Association of serum cortisol level with severity of depression and improvement in newly diagnosed patients with major depressive disorder in Jimma medical center, Southwest Ethiopia

Arefayne Alenko; Yohannes Markos; Chaltu Fikru; Eyasu Tadesse; Lealem Gedefaw

doi:10.1371/journal.pone.0240668

Association of serum cortisol level with severity of depression and improvement in newly diagnosed patients with major depressive disorder in Jimma medical center, Southwest Ethiopia

PLoS One. 2020 Oct 16;15(10):e0240668. doi: 10.1371/journal.pone.0240668. eCollection 2020.

Authors

Arefayne Alenko¹, Yohannes Markos², Chaltu Fikru³, Eyasu Tadesse², Lealem Gedefaw⁴

Affiliations

¹ Department of Psychiatry, Jimma University, Institute of Health, Faculty of Medical Science, Jimma, Ethiopia.
² Department of Biomedical Sciences, Jimma University, Institute of Health, Faculty of Medical Science, Jimma, Ethiopia.
³ Department of Epidemiology, Jimma University, Institute of Health, Faculty of Public Health, Jimma, Ethiopia.
⁴ Department of Laboratory Sciences, Jimma University, Institute of Health, Faculty of Medical Science, Jimma, Ethiopia.

Abstract

Background: Major Depressive Disorder (MDD) is the leading psychiatric disorder in low- and middle-income countries, and is to be the second leading cause of burden of disease by 2020. Cortisol plays a significant role in pathophysiology of MDD. Depression can alter serum cortisol level. However, the change in serum cortisol level and its association with depressive symptom severity and improvement among patients with MDD is not well studied.

Objective: To outline change in serum cortisol levels and its association with severity and improvement of depressive symptoms in newly diagnosed patients with MDD.

Method: Hospital based longitudinal study was conducted among 34 newly diagnosed patients who met DSM-V criteria of MDD. Venous blood sample was performed twice; pre- and post- 8 weeks of treatment. Serum cortisol concentration was measured using an extracted radioimmunoassay. The 17-item Hamilton Depression Scale (HAM-D) was used to rate depression at baseline and after 8 weeks of treatment. Paired t-test was done to look the mean difference of serum cortisol level and HAM-D, before and after treatment. Pearson correlation was done to look the association between serum cortisol levels, HAM-D scores and, sociodemographic and clinical factors. Statistical significance was set at p<0.05.

Results: There is no significant difference in cortisol concentrations at baseline and end line (t (33) = 2.02, p = 0.052). However, there is significant difference in HAM-D total score (t (33) = 5.67, p<0.001). Baseline and end line serum cortisol levels were significantly correlated (r = .561, p = .001). Monthly family income is correlated with baseline HAM-D total score (r = -0.373, p = .030). There is no significant relationship between baseline serum cortisol level and HAM-D score. There is also no significant relationship between end line serum cortisol level and HAM-D score.

Conclusions: The symptoms of MDD were reduced following treatment but there is no significant difference in serum cortisol levels. Baseline and end line serum cortisol levels were significantly correlated. We recommend further research based on large sample.

Publication types

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

MeSH terms

Adult
Age Factors
Depressive Disorder, Major / blood*
Depressive Disorder, Major / diagnosis*
Depressive Disorder, Major / epidemiology
Ethiopia / epidemiology
Female
Humans
Hydrocortisone / blood*
Income
Male
Middle Aged
Severity of Illness Index*

Substances

Hydrocortisone

Grants and funding

Name of author received award/fund: Arefayne Alenko This research work is funded by Jimma University Institute of Health Grant number/Ref. No: IHRPGD/594/2019. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.