Higher Salivary Cortisol Levels Research Articles

Effects of Official Chess Competition on Salivary Cortisol and Mood Swings in Adolescent Girls: A Win-Loss Approach.

The current study examined the effects of official chess competition on salivary cortisol and mood swings in adolescent girls. Fourteen girl competitive chess players participated in the 5-day Swiss chess tournament held in nine heavy and light rounds. The tournament was performed at 9:00 a.m. (first, third, fifth, seventh, and ninth rounds) and 3:00 p.m. (second, fourth, sixth, and eighth rounds). Salivary cortisol and mood was measured before the tournament, before and after the second, fourth, sixth, and eighth rounds, and following the tournament (10 samples). The resting levels of salivary cortisol had considerably greater values on the first, second, third, and fourth competition days compared to 1 week before the competition (P = 0.001). The post-competition cortisol concentration was significantly higher on the second and third days than before the competition (P = 0.001). Winners had considerably higher levels of salivary cortisol compared to losers (P = 0.001). There was a significant increase in total mode disturbance (P = 0.001), anger (P = 0.009), and tension (P = 0.045) following heavy rounds (second and third day) compared to the values before the competition. At the same time, the Scores of vigor decreased significantly (P = 0.001). The findings of the present study showed participating in the official chess competition increased salivary cortisol and caused negative alterations in mood components associated with the difficulty and outcome of the match, indicating the psychological stress. Hence, psychological interventions can be used for psychological recovery of competitive chess players after the competition.

Relationship of Self-perceived Stress and Expression of Salivary Cortisol in Relation to Gender and Academic Levels among Dental Students

Purpose Although cortisol is commonly regarded as the body's stress hormone, it also has a range of other effects on other biological functions. The aim of this prospective cohort's study was to examine the link between self-perceived stress and salivary cortisol expression in relation to gender and academic levels in a subgroup of dental students. Material and Methods 151 students (79 males and 72 females) who provided written consent took part in this study. To explore the causes of self-perceived stress and divide the participants into Mild, Moderate, and High-stress categories, a self-administered stress questionnaire was employed. The enzyme-linked immunosorbent assay (ELISA) was utilized to quantify the level of cortisol present in saliva samples. Salivary cortisol levels, self-perceived stress, and demographic data, including age, gender, and educational attainment, were recorded for every participant. Chi-square and two-tailed Student's t-tests (0.05) were employed to analyze group comparisons. Results Female students responded more stressfully (P<0.05) to questions on decision-making issues, academic dishonesty, a hectic course load, a lack of downtime, the transition from the pre-clinic to the clinic, and the challenge of mastering fine manual dexterity. For male and female subjects, the mean & standard deviation of levels of cortisol were 1.54+0.41 and 1.28+0.45, respectively (p=0.000). At preclinical and clinical levels, the mean & standard deviation of levels of cortisol were 1.48+0.44 and 1.37+0.45, respectively (P=0.150). Conclusion Female students appeared to have a higher self-assessed stress level. Male students had significantly higher levels of salivary cortisol in comparison to female students. No significant differences were found for the levels of salivary cortisol at the preclinical and clinical academic levels.

Effects of Nesting Material Provision and High-Dose Vitamin C Supplementation during the Peripartum Period on Prepartum Nest-Building Behavior, Farrowing Process, Oxidative Stress Status, Cortisol Levels, and Preovulatory Follicle Development in Hyperprolific Sows.

