Depression and 24-hour urinary cortisol in medical outpatients with coronary heart disease: The Heart and Soul Study
Biological PsychiatryPublished 1 August 2004Open access
Christian Otte, Charles R. Marmar, Sharon Pipkin, Rudolf H. Moos, Warren S. Browner, Mary A. Whooley
Citations125
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
In patients with CHD, depression is associated with elevated cortisol levels, and elevated cortisol was not associated with worse cardiac function.
Abstract
In patients with CHD,depression is associated with elevated cortisol levels.
Keywords
MedicineNeuroscience
Journal of General Internal MedicineThe PHQ-9
44,186 Citations2001Kurt Kroenke, Robert L. Spitzer +1 more
In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity, which makes it a useful clinical and research tool.
Dementia and Geriatric Cognitive DisordersDepression and Quality of Life in Older Persons: A Review
14,115 Citations2015Heidi Sivertsen, Guro Hanevold Bjørkløf +3 more
A significant association between severity of depression and poorer QOL in older persons was found, and the association was found to be stable over time, regardless of which assessment instruments for QOL were applied.
JAMAValidation and Utility of a Self-report Version of PRIME-MD<SUBTITLE>The PHQ Primary Care Study</SUBTITLE>
9,822 Citations1999Robert L. Spitzer
The study suggests that the PHQ has diagnostic validity comparable to the original clinician-administered PRIME-MD, and is more efficient to use.
The LancetAlternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study
7,036 Citations1997Christopher J L Murray, Alan D López
Three scenarios of future mortality and disability for different age-sex groups, causes, and regions, developed as part of the Global Burden of Disease Study, found some robust results with implications for health policy.
Endocrine ReviewsHow Do Glucocorticoids Influence Stress Responses? Integrating Permissive, Suppressive, Stimulatory, and Preparative Actions*
6,574 Citations2000Robert M. Sapolsky, L. Michael Romero +1 more
This review considers recent findings regarding GC action and generates criteria for determining whether a particular GC action permits, stimulates, or suppresses an ongoing stress-response or, as an additional category, is preparative for a subsequent stressor.
Archives of Internal MedicineThe AUDIT Alcohol Consumption Questions (AUDIT-C)<subtitle>An Effective Brief Screening Test for Problem Drinking</subtitle>
6,191 Citations1998Kristen Bush
Results: Of 393 eligible patients, 243 (62%) completed AUDIT-C and interviews, and the 2 questionnaires performed similarly for detecting heavy drinking and/or active abuse or dependence.
Archives of General PsychiatryNational Institute of Mental Health Diagnostic Interview Schedule
5,278 Citations1981Lee N. Robins
A new interview schedule allows lay interviewers or clinicians to make psychiatric diagnoses according to DSM-III criteria, Feighner criteria, and Research Diagnostic Criteria.
The LancetImpact of sleep debt on metabolic and endocrine function
3,657 Citations1999Karine Spiegel, Rachel Leproult +1 more
Sleep debt has a harmful impact on carbohydrate metabolism and endocrine function similar to those seen in normal ageing and, therefore, sleep debt may increase the severity of age-related chronic disorders.
JAMAPituitary-Adrenal and Autonomic Responses to Stress in Women After Sexual and Physical Abuse in Childhood
1,956 Citations2000Christine Heim
The findings suggest that hypothalamic-pituitary-adrenal axis and autonomic nervous system hyperreactivity, presumably due to CRF hypersecretion, is a persistent consequence of childhood abuse that may contribute to the diathesis for adulthood psychopathological conditions.
JAMADepression Following Myocardial Infarction
1,943 Citations1993Nancy Frasure‐Smith
Major depression in patients hospitalized following an MI is an independent risk factor for mortality at 6 months and its impact is at least equivalent to that of left ventricular dysfunction (Killip class) and history of previous MI.
