Scientists find revolutionary ‘biomarker’ for clinical depression in teenage boys

Young men who have depressive symptoms and high cortisol levels are the most susceptible

A revolutionary way of identifying the teenage boys who are most likely to develop clinical depression in later life has been discovered by researchers at the University of Cambridge.

Predicting those who may be at risk of depressive symptoms has been puzzling doctors for decades but now scientists have found the first biomarker – or biological signpost – for clinical depression.

Teenage boys who have a combination of depressive symptoms and raised levels of the stress hormone cortisol are up to 14 times more likely to develop clinical depression than those who show neither trait.

Around one in six people suffer from clinical depression at some point in their lives and three-quarters of mental health diseases start before people are 24 years old. Researchers believe this latest discovery, published last night in the journal Proceedings of the National Academy of Sciences of the United States of America (PNAS), could help target treatment and mean doctors can intervene earlier.

Professor Ian Goodyer from the University of Cambridge, who led the study, said: “Depression is a terrible illness that will affect as many as 10 million people in the UK at some point in their lives. Through our research, we now have a very real way of identifying those teenage boys most likely to develop clinical depression.

“This will help us strategically target preventions and interventions at these individuals and hopefully help to reduce their risk of serious episodes of depression and their consequences in adult life.”

At the moment the indicators work only for men because cortisol levels are higher in women and they have not found an equivalent way of predicting outcomes for female patients.

Researchers analysed several early morning saliva samples taken within a week from more than 1,850 teenagers – and did the same again a year later. The samples showed cortisol levels were stable over the year and were then combined with self-reports about symptoms of depression.

The teenagers were then divided into four groups, ranging from group one, who had normal levels of morning cortisol and low symptoms of depression over time, through to group four, who had elevated levels of morning cortisol and high symptoms of depression over time.

Teenage boys in group four were 14 times more likely to develop clinical depression than those in the first group. 

Teenage girls in this fourth group were only four times more likely than those in the first group to develop major depression – and were no more likely to develop the condition than those with either high morning cortisol or symptoms of depression alone. The findings suggest gender differences in how depression develops.

Paul Jenkins, chief executive of Rethink Mental Illness, said: “These findings represent a major development in our understanding of depression among teenage boys. When young people receive early intervention treatment, they have a much better chance of getting better and avoiding long-term mental health problems.

“The prospect of identifying boys at risk at an earlier stage, should enable us to make a big step forward in successfully treating serious mental illness.”

John Williams, head of neuroscience and mental health at the Wellcome Trust, which funded the research, said: “Progress in identifying biological markers for depression has been frustratingly slow, but now we finally have a biomarker for clinical depression. The approach taken by Professor Goodyer’s team may yet yield further biomarkers. It also gives tantalising clues about the gender differences in the causes and onset of depression.”

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