TY - JOUR

T1 - Evaluation of salivary cortisol as a biomarker of self-reported mental stress in field studies

AU - Hjortskov, Nis

AU - Garde, Anne Helene

AU - Ørbæk, Palle

AU - Hansen, Åse Marie

PY - 2004/4/1

Y1 - 2004/4/1

N2 - This study examines the association between self-reported mental stress and the salivary cortisol response via a systematic literature review by using recommendations from the Cochrane Collaboration. Literature in different databases was screened and articles were selected on the basis of a set of inclusion criteria. Each article was assigned a total score on the basis of a rating system including objective and design of the studies, description of possible confounders, sampling strategy, description of psychosocial factors, and statistical analysis. The findings of the studies were considered to be inconsistent if less than 75 per cent of the high and medium quality studies reported the same conclusion. The literature search revealed a total of 73 studies. According to the inclusion criteria 14 field studies were selected for further evaluation. According to the rating system, seven studies were considered to be of high quality and seven studies of medium quality. No studies were considered to be of low quality. Four studies reported a positive association; two studies reported negative association and eight reported no association between self-reported mental stress and the cortisol response. Accordingly, the evaluation of the studies in this paper showed insufficient evidence for an association between self-reported mental stress and the cortisol response in field studies. Possibly the large diversity in study designs, the types and measures of mental stress, and the various salivary cortisol sampling strategies obscure any potential relationship.

AB - This study examines the association between self-reported mental stress and the salivary cortisol response via a systematic literature review by using recommendations from the Cochrane Collaboration. Literature in different databases was screened and articles were selected on the basis of a set of inclusion criteria. Each article was assigned a total score on the basis of a rating system including objective and design of the studies, description of possible confounders, sampling strategy, description of psychosocial factors, and statistical analysis. The findings of the studies were considered to be inconsistent if less than 75 per cent of the high and medium quality studies reported the same conclusion. The literature search revealed a total of 73 studies. According to the inclusion criteria 14 field studies were selected for further evaluation. According to the rating system, seven studies were considered to be of high quality and seven studies of medium quality. No studies were considered to be of low quality. Four studies reported a positive association; two studies reported negative association and eight reported no association between self-reported mental stress and the cortisol response. Accordingly, the evaluation of the studies in this paper showed insufficient evidence for an association between self-reported mental stress and the cortisol response in field studies. Possibly the large diversity in study designs, the types and measures of mental stress, and the various salivary cortisol sampling strategies obscure any potential relationship.

KW - Cochrane review

KW - Cortisol

KW - Mental stress

KW - Salivary

KW - Self-reports

UR - http://www.scopus.com/inward/record.url?scp=2342616113&partnerID=8YFLogxK

U2 - 10.1002/smi.1000

DO - 10.1002/smi.1000

M3 - Review

AN - SCOPUS:2342616113

VL - 20

SP - 91

EP - 98

JO - Stress and Health

JF - Stress and Health

SN - 1532-2998

IS - 2

ER -