Increased HPA axis response to psychosocial stress in remitted depression: the influence of coping style

The aim of the study was to examine the modulating effects of coping style on the response to psychosocial stress in remitted major depression (MD) and healthy controls. Thirty-three participants with a lifetime history of MD, who were in remission, and 32 age- and gender-matched healthy controls were recruited from a longitudinal-epidemiological study, in which the presence or absence of mental disorders was prospectively ascertained. Participants (aged 30-41 years) underwent two consecutive Trier Social Stress Tests (TSSTs). Subjects with a lifetime history of MD showed larger plasma ACTH and cortisol concentrations in response to both TSSTs, confirming a disturbed hypothalamic-pituitary-adrenal (HPA) axis regulation. Moreover, the MD group reported less positive, adaptive coping strategies and more negative, maladaptive strategies than the control group. The amount of negative coping predicted the size of the plasma cortisol response in the combined group. Our results demonstrate the importance of psychological coping strategies for the investigation of HPA axis response in depression.