The relationships between relative hypo- and hypercortisolism and mean questionnaire scores among bipolar patients.

Adj, adjusted; BAI, Beck Anxiety Inventory; BSA-S, Brief Scale of Anxiety – Self assessment; BDI, Beck Depression Inventory; BMI, body mass index; DST, dexamethasone suppression test; GAF, Global Assessment of Functioning; MADRS-S, Montgomery Åsberg Depression Rating Scale – Self assessment; QOL, Quality of Life. All values are means with standard deviations within the following parentheses. Analyses of covariance were used when testing for adjusted differences between two means. The adjusted model contained the variables age, sex and diagnosis (bipolar type 1 or 2) in addition to cortisol group (low, mid, high). We also tested for additional potential confounding through individually including within the model the following variables: BMI, smoking, antidepressant medication, neuroleptic medication, sedative medication and medication with mood stabilizer (see statistical section). Significant adjusted analyses remained significant also after these additional potential confounders were added to the model except for a few instances where the cortisol variable showed a trend toward significance (p-values between 0.05 to 0.085): BSA-S, GAF current, the independence and social relationships domains (QOL) within the low vs. mid group analyses. In one of these additional potential confounding analyses however, when BMI was added to the adjusted model pertaining to low vs mid cortisol group comparisons with respect to the independence domain the analysis did not show significance nor trend (p = 0.153).aPost-DST cortisol groups were formed by using the 25th and 75th percentiles among the controls as cut-offs to divide both controls and patients into 3 groups. A low post DST cortisol value (subjects below the 25th percentile) was used to identify subjects exhibiting relative hypocortisolism and a high post DST cortisol value (subjects above the 75th percentile) was used to identify subjects exhibiting relative hypercortisolism. Subjects showing post DST cortisol values between the 25th and 75th percentiles were identified as subjects exhibiting eucortisolism.bIn the GAF analyses n were as follows: low group, n = 37; mid group, n = 59, high group, n = 46 (n = total 142).cIn the Quality of Life analyses n were as follows: low group, n = 36; mid group, n = 60; high group, n = 48 (n = total 144).