Hyperprolific sows often experience increased oxidative stress during late gestation and lactation periods, which can adversely affect the farrowing process and overall lactation performance. This study examines the influence of providing a coconut coir mat (CCM; 1 × 1 m) as nesting material, supplementing high-dose vit-C (HVC; 20% vit-C, 10 g/kg feed) as an antioxidant, or both on maternal behavior, the farrowing process, oxidative status, cortisol levels, and preovulatory follicle developments in sows with large litters. In total, 35 sows (Landrace × Yorkshire; litter size 15.43 ± 0.27) were allocated to the following four treatment groups: control (n = 9, basal diet), vit-C (n = 8, basal diet + HVC), mat (n = 10, basal diet + CCM), and mat + vit-C (n = 8, basal diet + HVC + CCM). A post-hoc analysis showed that compared with sows that were not provided CCM, mat and mat + vit-C groups demonstrated increased durations of nest-building behavior during the period from 24 h to 12 h before parturition (p < 0.05 for both), reduced farrowing durations, and decreased intervals from birth to first udder contact (p < 0.01 for both). The mat group exhibited lower advanced oxidation protein product (AOPP) levels during late gestation and lactation periods than the control group (p < 0.05). Sows with HVC supplementation showed longer farrowing durations than those without HVC supplementation (p < 0.0001). The vit-C group had higher salivary cortisol levels on day 1 after farrowing than the other treatment groups (p < 0.05). Furthermore, the follicle diameters on day 3 after weaning in the vit-C group tended to be smaller than those in the control group (p = 0.077). HVC supplementation prolonged farrowing and increased the physiological stress on postpartum, and no advantageous effects on maternal behavior and developmental progression of preovulatory follicles were observed. Hence, alternative solutions beyond nutritional approaches are required to address increased oxidative stress in hyperprolific sows and secure their welfare and reproductive performance. The present results substantiated the positive impact of providing CCM as nesting material for sows with large litters on nest-building behavior and the farrowing process, which could mitigate the deleterious consequences induced by peripartum physiological and oxidative stress.

Perceived Stress, Cortisol Responses, and the Effect of Social Networks among Uninsured Free Clinic Patients.

Stress among free clinic patients is an important issue to address in health care. Evaluating the differences between perceived stress and physiological stress will help healthcare professionals to better understand the stress and coping management skills that will improve health outcomes for underserved populations. The aim of this study was to accelerate research to better understand the biological and psychological aspect of stress in health disparities. This was a cross-sectional study using a convenience sample of free clinic patients aged 18 years and older who spoke English and/or Spanish. Multiple modals of data were collected from 178 participants during summer 2019, including a self-administered paper survey and a biomedical saliva sample. Descriptive statistics were used to present the characteristics of the participants, and a correlation heatmap was used to show a graphical representation of the main variables. Two models of multivariable regression were performed to understand factors associated with cortisol and perceived stress. Higher levels of perceived stress were not significantly more prevalent than higher levels of salivary cortisol among free clinic patients; however, higher levels of social networking were significantly associated with lower levels of perceived stress. Our analysis revealed that having more friends in a social network was slightly more associated with lower levels of perceived stress than having more family members. The result of this study provides awareness to healthcare promoters and educators concerning the health of uninsured patients. More specifically, this study provides a foundation to understand the salivary cortisol levels and the relation to perceived stress among this population. Further studies are needed to measure salivary cortisol repeatedly during a period of time among a larger population to better understand the reasons behind normal cortisol level manifesting along with chronic stress.

Associations in time between salivary cortisol and emotions in depressed patients and controls

