Salivary cortisol profiles in patients remitted from recurrent depression: one-year follow-up of a mindfulness-based cognitive therapy trial.
Marianne Gex-Fabry, Françoise Jermann, Markus Kosel, Michel F Rossier, Martial Van der Linden, Gilles Bertschy, Guido Bondolfi, Jean-Michel Aubry
Journal of Psychiatric Research January 2012 DOI: 10.1016/j.jpsychires.2011.09.011 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 56 |
| Population | Patients remitted from recurrent depression (≥3 episodes) |
| Interventions | Mindfulness-based cognitive therapy (MBCT) Treatment as usual (TAU) |
| Duration | 8-week intervention with follow-up at 3, 6, 9, and 12 months |
| Measures | Cortisol awakening response (CAR), average day exposure (AUCday), diurnal slope |
| Topics | Depression Meditation |
| Key findings | MBCT plus treatment as usual did not change diurnal cortisol patterns compared with treatment as usual alone over 12 months. Intra-individual variability exceeded inter-individual variability for cortisol awakening response (62.2% vs. 32.5%), average daily exposure (30.9% vs. 23.6%), and diurnal slope (51.0% vs. 34.2%). Later awakening and longer depression history were associated with lower cortisol measures. |
Abstract
Few studies have examined changes of diurnal cortisol profiles prospectively, in relation to non-pharmacological interventions such as mindfulness-based cognitive therapy (MBCT). Fifty-six patients remitted from recurrent depression (≥3 episodes) were included in an 8-week randomized controlled trial comparing MBCT plus treatment as usual (TAU) with TAU for depression relapse prophylaxis. Saliva samples (0, 15, 30, 45, 60 min post-awakening, 3 PM, 8 PM) were collected on six occasions (pre- and post-intervention, 3-, 6-, 9-, 12-month follow-up). Cortisol awakening response (CAR), average day exposure (AUCday) and diurnal slope were analyzed with mixed effects models (248 profiles, 1-6 per patient). MBCT (n = 28) and TAU groups (n = 28) did not significantly differ with respect to baseline variables. Intra-individual variability exceeded inter-individual variability for the CAR (62.2% vs. 32.5%), AUC(day) (30.9% vs. 23.6%) and diurnal slope (51.0% vs. 34.2%). No time, group and time by group effect was observed for the CAR and diurnal slope. A significant time effect (p = 0.003) was detected for AUCday, which was explained by seasonal variations (p = 0.012). Later wake-up was associated with lower CAR (-11.7% per 1-hour later awakening, p < 0.001) and lower AUCday (-4.5%, p = 0.014). Longer depression history was associated with dampened CAR (-15.2% per 10-year longer illness, p = 0.003) and lower AUCday (-8.8%, p = 0.011). Unchanged cortisol secretion patterns following participation in MBCT should be interpreted with regard to large unexplained variability, similar relapse rates in both groups and study limitations. Further research is needed to address the scar hypothesis of diminished HPA activity with a longer, chronic course of depression.
Comparable studies
Other randomized controlled trials on depression, most cited first.
Citations in the library
Cited by 13
- Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse JAMA Psychiatry April 28, 2016
- Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, and Zen Meditation for Depression, Anxiety, Pain, and Psychological Distress Journal of Psychiatric Practice July 1, 2012
- Prospects for a clinical science of mindfulness-based intervention. American Psychologist October 1, 2015
- Depression, Mindfulness, and Psilocybin: Possible Complementary Effects of Mindfulness Meditation and Psilocybin in the Treatment of Depression. A Review Frontiers in Psychiatry March 31, 2020
- Biological Pathways Linking Mindfulness with Health INDIGO June 30, 2018
and 8 more in the library
Cites 6
- Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology 2000
- Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Journal of Consulting and Clinical Psychology 2004
- Changes in the cortisol awakening response (CAR) following participation in mindfulness-based stress reduction in women who completed treatment for breast cancer. Complementary Therapies in Clinical Practice November 26, 2010
- How does mindfulness-based cognitive therapy work? Behaviour Research and Therapy August 13, 2010
- Depression relapse prophylaxis with Mindfulness-Based Cognitive Therapy: replication and extension in the Swiss health care system. Journal of Affective Disorders August 8, 2009
and 1 more in the library