[Cortisol reactivity and adult mental health in adults exposed to early violence: a systematic reviewReatividade do cortisol e saúde mental em adultos com exposição precoce à violência: uma revisão sistemática]

Increased Cortisol Response and Low Quality of Life in Women Exposed to Intimate Partner Violence With Severe Anxiety and Depression

BACKGROUND

Intimate partner violence (IPV) is one of the most prevalent forms of violence against women globally and it is considered a public health problem. Because the experience of IPV is stressful and traumatic for victims, they are at high risk of developing alteration of the Hypothalamus-Pituitary-Adrenal (HPA) axis functioning as well as anxiety and depression symptoms. The aim of this study was to compare the quality of life and changes in cortisol response to an acute stressor between women exposed to IPV and non-exposed women. Differences according to symptoms of anxiety and depression including the risk of suicide thoughts, were also analyzed.

METHOD

Our sample size consisted of 130 women (ages 18-68) grouped as follows: 71 women experiencing IPV and 59 women without history of IPV as control group. All participants completed a battery of questionnaires including IPV exposure, anxiety, and depression symptoms (Beck Inventories), as well as quality of life (WHOQOL-BREF). Salivary cortisol levels in response to a cognitive test with verbal, mathematical, and abstract reasoning were measured at four time points.

RESULTS

Women exposed to IPV, with severe anxiety and depression symptoms as well as suicide thoughts, exhibited heightened cortisol response after the cognitive test and reported lower quality of life compared to (i) women experiencing IPV with moderate symptoms of anxiety and depression, who showed a blunted response, and (ii) women without history of IPV with minimal to moderate symptoms, who showed a decreased cortisol profile. Social relationships dimension was in particular the most affected aspect of quality of life.

CONCLUSIONS

Our findings highlight the role of cortisol responses as a complementary biological marker to be associated with severe psychiatric disturbances in women exposed to IPV.

Is prenatal arsenic exposure associated with salivary cortisol in infants in Arica, Chile? An exploratory cohort study

INTRODUCTION

In animal models, gestational exposure to inorganic arsenic has been associated with higher corticosterone concentration and consequent impairment of stress control in offspring. An equivalent association relating cortisol, a glucocorticoid hormone, in humans has not been previously studied.

OBJECTIVE

The aim of the study was to explore the association between prenatal inorganic arsenic exposure and salivary cortisol in infants from Arica, Chile.

MATERIAL AND METHODS

A cohort study of 168 mother-child dyads was recruited. In the 2nd trimester of pregnancy, urinary inorganic arsenic was assessed; 18-24 months after delivery, salivary cortisol was measured in the children. Maternal cortisol, maternal depression, stress, and socio-economic status were also evaluated.

RESULTS

The adjusted association was estimated with multiple linear regression after evaluating confounding through a directed acyclic graph. Median urinary inorganic arsenic in pregnant women was 14.1 µg/L (IQR: 10.4-21.7) while salivary cortisol in the children was 0.17 µg/L (IQR: 0.11-0.38). Among children from the highest income families (> 614 USD/month), arsenic exposure was associated with salivary cortisol. Children in the third quartile of arsenic exposure had -0.769 units of the logarithm of salivary cortiso, compared with those in the first quartile (p = 0.045).

CONCLUSIONS

In this sample, prenatal exposure to arsenic was associated with salivary cortisol (third quartile of inorganic arsenic), only in infants belonging the highest income strata (> 614 USD). More studies are needed to confirm these preliminary results.