Prediction of Medium-Term Outcome by Cortisol Response to the Combined Dexamethasone-CRH Test in Patients With Remitted Depression
OBJECTIVE: Current hypotheses hold that mechanisms underlying abnormal hypothalamic-pituitary-adrenocortical (HPA) function are causal factors in the precipitation of depression. If this is the case, then normalization of initially disturbed HPA regulation should indicate a good prognosis and persis...
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| Published in: | The American journal of psychiatry Vol. 156; no. 6; pp. 949 - 951 |
|---|---|
| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Washington, DC
American Psychiatric Publishing
01-06-1999
American Psychiatric Association |
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| Abstract | OBJECTIVE: Current hypotheses hold that mechanisms underlying abnormal hypothalamic-pituitary-adrenocortical (HPA) function are causal factors in the precipitation of depression. If this is the case, then normalization of initially disturbed HPA regulation should indicate a good prognosis and persistent HPA dysregulation should be associated with a greater likelihood of relapse or chronicity. METHOD: The combined dexamethasone corticotropin-releasing hormone test was administered twice to inpatients with major depression (N=40), once after initiation of treatment and once after remission, shortly before discharge. RESULTS: Patients with a high cortisol response on both occasions or with a substantially increased cortisol response at discharge were at much higher risk for relapse within the next 6 months than those with low cortisol responses. CONCLUSIONS: An easy-to-administer neuroendocrine test allows the prediction of medium-term outcome in patients with remitted depression. |
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| AbstractList | OBJECTIVECurrent hypotheses hold that mechanisms underlying abnormal hypothalamic-pituitary-adrenocortical (HPA) function are causal factors in the precipitation of depression. If this is the case, then normalization of initially disturbed HPA regulation should indicate a good prognosis and persistent HPA dysregulation should be associated with a greater likelihood of relapse or chronicity.METHODThe combined dexamethasone/corticotropin-releasing hormone test was administered twice to inpatients with major depression (N = 40), once after initiation of treatment and once after remission, shortly before discharge.RESULTSPatients with a high cortisol response on both occasions or with a substantially increased cortisol response at discharge were at much higher risk for relapse within the next 6 months than those with low cortisol responses.CONCLUSIONSAn easy-to-administer neuroendocrine test allows the prediction of medium-term outcome in patients with remitted depression. OBJECTIVE: Current hypotheses hold that mechanisms underlying abnormal hypothalamic-pituitary-adrenocortical (HPA) function are causal factors in the precipitation of depression. If this is the case, then normalization of initially disturbed HPA regulation should indicate a good prognosis and persistent HPA dysregulation should be associated with a greater likelihood of relapse or chronicity. METHOD: The combined dexamethasone corticotropin-releasing hormone test was administered twice to inpatients with major depression (N=40), once after initiation of treatment and once after remission, shortly before discharge. RESULTS: Patients with a high cortisol response on both occasions or with a substantially increased cortisol response at discharge were at much higher risk for relapse within the next 6 months than those with low cortisol responses. CONCLUSIONS: An easy-to-administer neuroendocrine test allows the prediction of medium-term outcome in patients with remitted depression. Current hypotheses hold that mechanisms underlying abnormal hypothalamic-pituitary-adrenocortical (HPA) function are causal factors in the precipitation of depression. If this is the case, then normalization of initially disturbed HPA regulation should indicate a good prognosis and persistent HPA dysregulation should be associated with a greater likelihood of relapse or chronicity. The combined dexamethasone/corticotropin-releasing hormone test was administered twice to inpatients with major depression (N = 40), once after initiation of treatment and once after remission, shortly before discharge. Patients with a high cortisol response on both occasions or with a substantially increased cortisol response at discharge were at much higher risk for relapse within the next 6 months than those with low cortisol responses. An easy-to-administer neuroendocrine test allows the prediction of medium-term outcome in patients with remitted depression. |
| Author | Holsboer, Florian Frieboes, Ralf-Michael Zobel, Astrid W. Yassouridis, Alexander |
| Author_xml | – sequence: 1 givenname: Astrid W. surname: Zobel fullname: Zobel, Astrid W. – sequence: 2 givenname: Alexander surname: Yassouridis fullname: Yassouridis, Alexander – sequence: 3 givenname: Ralf-Michael surname: Frieboes fullname: Frieboes, Ralf-Michael – sequence: 4 givenname: Florian surname: Holsboer fullname: Holsboer, Florian |
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| Keywords | Mood disorder Human Hypothalamohypophysoadrenal axis Steroid hormone Psychotropic Treatment efficiency Peptide hormone Corticotropin releasing factor Prediction Biological marker Depression Hydrocortisone Glucocorticoid Hypothalamic hormone Dexamethasone test Chemotherapy Adrenal hormone Antidepressant agent Hormone releasing factor |
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| Title | Prediction of Medium-Term Outcome by Cortisol Response to the Combined Dexamethasone-CRH Test in Patients With Remitted Depression |
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