Recent life events, cortisol, dehydroepiandrosterone and the onset of major depression in high-risk adolescents

BACKGROUND: It is not clear whether cortisol or dehydroepiandrosterone (DHEA) hypersecretion increases the risk for major depression in the presence of undesirable life events. AIMS: To determine whether there is a specific pattern of psychoendocrine factors that predicts the onset of major depressive disorder. METHOD: 180 adolescents (73 boys, 107 girls) at high risk for psychopathology were assessed for cortisol, DHEA, depressive symptoms, life events and psychiatric disorder at entry and 12 months later. RESULTS: Major depression was predicted for both genders by the additive effects of: higher depressive symptoms; personal disappointments and losses only in the month before onset; one or more daily levels of cortisol at 08.00 h or DHEA at 20.00 h greater than the 80th percentile of the daily mean. CONCLUSIONS: A subgroup of adolescents may carry a physiological risk for major depression which may be either of genetic and/or earlier psychosocial origin.