# The correlation between plasma cortisol levels and scores of psychological scales among patients with recurrent depressive disorder in Vietnam

## TL;DR

This study in Vietnam found that cortisol levels in patients with recurrent depression decreased during treatment and were initially linked to higher psychological distress scores.

## Contribution

The study provides new insights into cortisol dynamics and psychological scales in Vietnamese patients with recurrent depressive disorder.

## Key findings

- High cortisol levels in patients with recurrent depression decreased after four weeks of treatment.
- Morning cortisol levels at baseline correlated with higher anxiety and depression scores.
- No cortisol-scale correlations were observed after four weeks of treatment.

## Abstract

We aimed to examine levels of plasma cortisol in the morning and evening before and after standardised treatment, and analyze the correlation between these levels and scores of psychological assessment scales among patients with recurrent depressive disorder (PRDD) in Vietnam.

From January 2020 to December 2021, a cross-sectional study was carried out at the National Institute of Mental Health in Bach Mai Hospital. After using a convenience sampling method, 109 consecutive patients met our criteria were recruited. We measured and analysed plasma cortisol levels in all participants at baseline (T0), two weeks after treatment (T1) and four weeks after treatment (T2). Spearman correlation was applied to assess the correlations between plasma cortisol at six different time and scores of six psychological assessment scales including HAM-D, HAM-A, BDI, SAS, DASS, and MMSE.

Among 109 PRDD, the percentage of subjects had high cortisol levels decreased during hospital treatment. At admission (T0), these figures were 4.76% in the morning and 8% in the evening. After 4-week treatment (T2), these figures declined to 1.32% and 3.09%, respectively. At T0, the morning cortisol concentrations had a positive correlation with the mean scores of HAM-A (r = 0.257), BDI (r = 0.251), and SAS (r = 0.276) (p ≤ 0.05), whereas the evening cortisol concentrations in the evening had a positive correlation with the mean scores of BDI (r = 0.197), SAS (r = 0.206), and Depression subscale of DASS (r = 0.252) (p ≤ 0.05). At T2, we did not detect any correlation between morning or evening cortisol levels and six test scores.

The utilization of psychological measures for monitoring purposes can facilitate the assessment of alterations in cortisol levels among individuals experiencing recurrent depression, hence aiding in the treatment of depression in this population. Additional investigation using a more extensive sample size is required to furnish additional substantiation on this matter in Vietnam.