IntroductionDepression can be understood as a complex dynamic system, where depressive symptoms can directly affect each other. Knowledge on this symptom-symptom interaction is still scarce and is likely to differ between individuals. The hypothalamic-pituitary-adrenal (HPA) axis is often implicated in depression, with hypercortisolism and impaired glucocorticoid receptor-mediated feedback inhibition being commonly reported. High salivary cortisol levels may reflect a reaction to symptoms, or may rather be a cause, effectively ‘binding’ symptoms.ObjectivesWe aimed to analyze the temporal interplay between salivary cortisol and emotions in depressed patients and controls by using the novel Dynamic Time Warp analysis (DTW) approach.MethodsThe ‘Mood and movement in daily life’ (MOOVD) study consisted of 30 pair-matched (15 depressed and 15 control) participants. Salivary cortisol was collected three times a day for 30 days, resulting in 90 measurements per individual. At the same moments, participants completed questionnaires on an electronic diary, which included different momentary positive (PA) and negative (NA) affect items. The dynamic interplay between salivary cortisol and affect were analyzed by DTW, which extends momentarily associations to include one earlier and one later time point, in both undirected and directed analyses.ResultsIndividual networks differed substantially within groups. At the group level, undirected and directed network analyses showed differences between depressed patients and controls. In undirected analysis, connectivity of PA items was comparable between depressed patients and controls, but the NA items showed a less dense network in depressed patients. Directed DTW analyses indicated (p = 0.07) that increases in salivary cortisol preceded that of some NA items (e.g., tiredness) in controls, but tended to follow upon NA item increase (e.g., not feeling appreciated) in depressed patients.ConclusionsAt the group level, connectiveness between NA items was substantially weaker in depressed patients compared to controls. As in complex systems strong internal connectivity facilitates “critical transitions” to different states, this may reflect (or explain) the persistence of a chronically depressed state. We preliminary conclude that high salivary cortisol in depression may be a consequence of NA, rather than a cause. Replication of these first exploratory findings are needed.Disclosure of InterestNone Declared

LEVELS OF SALIVARY CORTISOL IN ADULTS AND CHILDREN WITH BRUXISM DIAGNOSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS.

To evaluate the levels of salivary cortisol in adults and children diagnosed with bruxism. A search strategy was developed using the following terms: "cortisol", "bruxism" and "sleep bruxism". These were searched in databases: Medline, Embase, Scopus, Cochrane, Web of Science, LILACS and gray literature, for studies published until May 2020. We obtained a total of six primary studies, involving 854 participants, who met the criteria and were included in the present study. The analysis cortisol levels shows a significant difference favourable to the control group 1.10 (95% CI: 0.68-1.53), showing that patients with bruxism have higher values of salivary cortisol. Heterogeneity of I² = 4% (P = .31). It was concluded that despite the different methodologies adopted for the collection and analysis of salivary content, this review found significant results of higher levels of salivary cortisol in adult patients with bruxism.

Diurnal Salivary Cortisol Profiles in Patients with Cushing's Syndrome.

Quantification of salivary cortisol is one of the highly sensitive and specific screening parameters for Cushing's syndrome (CS). However, only late-night salivary cortisol is part of the standard screening procedure. In this study, we aimed to analyze salivary cortisol day profiles in patients with different types of CS to test whether specific patterns might be relevant for diagnosis and subtyping. Among 428 patients including those with confirmed Cushing's syndrome (N=111, of those 75 with Cushing's disease, 27 patients with adrenal CS and nine patients with ectopic CS), autonomous cortisol secretion (N=39) or exclusion of CS (control group, N=278) salivary cortisol was measured five times a day. At each of the five time points, salivary cortisol was significantly higher in patients with CS compared to the control group (p≤0.001). Using the entire profile instead of one single salivary cortisol at 11 p.m. improved diagnostic accuracy (85 vs. 91%) slightly. Patients with ACTH-dependent CS had higher salivary cortisol levels than patients with adrenal CS. Also, morning cortisol was significantly higher in patients with ectopic CS than in patients with Cushing's disease (p=0.04). Nevertheless, there was a strong overlap between diurnal profiles, and the diagnostic yield for subtyping was low. The study results show that using diurnal salivary cortisol profiles for CS diagnosis results in a limited increase in diagnostic accuracy. With significant differences between Cushing subtypes, cortisol profiles are not useful in everyday clinical practice for subtyping of CS.

Preliminary analysis of reproductive, behavioral and physiological characteristics of military working dogs.