CirculationDepression and 18-Month Prognosis After Myocardial Infarction
1,562 Citations1995Nancy Frasure‐Smith, François Lespérance +1 more
Depression while in the hospital after an MI is a significant predictor of 18-month post- MI cardiac mortality and significantly improves a risk-stratification model based on traditional post-MI risks, including previous MI, Killip class, and PVCs.
Journal of the American College of CardiologyAngiographic progression of coronary artery disease and the development of myocardial infarction
1,453 Citations1988John A. Ambrose, Mark Tannenbaum +7 more
It is suggested that myocardial infarction frequently develops from previously nonsevere lesions, and proximal lesion location is the only significant predictor of evolution of lesions greater than or equal to 50% to infarctions.
Molecular PsychiatryOrganization of the stress system and its dysregulation in melancholic and atypical depression: high vs low CRH/NE states
1,258 Citations2002P W Gold, George P. Chrousos
The mediators and circuitries of the stress system are reviewed to lay the groundwork for placing in context physiologic and structural alterations in depression that may occur as part of stress system dysfunction.
Biological PsychiatryMood disorders and allostatic load
1,120 Citations2003Bruce S. McEwen
The amygdala becomes hyperactive in posttraumatic stress disorder (PTSD) and depressive illness, and hypertrophy of amygdala nerve cells is reported after repeated stress in an animal model.
The Journal of Clinical Endocrinology & MetabolismStress-Related Cortisol Secretion in Men: Relationships with Abdominal Obesity and Endocrine, Metabolic and Hemodynamic Abnormalities<sup>1</sup>
876 Citations1998Roland Rosmond, Mary F. Dallman +1 more
Endocrine ReviewsAntidepressants and Hypothalamic-Pituitary-Adrenocortical Regulation
832 Citations1996FLORIAN HOLSBOER, Nicholas Barden
It is shown that antidepressants interfere not only with the production and release of catecholamines and indolamines but also with the signal transduction of those neurotransmitters that have long been implicated in the pathogenesis and treatment of depression.
JAMADepressive Symptoms and Health-Related Quality of Life
747 Citations2003Bernice Ruo, John S. Rumsfeld +4 more
Among patients with coronary disease, depressive symptoms are strongly associated with patient-reported health status, including symptom burden, physical limitation, quality of life, and overall health.
CirculationFive-Year Risk of Cardiac Mortality in Relation to Initial Severity and One-Year Changes in Depression Symptoms After Myocardial Infarction
731 Citations2002François Lespérance, Nancy Frasure‐Smith +2 more
The level of depression symptoms during admission for MI is more closely linked to long-term survival than the level at 1 year, particularly in patients with moderate to severe levels of depression, suggesting that the presumed cardiovascular mechanisms linking depression to cardiac mortality may be more or less permanent for them.
Journal of Psychiatric ResearchEffects of the high-affinity corticotropin-releasing hormone receptor 1 antagonist R121919 in major depression: the first 20 patients treated
704 Citations2000Astrid Zobel, Thomas Nickel +5 more
The data suggested that CRH(1)-receptor blockade does not impair the corticotropin and cortisol secretory activity either at baseline or following an exogenous CRH challenge, and significant reductions in depression and anxiety scores are observed using both, patient and clinician ratings.
The LancetDepression as a risk factor for mortality after coronary artery bypass surgery
661 Citations2003James A. Blumenthal, Heather S. Lett +7 more
Despite advances in surgical and medical management of patients after CABG, depression is an important independent predictor of death afterCABG and should be carefully monitored and treated if necessary.
CirculationMental Stress Induces Transient Endothelial Dysfunction in Humans
660 Citations2000Lorenzo Ghiadoni, Ann E. Donald +9 more
These findings suggest that brief episodes of mental stress, similar to those encountered in everyday life, may cause transient endothelial dysfunction in healthy young individuals and might represent a mechanistic link between mental stress and atherogenesis.
Journal of Psychiatric ResearchThe rationale for corticotropin-releasing hormone receptor (CRH-R) antagonists to treat depression and anxiety
652 Citations1999Herta Flor
Patients with clinical conditions that are causally related to HPA hyperactivity may profit from treatment with a CRH1 receptor antagonist, as the animals were less anxious than wild-type mice when experimentally stressed.
