The role of childhood maltreatment in cortisol in the hypothalamic-pituitary-adrenal (HPA) axis in methamphetamine-dependent individuals with and without depression comorbidity and suicide attempts

Bijan Pirnia; Vahid Khosravani; Faezeh Maleki; Rozita Kalbasi; Kambiz Pirnia; Parastoo Malekanmehr; Alireza Zahiroddin

doi:10.1016/j.jad.2019.11.168

The role of childhood maltreatment in cortisol in the hypothalamic-pituitary-adrenal (HPA) axis in methamphetamine-dependent individuals with and without depression comorbidity and suicide attempts

J Affect Disord. 2020 Feb 15:263:274-281. doi: 10.1016/j.jad.2019.11.168. Epub 2019 Dec 2.

Authors

Bijan Pirnia¹, Vahid Khosravani², Faezeh Maleki³, Rozita Kalbasi⁴, Kambiz Pirnia⁵, Parastoo Malekanmehr⁶, Alireza Zahiroddin⁷

Affiliations

¹ Department of Psychology, Faculty of Humanities, University of Science and Culture, Tehran, Iran; Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: b.pirnia@usc.ac.ir.
² Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran.
³ Division of Cognitive Neuroscience, Faculty of Educational Sciences and Psychology, University of Tabriz, Tabriz, Iran.
⁴ Department of Psychology, Islamic Azad University, Kish International Branch, Kish Island, Iran.
⁵ Internal disease specialist, Technical Assistant in Bijan Center for Substance Abuse Treatment, Tehran, Iran.
⁶ Department of Psychology, Faculty of Psychology, Islamic Azad University, Tonekabon Branch, Mazandaran, Iran.
⁷ Department of Psychiatry, Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

PMID: 31818789
DOI: 10.1016/j.jad.2019.11.168

Abstract

Background: The hypothalamic-pituitary-adrenal (HPA) axis dysregulation which was found to have an important role in the pathophysiology of depression, suicide, and substance dependence, may be influenced by childhood maltreatment (CM). The present study aimed to investigate the relationship between CM and cortisol changes in methamphetamine-dependent individuals.

Methods: In a cross-sectional study, methamphetamine-dependent individuals (n = =195) with or without both comorbid major depressive disorder (MDD) and a history of suicide attempts were selected and completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Beck Scale for Suicide Ideation (BSSI), and the Beck Depression Inventory-II (BDI-II). To assess cortisol levels, saliva samples were collected at six time intervals for two consecutive days.

Results: A history of CM significantly predicted wake-up cortisol level, cortisol awakening response (CAR), and diurnal cortisol slope. Methamphetamine-dependent individuals with both MDD and lifetime suicide attempts had higher CM and higher cortisol levels with a blunted diurnal cortisol slope than individuals who were merely methamphetamine-dependent. Individuals with high CM showed higher cortisol levels with a blunted diurnal slope than those with low or without CM.

Limitations: Cross-sectional data and use of self-report scales, especially retrospective measurements (e.g., the CTQ-SF), were important limitations of this study.

Conclusion: Findings suggest that methamphetamine-dependent individuals with adverse psychological factors such as CM, MDD, and suicide attempts may show dysregulation in biological factors including cortisol level. In addition, CM and its effects on cortisol in the HPA axis may emerge as important factors regarding psychopathological use of methamphetamine.

Keywords: Childhood maltreatment; Cortisol; Depression; Methamphetamine; Suicide.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Child Abuse* / psychology
Comorbidity
Cross-Sectional Studies
Depression
Depressive Disorder, Major* / epidemiology
Humans
Hydrocortisone*
Hypothalamo-Hypophyseal System
Methamphetamine* / adverse effects
Pituitary-Adrenal System
Retrospective Studies
Saliva
Suicide, Attempted*

Substances

Methamphetamine
Hydrocortisone