The use of dogs in military work environments has always aroused great interest in the general population and determining the stress levels they go through is extremely important to maintain their welfare. The aim of this research was to evaluate if the work shifts in military working dogs leads to stress conditions and if this working influences on the reproductive performance and life quality. The study was conducted at the Military Police Kennel located at Campinas, Sao Paulo, Brazil. Eight male dogs of four different breeds (German Shepherd, Belgian Malinois Shepherd, Doberman, and Rottweiler) were evaluated during two different shifts: Working Shifts: animals working 12 hours a day with 2 hour-interval; and Control Shifts: animals that were on their day off (36 hours). Saliva samples were collected for cortisol analysis at the control and working shifts. The study was carried out over 60 days and analyzed behavior, physiology, and reproduction quality. Saliva samples, behavior observation of stereotyping, resting and moving activities and semen analysis were collected by digital stimulation (for combined second and third fractions). The salivary cortisol levels during the control and working shifts were between 0.361–0.438 and 0.312–0.592 µg/dL, respectively; the highest values were found at the end of working shifts. The animals were resting during most of the observation period, but few showed stereotypic behaviors. The testicular consistency was firm and semen parameters were within the normal values in German Shepherd, Belgian Malinois Shepherd, and Doberman dogs. However, Rottweiler dogs had a higher rate of sperm abnormalities, higher salivary cortisol levels, and more stereotypic behaviors. Nevertheless this work highlights the importance of further research relating reproduction and cortisol levels in military dogs.

Evaluation of stress among dental undergraduates and postgraduates using salivary cortisol as a biomarker.

Stress is a non-specific response of the body to any demand. Professional education has a certain level of stress inherent in it. Dental students have been reported in the literature to experience more stress than medical students. To evaluate the stress levels of dental students: first-year undergraduates, house surgeons, and final-year postgraduates, using salivary cortisol as a stress biomarker. Dental students above 18 years of age and without any systemic illness were included in the study. Those students with a drug history of corticosteroids, anti-depressants, and oral contraceptives were excluded from the study. Female participants experiencing pre-menstrual symptoms, pregnancy, and familial stressor issues were excluded from the study. First-year undergraduates, house surgeons, and final-year postgraduates were enrolled in the study. Unstimulated whole saliva was collected in the morning and evening between 9:00 and 10:00 am and between 3:00 and 4:00 pm. Salivary cortisol levels were assessed by chemiluminescence immuno-assay (CLIA). Paired sample t-test was used to compare the diurnal variation among morning and afternoon samples within the groups. The salivary cortisol levels were found to be significant within the groups. One-way ANOVA was used to compare the salivary cortisol levels between the groups. The salivary cortisol levels within the groups were not statistically significant. Salivary cortisol is a non-invasive biomarker of stress. Postgraduates had higher salivary cortisol levels than other study groups.

Effects of Positive Reinforcement Training and Novel Object Exposure on Salivary Cortisol Levels under Consideration of Individual Variation in Captive African Elephants (Loxodonta africana).

Simple SummaryRegular training for medical or enrichment purposes and the provision of environmental enrichment, such as varied feeding schedules and novel objects, are part of the management of African elephants in zoos. The present study aimed to find out whether training and enrichment in the form of a novel object induced physiological changes in captive African elephants. We repeatedly sampled the saliva of ten animals (three zoos) before and after training and the exposure to a novel object for the analysis of cortisol and as a measure of stress and arousal. We found high salivary cortisol levels before and low levels after training. A novel object, in contrast, moderately increased the salivary cortisol levels. Moreover, males and young elephants showed lower salivary cortisol levels than females and old elephants, respectively. The zoo, handling method (free vs. protected contact to keepers), reproductive and social status, however, did not influence the salivary cortisol levels of the animals studied. We conclude that the relatively high cortisol values before training could be due to anticipation of the training event. A novel object, in contrast, may have evoked arousal, which led to the observed cortisol increase. In addition, understanding why animals differ in stress responses will help to manage stress in zoo elephants with the goal of ensuring their welfare.Dealing with potential stress in species that have high husbandry requirements, such as elephants, is a challenge for zoos. The objective of the present study was to determine whether positive reinforcement training (PRT) and exposure to a novel object (NOV) for enrichment induced a salivary cortisol response indicative of activation of the hypothalamic–pituitary–adrenal (HPA) axis and which factors determine individual variation in this regard in captive African elephants. We repeatedly sampled the saliva of ten animals (three zoos) for the analysis of cortisol (SACort) before and up to 60 min (in 10–15 min intervals) after the onset of PRT (three repeats) or NOV (nine repeats), which lasted 10 min. There was considerable individual variation in SACort in response to PRT or NOV. Using mixed models, we were able to control these and to reveal that PRT was associated with high SACort before and relatively low SACort after PRT, while NOV induced a moderate SACort increase. The individual differences in SACort were related to age and sex (NOV), while the effects of zoo, handling method (free vs. protected contact) and reproductive and social status were variable. We conclude that positive affective states, such as anticipation or arousal, should be taken into account when interpreting the differences in the SACort responses between PRT and NOV. In addition, understanding the individuality of stress will support management decisions aimed at promoting captive elephant welfare.

