Basal and reactive cortisol: A systematic literature review of offspring of parents with depressive and bipolar disorders

Bonnie Klimes-Dougan, Victoria Papke, Katherine A. Carosella, Andrea Wiglesworth, Salahudeen A. Mirza, Tori Espensen-Sturges, Christina Meester

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations


One of the most consistent biological findings in the study of affective disorders is that those with depression commonly show abnormal cortisol response, which suggests dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Children of parents with mood disorders offer the opportunity to explore the biological pathways that may confer risk for psychopathology. This review explores basal and reactive cortisol in the offspring of parents who are currently depressed or have had a history of a depressive or bipolar disorder. Using PRISMA guidelines, search terms yielded 2002 manuscripts. After screening, 87 of these manuscripts were included. Results from the literature suggest that while the degree and direction of dysregulation varies, offspring of a parent with depression tend to show elevations in both basal (particularly morning and evening) and reactive (tentatively for social stressors) cortisol levels. There were few studies focused on offspring of parents with bipolar disorder. This review also discusses implications and recommendations for future research regarding the HPA axis in the intergenerational transmission of depressive disorders.

Original languageEnglish (US)
Article number104528
JournalNeuroscience and Biobehavioral Reviews
StatePublished - Apr 2022

Bibliographical note

Funding Information:
We would like to thank the members of the Research in Adolescent Depression (RAD) Lab ( at the University of Minnesota for their support and helpful insights.

Publisher Copyright:
© 2022 Elsevier Ltd


  • Bipolar disorder
  • Children
  • Cortisol
  • Depression
  • HPA axis
  • Intergenerational
  • Offspring
  • Parental

PubMed: MeSH publication types

  • Journal Article
  • Review
  • Systematic Review


Dive into the research topics of 'Basal and reactive cortisol: A systematic literature review of offspring of parents with depressive and bipolar disorders'. Together they form a unique fingerprint.

Cite this