The International Journal of Psychiatry in MedicineDepression following Myocardial Infarction
635 Citations1992A W Forrester, John R. Lipsey +4 more
Major depression is common in the acute post-myocardial infarction period and confer significant psychiatric morbidity and, if sustained, require psychiatric intervention.
Biological PsychiatryAssociation of depression with medical illness: does cortisol play a role?
577 Citations2003E. Sherwood Brown, Femina P. Varghese +1 more
The data provide some support for similar health effects in depressed patients and patients with Cushing's disease or the metabolic syndrome; however, additional studies are needed relating systemic effects of depression to cortisol.
Biological PsychiatryEpidemiology of comorbid coronary artery disease and depression
548 Citations2003Bruce E. Rudisch, Charles B. Nemeroff
The role of confounding risk factors is presented, such as global burden of comorbid medical illness and modification of traditional risk factors, which may, in part, mediate the effect of depression on coronary artery disease.
Biological PsychiatryDepression and cardiovascular disease: mechanisms of interaction
501 Citations2003Karen E. Joynt, David J. Whellan +1 more
Seven potential mechanisms for the relationship between depression and cardiovascular disease are reviewed and the available evidence surrounding each mechanism is presented.
JAMADetection of Depressive Disorder for Patients Receiving Prepaid or Fee-for-Service Care
392 Citations1989Kenneth B. Wells
Clinicians' awareness of depression for patients with current depressive disorder who received care in either a single-specialty solo or small group practice, a large multispecialty grouppractice, or a health maintenance organization in three US sites is estimated.
Archives of Internal MedicineDepression and 1-Year Prognosis in Unstable Angina
381 Citations2000François Lespérance, Nancy Frasure‐Smith +2 more
Depressed patients with unstable angina were more likely to experience cardiac death or nonfatal myocardial infarction than other patients and are associated with an increased risk of major cardiac events during the following year.
Biological PsychiatryDepression, mortality, and medical morbidity in patients with coronary heart disease
375 Citations2003Robert M. Carney, Kenneth E. Freedland
There is substantial evidence that depression is a risk factor for cardiac morbidity and mortality, both for patients without clinical evidence of coronary heart disease at index examination and for patients with established coronary disease.
Journal of Psychiatric ResearchCortisol response in the combined dexamethasone/CRH test as predictor of relapse in patients with remitted depression
356 Citations2001Astrid Zobel, Thomas Nickel +4 more
An exaggerated cortisol response in the combined DEX/CRH test predicts the recurrence of depressive psychopathology and the two proposed rules for predicting relapse within the first 6 months after discharge could be optimized by including age and gender.
American Journal of PsychiatryDST Studies in Psychotic Depression: A Meta-Analysis
351 Citations1997J. Craig Nelson, J M Davis
Among patients with major depression, psychotic depression is the subtype that is most closely associated with nonsuppression of cortisol on the DST, andHypercortisolemia is usually present in psychotic depression and may be important in understanding the pathophysiology of this syndrome.
Acta Psychiatrica ScandinavicaDepression and cardiovascular diseases
344 Citations1994Arpo Aromaa, Raimo Raitasalo +7 more
During a 6.6 year follow‐up, the risk of CVD death and coronary death was elevated in depressed persons both with and without CVDs at entry, and the hypothesis that depression is a cause ofCVDs requires further study.
The Journal of Clinical Endocrinology & MetabolismDiurnal Activity and Pulsatility of the Hypothalamus-Pituitary-Adrenal System in Male Depressed Patients and Healthy Controls
333 Citations1997Michael Deuschle, Ulrich Schweiger +7 more
It is concluded that increased hypothalamus-pituitary-adrenocortical activity in depression is related to a greater frequency of episodic hormone release, and it is hypothesize that the observed circadian changes might be partly due to altered mineralocorticoid and glucoc Corticoid receptor capacity and function.