Does high fidelity neonatal resuscitation simulation increase salivary cortisol levels of health care providers?

The use of simulation-based medical education is strongly recommended to insure neonatal resuscitation skills for health caregivers. High fidelity simulation was executed to allow the evaluation of technical and non-technical skills. Salivary cortisol level was considered reliable biomarkers of adrenocortical activity and useful tool to learning assessment and stress response. Our primary aim was to test changes in salivary cortisol levels before and after the simulation for neonatal resuscitation between high and low fidelity setting. Secondary aim was to evaluate salivary cortisol level in the participants, leader and not leader. Fifty-two health care providers were divided in ratio 1:1 into low-fidelity (LF group) and high-fidelity scenario (HF group) of neonatal resuscitation. In each group the participants assumed the role of team leader or not team leader. Salivary samples were collected from all participants 5 minutes before and after each simulation scenario by using oral swab. Analysis of difference was analyzed by Kruskal Wallis Test. Salivary cortisol levels were significantly higher in HF group (N.=26) than LF group (N.=26) before the performance (5.407 mmol/L vs. 3.090 mmol/L; P=0.018). In the HF group, salivary cortisol levels were significantly lower after simulation than before (P=0.007), moreover not team leader showed higher salivary cortisol levels before of the simulation than after (P=0.003). Team leaders showed higher salivary cortisol levels than not team leader after high-fidelity scenario (P=0.039). High-fidelity simulation scenario had a great impact on stress level, furthermore leaders showed higher salivary cortisol levels than not team leaders.

Diurnal Salivary Cortisol in Sarcopenic Postmenopausal Women: The OsteoLaus Cohort

Sarcopenia, similar to hypercortisolism, is characterized by loss of muscle mass and strength. Cortisol circadian rhythm changes with aging (blunted late-day nadir values) were suggested to contribute to this decline. We aimed to explore the relationship between diurnal salivary cortisol values and sarcopenia diagnosis and its components in postmenopausal women. This is a cross-sectional study within the OsteoLaus population-based cohort in Lausanne (Switzerland). Participants had a body composition assessment by dual X-ray absorptiometry (DXA), a grip strength (GS) measure, and salivary cortisol measures (at awakening, 30 min thereafter, 11 AM (sc-11AM) and 8 PM (sc-8PM)). Associations between salivary cortisol and sarcopenia diagnosed by six different criteria (based on appendicular lean mass (ALM) assessed by DXA, and muscle strength by GS), and its components, were analyzed. 471 women aged > 50 years (63.0 ± 7.5) were included. Various definitions identified different participants as sarcopenic, who consistently presented higher salivary cortisol at 11 AM and/or 8 PM. There were no associations between salivary cortisol levels and ALM measures, either absolute or after correction to height squared (ALM index) or body mass index. GS was inversely correlated to sc-11AM (r = − 0.153, p < 0.001) and sc-8PM (r = − 0.118, p = 0.002). Each 10 nmol/l increase of sc-11AM, respectively sc-8PM, was associated with a GS decrease of 1.758 (SE 0.472) kg, respectively 2.929 (SE 1.115) kg. In postmenopausal women, sarcopenia is associated with higher salivary cortisol levels at 11 AM and 8 PM. An increase of daily free cortisol levels in the physiological range could participate to sarcopenia development by decreasing muscle function in postmenopausal women.

