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RATIONALE: Cortisol hypersecretion is regarded as important in the pathophysiology of major depression. However, recent studies in community-based samples have been inconclusive. OBJECTIVE: To determine whether acutely depressed, medication-free subjects show an exaggerated release of cortisol in saliva in relation to awakening. METHODS: We studied the pattern of waking salivary cortisol in 20 unmedicated acutely depressed subjects and 40 healthy controls. RESULTS: In both groups, salivary cortisol increased rapidly after waking, peaking at 30 min. Overall, patients with acute depression secreted approximately 25% more cortisol than controls, though 60 min after waking, their cortisol levels were similar. CONCLUSIONS: Depressed patients in the community appear to have increased early morning cortisol secretion, but the demonstration of this effect requires control for time of waking.

Original publication




Journal article


Psychopharmacology (Berl)

Publication Date





54 - 57


Adult, Circadian Rhythm, Cushing Syndrome, Depressive Disorder, Major, Female, Humans, Hydrocortisone, Male, Middle Aged, Reference Values, Saliva, Secretory Rate, Wakefulness