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Cortisol as a predictor of psychological therapy response in depressive disorders: systematic review and meta-analysis


Fischer, Susanne; Strawbridge, Rebecca; Vives, Andres Herane; Cleare, Anthony J (2017). Cortisol as a predictor of psychological therapy response in depressive disorders: systematic review and meta-analysis. British Journal of Psychiatry, 210(2):105-109.

Abstract

BACKGROUND: Many patients with depressive disorders demonstrate resistance to psychological therapy. A frequent finding is hypothalamic-pituitary-adrenal (HPA) axis alterations. As cortisol is known to modulate cognitive processes, those patients may be less likely to profit from psychological therapy.

AIMS: To conduct a systematic review and meta-analysis on cortisol as a predictor of psychological therapy response.

METHOD: The Cochrane Library, EMBASE, MEDLINE and PsycINFO databases were searched. Records were included if they looked at patients with any depressive disorder engaging in psychological therapy, with a pre-treatment cortisol and a post-treatment symptom measure.

RESULTS: Eight articles satisfied our selection criteria. The higher the cortisol levels before starting psychological therapy, the more symptoms patients with depression experienced at the end of treatment and/or the smaller their symptom change.

CONCLUSIONS: Our findings suggest that patients with depression with elevated HPA functioning are less responsive to psychological therapy.

Abstract

BACKGROUND: Many patients with depressive disorders demonstrate resistance to psychological therapy. A frequent finding is hypothalamic-pituitary-adrenal (HPA) axis alterations. As cortisol is known to modulate cognitive processes, those patients may be less likely to profit from psychological therapy.

AIMS: To conduct a systematic review and meta-analysis on cortisol as a predictor of psychological therapy response.

METHOD: The Cochrane Library, EMBASE, MEDLINE and PsycINFO databases were searched. Records were included if they looked at patients with any depressive disorder engaging in psychological therapy, with a pre-treatment cortisol and a post-treatment symptom measure.

RESULTS: Eight articles satisfied our selection criteria. The higher the cortisol levels before starting psychological therapy, the more symptoms patients with depression experienced at the end of treatment and/or the smaller their symptom change.

CONCLUSIONS: Our findings suggest that patients with depression with elevated HPA functioning are less responsive to psychological therapy.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:06 Faculty of Arts > Institute of Psychology
Dewey Decimal Classification:150 Psychology
Language:English
Date:February 2017
Deposited On:22 Nov 2017 15:21
Last Modified:19 Feb 2018 09:19
Publisher:Royal College of Psychiatrists
ISSN:0007-1250
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1192/bjp.bp.115.180653
PubMed ID:27908897

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