Long-term cortisol in bipolar disorder: Associations with age of onset and psychiatric co-morbidity

Summary: Introduction: Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is hypothesized to play a role in the pathogenesis of bipolar disorder (BD). Conflicting results have been reported when saliva or serum was used to measure cortisol levels. A recently developed method is to measure cortisol in scalp hair, with 1cm of scalp hair representing 1 month. We studied whether there are differences in long-term hair cortisol levels between BD patients and healthy individuals and whether there are associations between hair cortisol and disease characteristics.Methods: Hair samples were collected in 100 BD patients and 195 healthy controls. Long-term cortisol levels were determined in 3cm hair segments. Saliva samples were collected on two consecutive evenings. Documented disease c...

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