{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:46:20Z","timestamp":1782301580228,"version":"3.54.5"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"\n Background<\/jats:title>\n The relationship between clinical features of depression and hypothalamic-pituitary-adrenal (HPA) axis activity in adolescents remains poorly understood. This study examined the main and interactive effects of depressive severity, cognitive function, and somatic symptoms on cortisol levels in adolescent depression.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This cross-sectional study included 138 adolescents. Based on their scores on the 24-item Hamilton Depression Rating Scale (HAMD-24) and the Patient Health Questionnaire-15 (PHQ-15), participants were divided into three groups: the depression with somatic symptoms group (DP group), the depression without somatic symptoms group (DW group), and a normal control group. To examine the main and interactive associations of clinical variables on cortisol levels, a general linear model (GLM) and simple slope analysis were employed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Although bivariate correlations and group comparisons revealed no direct associations between cortisol levels and clinical indicators, the GLM identified significant interaction effects: PHQ\u221215 \u00d7 HAMD\u221224 (\n B<\/jats:italic>\n \u00a0=\u00a00.01,\n p<\/jats:italic>\n \u00a0&lt;\u00a00.05) and PHQ\u221215 \u00d7 MoCA (\n B<\/jats:italic>\n \u00a0=\u00a00.06,\n p<\/jats:italic>\n &lt;\u00a00.05). The subsequent moderation model reached overall significance, further confirming the presence of these interactions (\n F<\/jats:italic>\n \u00a0=\u00a02.331,\n p<\/jats:italic>\n \u00a0=\u00a00.023,\n R\u00b2<\/jats:italic>\n \u00a0=\u00a00.13). Simple slope analyses showed that higher somatic symptoms were significantly associated with lower cortisol only when depression severity was low\u2212to\u2212moderate and cognitive function was low, whereas a non\u2212significant positive trend was observed when both were high.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The association between somatic symptoms and cortisol in adolescents is differentially moderated by depression severity and cognitive function: a significant negative association was observed under conditions of low\u2212to\u2212moderate depression and low cognitive function, whereas a non\u2212significant positive trend appeared when both were high. These hypothesis\u2212generating findings require replication in larger, prospective studies.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1850207","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T10:48:56Z","timestamp":1782298136000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The relationship between depression symptoms and cortisol levels in adolescents: the role of somatic symptoms and cognitive function"],"prefix":"10.3389","volume":"17","author":[{"given":"Xia","family":"Lan","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Luzhou Psychiatric Hospital","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pan","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Luzhou Psychiatric Hospital","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Luzhou Psychiatric Hospital","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Luzhou Psychiatric Hospital","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongfang","family":"He","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Affiliated Hospital of Southwest Medical University","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Luzhou Psychiatric Hospital","place":["Luzhou, Sichuan, 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