Salivary characteristics may be associated with burning mouth syndrome?

BackgroundBurning mouth syndrome (BMS) it is characterized by burning and uncomfortable sensations with no clinical alterations or laboratory findings. The evaluation of the salivary characteristics of people with BMS can help the understanding of the pathogenesis of this condition. This case-control study aimed to trace the salivary profile of women with burning mouth syndrome (BMS). Material and Methods40 women with BMS and 40 control women were recruited. Unstimulated salivary flow rate (uSFR), pH, salivary cortisol levels, salivary viscosity, and oral health impact profile (OHIP-14 questioner) were determined. P< 0.05 was considered statistically significant. ResultsFor uSFR, mean values obtained for BMS and for control group respectively were 0.35 and 0.61 mL/min; for pH, 7.23 and 7.34; for cortisol levels, 0.36 and 0.15 μg/dL; for viscosity values, 31.1 and 45.01 mPas and for OHIP-14 scores, 21.7 and 5.7. To uSFR, cortisol levels, viscosity values and OHIP-14 scores, differences were statistically significant. Salivary cortisol levels and OHIP-14 scores were correlated positively (rho = 0.624; p< 0.05). ConclusionsBMS women have lower uSFR and salivary viscosity and higher salivary cortisol levels that were associated with worse quality of life, compared with the control group. Key words:Xerostomia, Burning mouth syndrome, Viscosity.

The Microbiome-Metabolome Response in the Colon of Piglets Under the Status of Weaning Stress.

Weaning is stressful for piglets involving nutritional, physiological, and psychological challenges, leading to an increase in the secretion of cortisol, changes in gut microbiome and metabolites, whereas the underlying relationships remain unclear. To elucidate this, 14 Meishan female piglets were divided into the weaning group and the suckling group at the age of 21 days paired by litter and body weight. After 48 h of experiment, weaned piglets had lower body weight, but higher salivary cortisol level than that of their suckling litter mates (P < 0.05). The composition of the colonic bacterial community and metabolites were different between the two groups, and the first predominant genus of the suckling and weaned piglets colonic microbiome were Bacteroides and Prevotellaceae-NK3B31 group respectively. The suckling piglets had higher proportions of phylum Bacteroidetes and Lentisphaerae, and genus Bacteroides and Lactobacillus in the colonic microbial community, but lower abundance of genus Prevotellaceae-NK3B31 group than that of the weaned piglets (P < 0.05). Accordingly, there were 15 colonic metabolites differed between the two groups, in which 2 metabolites (phenylacetic acid and phenol) negatively related to the abundant of Lactobacillus genus (P < 0.05), while 9 metabolites (acetic acid, arabitol, benzoic acid, caprylic acid, cholesterol, dihydrocholesterol, galactinol, glucose phenol, phenylacetic acid, and oxamic acid, glycerol, propionic acid) positively associated with the proportion of Prevotellaceae-NK3B31 group genus (P < 0.05). Furthermore, the salivary cortisol level negatively associated with the abundance of phylum Lentisphaerae, but positively associated with the phylum Bacteroidetes and the genus Prevotellaceae-NK3B31 group (P < 0.05) respectively. These results provide us with new insights into the cause of the gut microbiome and stress, and the contributions of gut microbiome in metabolic and physiological regulation in response to weaning stress.

Assessment of correlations and concentrations of salivary and plasma steroids, testicular morphometry, and semen quality in different climatic conditions in goats

