Sex Differences in the Cortisol Response to the Trier Social Stress Test in Depressed and Nondepressed Adolescents

Two of the most robust findings in depression research are (a) that women are twice as likely to become depressed than men and (b) that stress is an important risk factor for depression. Although sex differences in stress reactivity may be an important determinant of differential risk for depression, few studies have examined sex differences in neurobiological reactivity to stress. The purpose of the current study was to assess sex differences in the HPA axis response to stress in depressed versus healthy controls by comparing the cortisol response to the Trier Social Stress Test in a community sample of adolescents (ages 12-18). Depressed boys showed significantly heightened cortisol reactivity compared with depressed girls, whose response was blunted compared with nondepressed girls. This diverging pattern of cortisol reactivity to stress among depressed girls and boys may help to explain the sex difference in depression prevalence that emerges during the adolescent period.