The cortisol awakening response at admission to hospital predicts depression severity after discharge in MDD patients.

Major Depressive Disorder (MDD) is associated with hypothalamic-pituitary-adrenal axis (HPA) dysregulation and altered cortisol awakening response (CAR), a non-invasive biomarker for HPA axis reactivity. We theorized that the CAR resembles the accumulated effects of depression over time, and may therefore predict depressive symptom severity once patients return home following inpatient treatment. Two studies are reported. In Study 1 (n = 101; 57% female), the CAR was measured at intake and self-ratings of depression severity was assessed six weeks following discharge. Study 2 (n = 127; 58% female) was a replication and extension of Study 1 where a follow-up assessment of self-rated depressi…