Emotional Regulation and Serum Cortisol Levels in Patients with Depressive Disorders versus General Population: A Cross-sectional Study

Introduction: Depressive disorders are among the most prevalent and disabling mental health conditions and are increasingly conceptualised as illnesses involving maladaptive emotional regulation. In parallel, neuroendocrine mechanisms—particularly Hypothalamic–Pituitary–Adrenal (HPA) axis dysregulation— have been implicated, with elevated morning cortisol reflecting sustained stress-system activation in depression. Aim: To determine the levels of emotional regulation and serum cortisol in patients with depressive disorders, in comparison with the general population. Materials and Methods: This single-centre, cross-sectional study was conducted in the outpatient Department of Psychiatry, Chettinad Hospital and Research Institute, Kelambakkam, Tamil Nadu, India, over eight months (November 2024-June 2025). A total of 74 participants were recruited using purposive sampling: 37 patients with depressive disorders and 37 individuals from the general population. Depression severity was assessed using the Hamilton Depression Rating Scale (HAM-D-17), emotionregulation difficulties were evaluated using the Difficulties in Emotion Regulation Scale (DERS total and subscales), and morning serum cortisol (8:00–9:00 AM) was measured via chemiluminescent immunoassay. Data were analysed using IBM Statistical Package for the Social Sciences (SPSS) Statistics version 26.0. Independent-samples t-test, Chi-square/Fisher’s exact test, and Pearson correlation were applied, with twotailed p-value