{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:23:20Z","timestamp":1792592600684,"version":"4.5.0"},"reference-count":32,"publisher":"Royal College of Psychiatrists","issue":"2","license":[{"start":{"date-parts":[[2018,1,2]],"date-time":"2018-01-02T00:00:00Z","timestamp":1514851200000},"content-version":"unspecified","delay-in-days":335,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Many patients with depressive disorders demonstrate resistance to psychological therapy. A frequent finding is hypothalamic\u2013pituitary\u2013adrenal (HPA) axis alterations. As cortisol is known to modulate cognitive processes, those patients may be less likely to profit from psychological therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To conduct a systematic review and meta-analysis on cortisol as a predictor of psychological therapy response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The Cochrane Library, EMBASE, MEDLINE and PsycINFO databases were searched. Records were included if they looked at patients with any depressive disorder engaging in psychological therapy, with a pre-treatment cortisol and a post-treatment symptom measure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight articles satisfied our selection criteria. The higher the cortisol levels before starting psychological therapy, the more symptoms patients with depression experienced at the end of treatment and\/or the smaller their symptom change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings suggest that patients with depression with elevated HPA functioning are less responsive to psychological therapy.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.bp.115.180653","type":"journal-article","created":{"date-parts":[[2016,12,1]],"date-time":"2016-12-01T21:00:15Z","timestamp":1480626015000},"page":"105-109","source":"Crossref","is-referenced-by-count":99,"title":["Cortisol as a predictor of psychological therapy response in depressive disorders: Systematic review and meta-analysis"],"prefix":"10.1192","volume":"210","author":[{"given":"Susanne","family":"Fischer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Strawbridge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres Herane","family":"Vives","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J.","family":"Cleare","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2018,1,2]]},"reference":[{"key":"S0007125000279646_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/0165-0327(89)90031-1"},{"key":"S0007125000279646_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2008.10.014"},{"key":"S0007125000279646_ref23","volume-title":"Psychotherapy Research","author":"Rush","year":"1982"},{"key":"S0007125000279646_ref26","first-page":"CD005168","article-title":"Antiglucocorticoid treatments for mood disorders","volume":"1","author":"Gallagher","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"S0007125000279646_ref31","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2011.11020335"},{"key":"S0007125000279646_ref5","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200422060-00003"},{"key":"S0007125000279646_ref30","doi-asserted-by":"publisher","DOI":"10.1080\/10253890701378967"},{"key":"S0007125000279646_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2013.03.022"},{"key":"S0007125000279646_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2008.09.004"},{"key":"S0007125000279646_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2014.02.026"},{"key":"S0007125000279646_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2012.09.001"},{"key":"S0007125000279646_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7894(05)80311-9"},{"key":"S0007125000279646_ref7","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0b013e31820ad12b"},{"key":"S0007125000279646_ref6","doi-asserted-by":"publisher","DOI":"10.3109\/15622975.2014.916414"},{"key":"S0007125000279646_ref14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"S0007125000279646_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsycho.2011.02.002"},{"key":"S0007125000279646_ref11","volume-title":"Practical Meta-Analysis.","author":"Lipsey","year":"2001"},{"key":"S0007125000279646_ref12","doi-asserted-by":"publisher","DOI":"10.1002\/9780470743386"},{"key":"S0007125000279646_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2010.03.007"},{"key":"S0007125000279646_ref16","article-title":"Rapid eye-movement density and latency and dexamethasone suppression as predictors of treatment response in depressed older adults","volume":"47","author":"Corbishley","year":"1990","journal-title":"Curr Ther Res Clin Exp"},{"key":"S0007125000279646_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(01)01157-X"},{"key":"S0007125000279646_ref18","first-page":"293","article-title":"Reynolds CF 3rd. 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