Cortisol awakening reaction in depressed patients with and without early life stress

It has been shown that depressed subjects with early life stress (ELS) have an increased HPA reactivity after psychosocial stress exposure. However, cortisols awakening responses (CAR) or daily profiles are not investigated in these patients so far. We studied the CAR and diurnal cortisol profiles on 3 consecutive days, with administration of 1mg dexamethasone (DEX) on day 2 in N=46 depressed in-patients during the first week after admission. ELS was assessed by the „Pre-, Peri-and Postnatal Stress Questionnaire“, parental bonding with the „Parental Bonding Inventory“. N=31 subjects reported ELS. HAMD rating scores were not different between the two groups. The ELS-group showed significantly lower cortisol (CORT) rise after awakening and significantly lower mean increases in CORT. However, no such differences were observed with respect to CORT levels throughout the day or CAR and day profiles after DEX. Independently from ELS, patients reporting a low degree of fathers care had higher CAR, while CAR after DEX or CORT day profiles were not influenced by bonding behaviour. Mothers bonding behaviour was unrelated to CORT activity. in line with lower CAR in healthy subjects experiencing early loss of relatives, ELS in depressed patients is associated to lower CAR. Corresponding to former animal studies a low extend of paternal care was associated with a higher CAR. So the question arises, if parental care and ELS are different parameters with respect to impact on later HPA activit