The Interaction of Oxytocin and Social Support, Loneliness, and Cortisol Level in Major Depression
Tsung-Yu Tsai 1, Huai-Hsuan Tseng 1, Mei Hung Chi 1, Hui Hua Chang 1, Cheng-Kuan Wu 1, Yen Kuang Yang 1, Po See Chen 1*
1Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, 1Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Received: December 21, 2018; Revised: March 11, 2019; Accepted: April 4, 2019; Published online: April 4, 2019.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Objective: Loneliness is a specific risk factor for depressive symptoms and suicidal behavior. The present study examined whether the serum oxytocin level would interact with social support and buffers loneliness and HPA-axis activity in drug-naïve patients with major depressive disorder (MDD).
Methods: Twenty-six (M:F=3:23, age: 45.54±12.97) patients with MDD were recruited. The 17-item Hamilton depression rating scale, UCLA Loneliness Scale and self-reported Measurement of Support Function questionnaire were administered. Serum oxytocin and cortisol levels were assessed using a commercial immunoassay kits.
Results: In MDD patients, a negative association was found between degrees of social support and loneliness (β =-0.39, p=0.04). The interaction between social support and serum oxytocin level was negatively associated with loneliness (β=−0.50, p=0.017) and serum cortisol level (β=−0.52, p=0.020) after adjusting for age. Follow-up analyses showed that the association between higher social support and lower loneliness was observed only in the higher-oxytocin group (r = −0.75, p = 0.003) but not in the lower group (r = −0.19, p = 0.53). The significance remained after further adjusting for sex and depression severity.
Conclusion: Low oxytocin level is a vulnerability factor for the buffering effect of social support for loneliness and aberrant hypothalamic-pituitary-adrenal (HPA)-axis activity in MDD patients.
Keywords: cortisol, loneliness, major depression, oxytocin, social support


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