Análise do cortisol salivar ao despertar, em homens e mulheres, com depressão: biomarcador da depressão maior

Abstract

Depression is a high prevalence disorder that affects about 17% of the world's population throughout life. It is fundamentally characterized, among others, by the presence of depressed mood and/or anecdony for at least two weeks. Its high incidence, in part, is due to the difficulty of diagnosis, which in turn is due to the absence of specific biomarkers for this disease. Currently the diagnosis is made by physicians in a subjective way, through interviews, or with the help of scales, which can generate sub or supra diagnoses. Thus, enormous effort has been made to delineate biomarkers in order to aid and give robustness to the diagnosis of major depression. Based on strong evidence from the literature we are inclined to analyze the response of salivary cortisol upon awakening in individuals with major depression and we observed a hyporesponsiveness of this hormone in women with melancholic depression who was not seen in women with atypical depression and healthy controls. There were also no statistical differences in cortisol on awakening in men with melancholic depression and healthy controls. It is speculated that hypocortisolemia results from the chronicity of the pathology and that this initially protective response, given the high severity and refractoriness of its cases, fails after the self-adjusting system does not function properly, keeping cortisol levels chronically low, which induces deleterious effects.