The current study aimed to investigate whether steroids (testosterone, estradiol, and cortisol) in the saliva of goats reflects their concentrations in the plasma. Also, it aimed at ascertaining, for the first time, the effect of changes in climatic conditions (spring versus summer) on the aforementioned steroids, testicular volume, testicular echotexture (pixel intensity; PI, and integrated density; ID), and semen quality in goats. Saliva and plasma samples were collected from 7 male Shiba goats weekly in spring and summer for measurement of testosterone (T; ng/ml), estradiol (E2; pg/ml), and cortisol (ng/ml) using radioimmunoassay. The changes in testicular volumes (TV/ml) and echogenicity were monitored weekly using ultrasonographic assessments concomitantly with subjective evaluations of semen parameters. Results revealed a highly significant positive correlation (r = 0.72; P < 0.0001) between plasma and salivary cortisol. Mild significant positive correlation was found between salivary and plasma T levels (r = 0.31; P < 0.002). However, low non-significant negative correlation was reported between salivary and plasma E2 levels (r = −0.24; P > 0.05). Higher levels of salivary cortisol were found in summer than in the spring (3.8 ± 0.6 ng/ml versus 1.4 ± 0.3 ng/ml; P < 0.001). However, no differences in levels of T, E2, and plasma cortisol were recorded between spring and summer (P > 0.05). Values of testicular PI and ID were significantly (P < 0.001) higher in the summer (94.5 ± 4.9, 258,388 ± 13,190, respectively) than in the spring (74.0 ± 2.1, 200,922 ± 5704, respectively). Meanwhile, TV and semen parameters did not significantly differ between spring and summer. In conclusion, saliva can be considered as an alternative biological fluid for the measurement of cortisol and T, but not suitable for E2. Climatic conditions significantly impact the levels of cortisol in saliva and testicular echogenicity in goats.

The potential predictive value of salivary cortisol on the occurrence of secondary cognitive impairment after ischemic stroke.

In this study, we aimed to investigate the relationship between salivary cortisol content and secondary mild cognitive impairment (MCI), thereby supporting the prediction of MCI in clinical practice. In this study, the salivary cortisol levels were examined in 120 patients with MCI after cerebral ischemic stroke (CIS) (CIS-MIC) and 80 CIS patients without MIC (CIS). The clinical data were compared among these patients with different cortisol levels. The salivary level of cortisol was significantly higher in patients with CIS-MIC (0.85-3.65nmol/L) than that in those with CIS (0.52-1.21nmol/L). The categorized analysis by CIS-MIC quartile showed that patient age, hyperlipidemia, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), etc. were significantly increased with increasing salivary cortisol levels. Moreover, univariate and multivariate logistic regression analyses revealed that the MCI risk of patients in the first quartile was 0.35 and 0.41 times, respectively, of the fourth quartile. Multiple linear regression showed that patient age, the time of rescue, and the salivary cortisol level were independent factors in the Mini-Mental State Exam (MMSE) score of MCI patients. Meanwhile, the receiver operating characteristic (ROC) curve showed that the area under the curve of salivary cortisol as a diagnostic marker for MCI after CIS was 0.982, with sensitivity of 0.973 and specificity of 0.980. In this study, we found that salivary cortisol level was an independent risk factor of MCI after CIS. A higher salivary cortisol level indicated a higher probability of MCI occurrence, and salivary cortisol level can be used as a predictive marker for MCI occurrence.

Physiological stress markers, mental health and objective physical function

ObjectiveThe observed poorer physical function in persons with mental disorders could partly be due to dysregulation in physiological stress systems. However, an integrated picture of the role of physiological stress systems on objective physical function is lacking. This study examined the association of multiple physiological stress systems with objective physical function, and explored whether these stress systems contribute to the relationship between depression/anxiety and poorer physical function. MethodsData of 2860 persons of the Netherlands Study of Depression and Anxiety was used. Physical function was indicated by hand grip strength assessed using a hand-held dynamometer and lung function assessed using a peak flow meter. Inflammatory markers (CRP, IL-6, TNF-α), salivary cortisol (cortisol awakening response (AUCg, AUCi), evening cortisol) and ANS markers (heartrate, PEP, RSA) were determined. Depression/anxiety disorders were determined using psychiatric interviews. Linear regression analyses were adjusted for sociodemographics, health and lifestyle factors. ResultsHigher inflammation levels were associated with lower hand grip strength (BCRP = -0.21(SE = 0.06), p < .001) and lower lung function (BCRP = -2.07(SE = 0.66), p = .002), BTNF-α = −3.35(SE = 1.42), p = .022). Higher salivary cortisol levels were associated with lower lung function (Bevening cortisol = −2.22(SE = 0.59), p < .001). The association, in women, between depression/anxiety disorders and poorer physical function did not significantly diminish after adjustment for physiological stress markers. ConclusionThis large cohort study showed that stress system dysfunction (especially the immune-inflammatory system and HPA-axis) contributes to poorer objective physical function. Stress system dysfunction did not explain the poorer physical function observed in persons with depression/anxiety disorders, suggesting that other pathways are involved to explain that association.

