TY - JOUR
T1 - Association of childhood maltreatment and cortisol with the severity and stability of depression symptoms
AU - UCC-SMART Study Group
AU - Scarth, M.
AU - Vonk, J.M.J.
AU - Gerritsen, L.
AU - GGeerlings, M.I.
N1 - Funding Information:
We gratefully acknowledge the contribution of the SMART research nurses; R. van Petersen (data-manager); B.G.F. Dinther (vascular manager) and the members of the Utrecht Cardiovascular Cohort-Second Manifestations of ARTerial disease-Study Group (UCC-SMART-Study Group): F.W. Asselbergs and H.M. Nathoe, Department of Cardiology; G.J. de Borst, Department of Vascular Surgery; M.L. Bots and M.I. Geerlings, Julius Center for health Sciences and Primary Care; M.H. Emmelot, Department of Geriatrics; P.A. de Jong and T. Leiner, Department of Radiology; A.T. Lely, Department of Obstetrics & Gynecology; N.P. van der Kaaij, Department of Cardiothoracic Surgery; L.J. Kappelle and Y.M. Ruigrok, Department of Neurology; M.C. Verhaar, Department of Nephrology, F.L.J. Visseren (chair) and J. Westerink, Department of Vascular Medicine, University Medical Center Utrecht and Utrecht University.
Publisher Copyright:
© 2021
PY - 2022/2/15
Y1 - 2022/2/15
N2 - 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.
AB - 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.
KW - Age
KW - Childhood maltreatment
KW - Cortisol
KW - Depression symptoms
KW - Latent class analysis
UR - http://www.scopus.com/inward/record.url?scp=85123938948&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2021.12.036
DO - 10.1016/j.jad.2021.12.036
M3 - Article
AN - SCOPUS:85123938948
SN - 0165-0327
VL - 299
SP - 559
EP - 567
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -