, Australia.
⁶ Melbourne School of Psychological Sciences, 12th floor Redmond Barry Building, The University of Melbourne, Melbourne, Victoria, 3010 Australia; Orygen, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, 3052, Australia.
⁷ Centre for Mental Health, Swinburne University of Technology, Burwood Rd Hawthorn 3122 Australia.
⁸ Melbourne School of Psychological Sciences, 12th floor Redmond Barry Building, The University of Melbourne, Melbourne, Victoria, 3010 Australia; Department of Psychology, University of Oregon, 1585 E 13th Avenue, Eugene, Oregon, 97403 USA.
⁹ Department of Psychology, University of Oregon, 1585 E 13th Avenue, Eugene, Oregon, 97403 USA; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, 3800 Australia. Electronic address: michelle.byrne@monash.edu.

PMID: 34126291
DOI: 10.1016/j.socscimed.2021.114098

Abstract

Rationale: Early-onset adolescent depression is related to poor prognosis and a range of psychiatric and medical comorbidities later in life, making the identification of a priori risk factors for depression highly important. Increasingly, dysregulated levels of immune and neuroendocrine markers, such as C-reactive protein (CRP) and cortisol, have been demonstrated as both precursors to and consequences of depression. However, longitudinal research with adolescent populations is limited and demonstrates mixed immuno-endocrine-depression links.

Objective: This study explored the putative bidirectional relationship between salivary measures of cortisol (Cort) and CRP, including the novel Cort:CRP ratio and depression.

Methods: Participants from the randomized control trial 'Sleep and Education: learning New Skills Early' (SENSE) Study were 122 adolescents at risk for depression (73 females) aged 12-16 years (M = 12.71 years, SD = 1.01 years) assessed at baseline (T1), post-intervention (T2), and a two-year follow-up (T3).

Results: Logistic regression results demonstrated that adolescents with higher T1 Cort:CRP_morn ratio levels were two-fold more likely to develop a first-onset depressive disorder from T2 to T3 as compared to adolescents with lower Cort:CRP_morn ratio levels, β = 0.73, t (36) = 2.15, p = .04, OR = 2.08. This effect was not moderated by treatment condition (β = -1.38, t (13) = -1.33, p = .20) and did not change when controlling for known risk factors for depression, including sex, age, body-mass index, socio-economic status, T1 anxiety disorder, nor T1 sleep disturbance, anxiety, or depressive symptoms (β = 0.91, t (31) = 2.14, p = .04).

Conclusion: Results highlight potential immuno-endocrine dysregulation as an underlying risk factor for adolescent first-onset depression, and may inform the development of targeted, preventative biobehavioral treatment strategies for youth depression.

Keywords: Adolescence; C-reactive protein; Cortisol; Depression; Risk factors.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Anxiety
Biomarkers
C-Reactive Protein*
Depression / diagnosis
Depression / epidemiology
Female
Humans
Hydrocortisone*

Substances

Biomarkers
C-Reactive Protein
Hydrocortisone

Grants and funding

K01 MH111951/MH/NIMH NIH HHS/United States