Psychological stress, cognitive decline and the development of dementia in amnestic mild cognitive impairment

To determine the relationship between psychological stress with cognitive outcomes in a multi-centre longitudinal study of people with amnestic mild cognitive impairment (aMCI) we assessed three parameters of psychological stress (Recent Life Changes Questionnaire (RLCQ); the Perceived Stress Scale (PSS) and salivary cortisol) and their relationship with rates of cognitive decline over an 18 month follow up period and conversion to dementia over a 5.5 year period. In 133 aMCI and 68 cognitively intact participants the PSS score was higher in the aMCI compared with control group but neither the RLCQ scores nor salivary cortisol measures were different between groups. In the aMCI group the RLCQ and the PSS showed no significant association with cognitive function at baseline, cognitive decline or with conversion rates to dementia but high salivary cortisol levels were associated with RLCQ scores and poorer cognitive function at baseline and lower rates of cognitive decline. No relationship was found between salivary cortisol levels and conversion rate to dementia. We conclude that psychological stress as measured by the RLCQ or PSS was not associated with adverse cognitive outcomes in an aMCI population and hypothesise that this may reflect diminished cortisol production to psychological stress as the disease progresses.

Effects of Motivation-Based Academic Group Psychotherapy on Psychological and Physiological Academic Stress Responses among Korean Middle School Students

ABSTRACT This study investigated the effects of motivation-based academic group psychotherapy on psychological and physiological academic stress responses. Indicators of academic stress were the psychological measures of academic burnout and physiological measures of salivary cortisol. The intervention group was expected to show higher salivary cortisol levels initially and that both measures of academic burnout and salivary cortisol would decrease post-intervention. After the first measurement, the intervention group received group psychotherapy, and the comparison group received no treatment. Means, standard deviations, and correlation coefficients were calculated and general linear modeling was conducted. No initial between-group difference was detected in salivary cortisol. Post-intervention, signs of academic burnout decreased in the intervention group, mostly for cynicism. However, salivary cortisol increased in both groups. Accordingly, possible mechanisms and implications are discussed.

A pilot study on salivary cortisol secretion and auditory P300 event-related potential in patients with physical disability-related stress

Objective: To evaluate the stress level and attention in workers with physical disabilities-related stress.Methods: Morning salivary cortisol was used as a stress marker while the event-related potential during the performance of the auditory oddball paradigm was conducted to investigate the attentive ability to sound stimuli. Eighteen injured workers (IP) and eighteen unaffected healthy adults (CP) were recruited for this study with half being men and the other half women (aged 21–55). Behavioral performance measures including reaction time (RT), accuracy rate, and commission error as well as the latency and amplitude of P300 wave over the central (Cz), centroparietal (CPz), and parietal (Pz) electroencephalogram electrode sites were used to compare the two groups.Results: This study demonstrated significantly higher salivary cortisol levels, longer RT, less accuracy to respond to the target during the auditory oddball paradigm in the IP group as compared to CP group. In addition, a significant prolongation of the peak latency of auditory P300 wave over CPz electrodes was also detected in IP group.Conclusion: The increased cortisol levels found in the IP group reflect the alteration of the basal hypothalamic-pituitary-adrenal axis as a result of the stresses of living with a physical disability. Delayed RT and the decreased in accuracy together with changing in peak latencies of auditory P300 wave indicate the impairment of attention networks in IP. Our study revealed that the patients with permanent physical disability.