American Journal of PsychiatryThe DST as a predictor of outcome in depression: a meta-analysis
331 Citations1993Saulo C. M. Ribeiro, Rajiv Tandon +2 more
Baseline DST results may be devoid of prognostic value, but posttreatment nonsuppression of cortisol on the DST is strongly associated with poor outcome, reiterate the importance of studying biological measures in relation to multiple validators of psychiatric illness beyond cross-sectional diagnosis.
Biological PsychiatryAn open label trial of C-1073 (mifepristone) for psychotic major depression*
314 Citations2002Joseph K. Belanoff, Anthony J. Rothschild +5 more
These results suggest that short term use of GR antagonists may be effective in the treatment of psychotic major depression and that further blinded studies are warranted.
Psychological MedicineUrinary free Cortisol excretion in depression
310 Citations1976Bernard J. Carroll, George C. Curtis +3 more
Urinary free Cortisol excretion was determined in 60 depressed inpat patients and in 35 psychiatric inpatients with other disorders and it was found that those with depressive neuroses excreted less than unipolar or bipolar depressives.
European Heart JournalAffective disorders and survival after acute myocardial infarction<xref ref-type="fn" rid="fn1">*</xref><subtitle>Results from the post-infarction late potential study</subtitle>
302 Citations1991KH Ladwig, Meinhard Kieser +3 more
The findings indicate that affective disorders play an important role in the post-acute phase after AMI although the extent of myocardial infarction and behaviour responses are not significantly related to one another.
Proceedings of the National Academy of SciencesDown-regulation of the expression of endothelial NO synthase is likely to contribute to glucocorticoid-mediated hypertension
288 Citations1999Thomas Wallerath, Klaus K. Witte +8 more
Plasma NO(2)(-)/NO(3)(-) (the oxidation products of NO) decreased to 40%, and the expression of endothelial NO synthase (NOS III) was found down-regulated in the aorta and several other tissues of glucocorticoid-treated rats, suggesting the expressional down-regulation of endothelium NOS III may contribute to the hypertension caused by glucOCorticoids.
Archives of General PsychiatryCortisol Secretion in Endogenous Depression
255 Citations1985Uriel Halbreich
The mean plasma level of cortisol between 1 and 4 PM was found to be highly correlated with the means 24h PC value in ED patients, as has been previously reported in normal subjects and patients with various other diseases.
AtherosclerosisThe association of elevated plasma cortisol and early atherosclerosis as demonstrated by coronary angiography
220 Citations1977Raymond G. Troxler, Eugene A. Sprague +3 more
Plasma cortisol was second only to serum cholesterol as a discriminator in the authors' patient population between diseased and non-diseased patients and a significant correlation between plasma cortisol and cholesterol, blood pressure, and smoking- the three cardinal risk factors for CAD.
Archives of General Psychiatry24-Hour Monitoring of Cortisol and Corticotropin Secretion in Psychotic and Nonpsychotic Major Depression
215 Citations2000Joel A. Posener, Charles DeBattista +4 more
In the population studied, PMD and NPMD patients have distinct profiles of HPA axis dysregulation.
Psychosomatic MedicineTreatment of Depression With Antiglucocorticoid Drugs
205 Citations1999Owen M. Wolkowitz, Victor I. Reus
Although definitive controlled trials remain to be conducted, there is a consistent body of evidence indicating that cortisol-lowering treatments may be of clinical benefit in select individuals with major depression and other hypercortisolemic conditions.
Psychosomatic MedicineDepressive Symptoms and Survival of Patients With Coronary Artery Disease
203 Citations2000John C. Barefoot, Beverly H. Brummett +4 more
Depressive symptoms differentially predicted survival, with depressive affect and hopelessness being particularly important and may be especially important in younger patients.
Archives of General PsychiatryIncreased Evening Activation of the Hypothalamic-Pituitary-Adrenal Axis in Depressed Patients
164 Citations1994Elizabeth A. Young
Data support the hypothesis of increased corticotropin releasing factor drive in the evening in depressed subjects and are in agreement with the longstanding observation of "early escape" from dexamethasone suppression between 4 and 11 PM in depressed patients.
