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Hair cortisol concentration and mental health during childhood and adolescence: evidence that higher cortisol concentration is associated with externalizing problems in a large Brazilian population-based birth cohort.

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Title: Hair cortisol concentration and mental health during childhood and adolescence: evidence that higher cortisol concentration is associated with externalizing problems in a large Brazilian population-based birth cohort.
Authors: Tovo-Rodrigues, Luciana (AUTHOR), Goularte, Laura Moreira (AUTHOR), Bierhals, Isabel Oliveira (AUTHOR), Santos, Iná S. (AUTHOR), Martins-Silva, Thais (AUTHOR), Rohde, Luis Augusto (AUTHOR), de Oliveira, Isabel Oliveira (AUTHOR), Gonzalez, Andrea (AUTHOR), Matijasevich, Alicia (AUTHOR), Murray, Joseph (AUTHOR)
Source: European Child & Adolescent Psychiatry. Sep2025, Vol. 34 Issue 9, p2739-2752. 14p.
Subjects: Mental illness risk factors, Adolescent development, Risk assessment, Hair analysis, Research funding, Questionnaires, Enzyme-linked immunosorbent assay, Hydrocortisone, Descriptive statistics, Longitudinal method, Teenagers' conduct of life, Child development, Externalizing behavior, Collection & preservation of biological specimens, Data analysis software, Confidence intervals, Biomarkers, Regression analysis, Child behavior, Adolescence, Children
Geographic Terms: Brazil
Abstract: Childhood and adolescence are pivotal periods for mental health. The hypothalamic-pituitary-adrenal axis is the primary stress system and its chronic activation is measurable via hair cortisol concentration (HCC), indicating long-term stress exposure. While HCC is linked to adult mental health, this relationship remains unclear among youth. Although a bidirectional relationship is possible, the impact of mental health problems on HCC in youths has been comparatively underexplored. This study aimed to assess the association between symptoms of mental health problems in childhood and adolescence and HCC levels at age 15 in a Brazilian population-based cohort. We analyzed data from the 2004 Pelotas Birth Cohort, which includes 4,231 children followed from birth. At ages 6, 11 and 15 years, mental health symptoms were assessed using the Strengths and Difficulties Questionnaire (SDQ). At age 15, HCC was measured from 3 cm hair samples, quantified through the enzyme-linked immunosorbent assay. To evaluate the cumulative impact of mental health symptoms from childhood to adolescence, group-based trajectory analysis was conducted. Subsequently, linear regression models were used to estimate associations between mental health scores and HCC, with adjustment for relevant covariates. Regression coefficients were exponentiated to improve interpretability. SDQ total difficulties (β = 1.004 [1.000;1.008]) and conduct problems (β = 1.017 [1.004;1.030]) at age 6 were associated with HCC at age 15 in adjusted models. Hyperactivity/inattention symptoms at ages 6 (β = 1.009 [1.001;1.018]) and 11 (β = 1.013 [1.004;1.022]) were associated with HCC in adjusted models. At age 15, hyperactivity/inattention symptoms and HCC was associated with HCC in the partially adjusted model (β = 1.009 [1.000;1.017]). Trajectories of chronic conduct problems and hyperactivity between ages 6 and 15 were also associated with elevated HCC, although for hyperactivity/inattention symptoms the association was not significant. These associations emphasize the links between mental health and chronic stress over time, especially between both conduct problems and hyperactivity/inattention symptoms in relation to higher concentrations of HCC. [ABSTRACT FROM AUTHOR]
Copyright of European Child & Adolescent Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Hair cortisol concentration and mental health during childhood and adolescence: evidence that higher cortisol concentration is associated with externalizing problems in a large Brazilian population-based birth cohort.
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  Data: <searchLink fieldCode="JN" term="%22European+Child+%26+Adolescent+Psychiatry%22">European Child & Adolescent Psychiatry</searchLink>. Sep2025, Vol. 34 Issue 9, p2739-2752. 14p.
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  Data: <searchLink fieldCode="DE" term="%22Brazil%22">Brazil</searchLink>
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  Data: Childhood and adolescence are pivotal periods for mental health. The hypothalamic-pituitary-adrenal axis is the primary stress system and its chronic activation is measurable via hair cortisol concentration (HCC), indicating long-term stress exposure. While HCC is linked to adult mental health, this relationship remains unclear among youth. Although a bidirectional relationship is possible, the impact of mental health problems on HCC in youths has been comparatively underexplored. This study aimed to assess the association between symptoms of mental health problems in childhood and adolescence and HCC levels at age 15 in a Brazilian population-based cohort. We analyzed data from the 2004 Pelotas Birth Cohort, which includes 4,231 children followed from birth. At ages 6, 11 and 15 years, mental health symptoms were assessed using the Strengths and Difficulties Questionnaire (SDQ). At age 15, HCC was measured from 3 cm hair samples, quantified through the enzyme-linked immunosorbent assay. To evaluate the cumulative impact of mental health symptoms from childhood to adolescence, group-based trajectory analysis was conducted. Subsequently, linear regression models were used to estimate associations between mental health scores and HCC, with adjustment for relevant covariates. Regression coefficients were exponentiated to improve interpretability. SDQ total difficulties (β = 1.004 [1.000;1.008]) and conduct problems (β = 1.017 [1.004;1.030]) at age 6 were associated with HCC at age 15 in adjusted models. Hyperactivity/inattention symptoms at ages 6 (β = 1.009 [1.001;1.018]) and 11 (β = 1.013 [1.004;1.022]) were associated with HCC in adjusted models. At age 15, hyperactivity/inattention symptoms and HCC was associated with HCC in the partially adjusted model (β = 1.009 [1.000;1.017]). Trajectories of chronic conduct problems and hyperactivity between ages 6 and 15 were also associated with elevated HCC, although for hyperactivity/inattention symptoms the association was not significant. These associations emphasize the links between mental health and chronic stress over time, especially between both conduct problems and hyperactivity/inattention symptoms in relation to higher concentrations of HCC. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Child & Adolescent Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1007/s00787-025-02693-x
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        Text: English
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        Type: general
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      – SubjectFull: Risk assessment
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