Evidence map›Paper›PMID 32593866›Full record

ArticlePsychoneuroendocrinology2020

The roles of comorbidity and trauma exposure and its timing in shaping HPA axis patterns in depression.

Stefanie E Mayer, Melissa Peckins, Kate R Kuhlman, Nirmala Rajaram, Nestor L Lopez-Duran, Elizabeth A Young, James L Abelson

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Psychoneuroendocrinology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Remission is insufficient: predictors and mechanistic models of recurrence in late-life depression.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026
    Review
  5. Review
  6. Article
  7. Article
  8. Article
  9. The researcher's guide to selecting biomarkers in mental health studies.BioEssays : news and reviews in molecular, cellular and developmental biology · 2024
    Review
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  12. Article
  13. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Stefanie E MayerDepartment of Psychiatry, University of California, Street, Suite 465, San Francisco, CA, USA. Electronic address: Stefanie.Mayer@ucsf.edu.
Melissa PeckinsDepartment of Psychology, St. John's University, NY, USA.
Kate R KuhlmanDepartment of Psychological Science, University of California, Irvine, CA, USA; Cousins Center for Psychoneuroimmunology, University of California Los Angeles, Los Angeles, CA, USA; Institute for Interdisciplinary Salivary Bioscience, University of California, Irvine, CA, USA.
Nirmala RajaramDepartment of Psychiatry, University of Michigan, MI, USA.
Nestor L Lopez-DuranDepartment of Psychology, University of Michigan, MI, USA.
Elizabeth A YoungDepartment of Psychiatry, University of Michigan, MI, USA.
James L AbelsonDepartment of Psychiatry, University of Michigan, MI, USA.
University of Michigan–Ann Arbor · USSt. John's University · USUniversity of California, Los Angeles · USUniversity of California, San Francisco · US

Funding

TRAINING PROGRAM IN DEVELOPMENTAL PSYCHOLOGYT32HD007109 · NICHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI GELMAN, SUSAN A., MONK, CHRISTOPHER STEPHEN · 1985 to 2025
$6.6M
Mentoring and Research in Integrative MedicineK24AT007827 · NCCIH · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HECHT, FREDERICK M · 2013 to 2022
$1.8M
Effects of comorbid anxiety disorders on the HPA axis profile of depressionR01MH078975 · NIMH · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI ABELSON, JAMES L · 2008 to 2012
$1.7M
Behavioral and inflammatory responses to stress: Implications for depression in youth exposed to adversityK08MH112773 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI KUHLMAN, KATE RYAN · 2017 to 2021
$862k
Understanding and Reversing the Effects of Early Life Adversity on Midlife Health: Improving Daily Psychological Stress Responses using an Ecological Momentary InterventionR00AG062778 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MAYER, STEFANIE EVA · 2021 to 2023
$747k
Understanding and Reversing the Effects of Early Life Adversity on Midlife Health: Improving Daily Psychological Stress Responses using an Ecological Momentary InterventionK99AG062778 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MAYER, STEFANIE EVA · 2019 to 2020
$311k
NCCIH NIH HHS K24 AT007827NIA NIH HHS K99 AG062778NIA NIH HHS R00 AG062778NICHD NIH HHS T32 HD007109NIMH NIH HHS K08 MH112773NIMH NIH HHS R01 MH078975
6 · The paper itself

Abstract

backgroundMuch work has documented hypothalamic pituitary adrenal (HPA) axis abnormalities in major depressive disorder (MDD), but inconsistencies leave this system's role in the illness unclear. Comparisons across studies are complicated by variation in co-morbidity (Posttraumatic Stress Disorder-PTSD, anxiety disorders), exposure to trauma, and timing of trauma (child vs. adult). Here, we examined the impact of these factors on HPA axis profiles in depression.

methodsWe recruited 5 groups of participants: MDD (n = 14), comorbid MDD + PTSD following adulthood trauma (MDD + PTSD-Adult; n = 12), comorbid MDD + PTSD following childhood trauma (MDD + PTSD-Child; n = 18), comorbid MDD + social anxiety disorder (MDD + SAD; n = 12), and non-depressed control participants who were sex and age matched to patients (combined total n = 36). HPA axis function was assessed using three challenges: stress reactivity via the Trier Social Stress Test (TSST), feedback sensitivity via a dexamethasone suppression test (DST), and central drive via a metyrapone challenge (MET). We compared hormonal responses between patient groups and their respective non-depressed controls.

resultsMDD + PTSD-Child showed low cortisol levels at baseline, and reduced adrenocorticotropic hormone (ACTH) levels at baseline and throughout the TSST. MDD-only, MDD + PTSD-Adult, and MDD + SAD did not differ from non-depressed controls in HPA axis responses to the TSST. Controlling for childhood trauma severity, the reduced baseline levels in MDD + PTSD-Child were no longer significant and significantly reduced baseline cortisol levels emerged for MDD + PTSD-Adult. No diagnostic group effects were detected with DST and MET. Childhood maltreatment subtypes were associated with unique HPA axis responses to TSST and MET.

conclusionComorbidity and trauma exposure, as well as their timing and type, contribute to inconsistencies in the depression literature and must be included in efforts to clarify the role of the HPA axis in MDD.

Indexed as

Adrenocorticotropic HormoneAdultAdverse Childhood ExperiencesAnxiety DisordersComorbidityDepressionDexamethasoneFemaleHumansHydrocortisoneHypothalamo-Hypophyseal SystemMajor Depressive DisorderMalePituitary-Adrenal SystemStress Disorders, Post-TraumaticAdrenocorticotropic HormoneDexamethasoneHydrocortisoneComorbidityDepressionHPATiming of traumaTrauma exposure

Identifiers

PMID32593866
PMCPMC7502500
OpenAlexW3036068788

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.