The World Journal of Biological PsychiatryStress Hormone-Related Psychopathology: Pathophysiological and Treatment Implications
150 Citations2001Owen M. Wolkowitz, Elissa S. Epel +1 more
Mechanisms by which hormonal imbalance might contribute to illness are discussed and certain clinical manifestations of such hormonal imbalances are reviewed, and pharmacological and behavioural treatment strategies aimed at normalizing hormonal output and lessening psychiatric and physical pathology are discussed.
Psychosomatic MedicineDepressive Symptoms and Mortality Two Years After Coronary Artery Bypass Graft Surgery (CABG) in Men
111 Citations2003Matthew M. Burg, Cristina M. Benedetto +1 more
Elevated depressive symptoms before CABG surgery appear to be an important independent contributor to long‐term mortality.
HypertensionIncreased Urinary Free Cortisol
97 Citations1998W. Reid Litchfield, Steven C. Hunt +6 more
Data suggest that there is an association between salt-resistant hypertension and high urine cortisol levels, which may have a genetic basis and be significantly related to hypertension by repeated measures ANCOVA.
Clinical Pharmacology & TherapeuticsEthnicity influences morphine pharmacokinetics and pharmacodynamics
93 Citations2001M. Soledad Cepeda, John T. Farrar +6 more
The objective was to evaluate ethnic differences in response to morphine and to determine whether any detectable differences were pharmacokinetically based.
American Journal of Physiology-Heart and Circulatory PhysiologyInhibitory effect of glucocorticoid on coronary artery endothelial function
90 Citations2002Kestrel Rogers, Christi A. Bonar +2 more
The results suggest that cortisol, through activation of glucocorticoid receptors, suppresses NO(x) release in BCAEC by downregulating eNOS proteins and inhibiting intracellular Ca(2+) mobilization.
Biological PsychiatryUrinary free cortisol in psychotic depression
76 Citations1987Raymond F. Anton
Although some clinical variables other than psychotic features differed between the two groups, these could not account for the UFC differences and the older patients in the MDPF group accounted for the high UFC excretion, suggesting an interaction between age and diagnosis.
PsychoneuroendocrinologyCortisol and vital exhaustion in relation to significant coronary artery stenosis in middle-aged women with acute coronary syndrome
70 Citations2002Jenny Koertge, Faris Al-Khalili +4 more
Cortisol, but not vital exhaustion, was independently related to coronary stenosis in women with acute coronary syndrome and the influence of cortisol was important compared to standard risk factors of CAD.
Journal of Diabetes and its ComplicationsIncreased Urinary-Free Cortisol Outputs in Diabetic Patients
67 Citations1998Monique Roy, Alec Roy +1 more
European Journal of EndocrinologyDuring a corticotropin-releasing hormone test in healthy subjects, administration of a beta-adrenergic antagonist induced secretion of cortisol and dehydroepiandrosterone sulfate and inhibited secretion of ACTH
44 Citations2003S Kizildere, T. Glück +3 more
Sympathetic hyperactivity may be a common denominator for low levels of DHEAS in inflammatory and non-inflammatory diseases and a beta-adrenergic influence seems to inhibit adrenal steroids under unstimulated and stimulated conditions.
Clinical Pharmacology & TherapeuticsLosartan attenuates symptomatic and hormonal responses to hypoglycemia in humans
39 Citations2001Eva Deininger, Kerstin M. Oltmanns +8 more
Journal of Laboratory and Clinical MedicineAssociated daily biosynthesis of cortisol and thromboxane A2: A preliminary report
13 Citations1996Filippo Luca Fimognari, Gianfranco Piccirillo +6 more
The close association between cortisol and thromboxane A2 biosynthesis thus appears to be a general phenomenon and may be important in interpreting the well-described causative link between stress and atherothrombotic cardiovascular disease.
