Observational studyPsychosomatic medicine2017
Cortisol Awakening Response as a Prospective Risk Factor for Depressive Symptoms in Women After Treatment for Breast Cancer.
Observational study in Psychosomatic medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 24 citations in OpenAlex.
- Sedentary behavior and physical activity are longitudinally associated with diurnal cortisol rhythms in individuals up to 1 year after colorectal cancer treatment: A prospective cohort study.Research square · 2026Article
- Construction of a nomogram-based risk prediction model for depressive symptoms in middle-aged and young breast cancer patients.World journal of clinical oncology · 2025Article
- Effects of Walking and Barre Exercise on CES-D, Stress Hormones, hs-CRP, and Immunoglobulins in Elderly Women.Journal of clinical medicine · 2025Article
- Childhood adversity and the cortisol awakening response in depression: A meta-analysis.Journal of mood and anxiety disorders · 2023Article
- Cortisol levels in rural Latina breast cancer survivors participating in a peer-delivered cognitive-behavioral stress management intervention: TheComprehensive psychoneuroendocrinology · 2022Article
- The Associations of Psychologic and Physiologic Manifestations of Parental Stress in Critical Congenital Heart Disease.Biological research for nursing · 2022Article
- Circadian disruption and cancer- and treatment-related symptoms.Frontiers in oncology · 2022Review
- Feasibility and value of salivary cortisol sampling to reflect distress in head and neck cancer patients undergoing chemoradiation: A proof-of-concept study.International journal of oncology research · 2022Article
- School commute time, chronotype, and altered HPA axis functioning during adolescence.Psychoneuroendocrinology · 2021Article
- Vulnerability to inflammation-related depressive symptoms: Moderation by stress in women with breast cancer.Brain, behavior, and immunity · 2021Article
- Sleep problems in adolescence are prospectively linked to later depressive symptoms via the cortisol awakening response.Development and psychopathology · 2020Article
- Emotional Processing Coping Methods and Biomarkers of Stress in Young Adult Testicular Cancer Survivors.Journal of adolescent and young adult oncology · 2020Article
- Testing plausible biopsychosocial models in diverse community samples: Common pitfalls and strategies.Psychoneuroendocrinology · 2019Review
- Stability of diurnal cortisol measures across days, weeks, and years across middle childhood and early adolescence: Exploring the role of age, pubertal development, and sex.Psychoneuroendocrinology · 2019Article
- Xiaoyao Kangai Jieyu Fang, a Chinese Herbal Formulation, Ameliorates Cancer-Related Depression Concurrent with Breast Cancer in Mice via Promoting Hippocampal Synaptic Plasticity.Evidence-based complementary and alternative medicine : eCAM · 2018Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
objectiveThe aim of the study was to investigate hypothalamic-pituitary-adrenal axis (HPA axis) functioning as a neurobiological risk factor for depressive symptoms in an ongoing longitudinal, observational study of women undergoing treatment and recovery from breast cancer. Many women with breast cancer experience depressive symptoms that interfere with their treatment, recovery, and quality of life. Psychosocial risk factors for depression among patients with cancer and survivors have been identified, yet neurobiological risk factors in this population remain largely unexamined.
methodsWomen recently diagnosed with early-stage breast cancer (N = 135) were enrolled before starting neoadjuvant/adjuvant treatment (radiation, chemotherapy, endocrine therapy). At baseline, participants collected saliva samples to measure diurnal HPA axis functioning for 3 days: at waking, 30 minutes after waking, 8 hours after waking, and bedtime. Participants also completed a standardized measure of depressive symptoms (Center for Epidemiological Studies-Depression Scale) at baseline and 6 months after completion of primary treatment. Multivariate regression was used to predict continuous depressive symptoms at 6-month posttreatment from continuous depressive symptoms at baseline, cortisol awakening response (CAR), and other measures of diurnal HPA axis functioning.
resultsThe magnitude of CAR predicted changes in depressive symptoms over time, such that women with a higher CAR showed a greater increase from baseline to 6-month posttreatment (b = 5.67, p = .023). Diurnal slope and total cortisol output were not associated with concurrent depressive symptoms or their change over time.
conclusionsElevated CAR may be a neurobiological risk factor for increases in depressive symptoms in the months after breast cancer treatment and warrants further investigation.
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