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Am J Psychiatry. 1999 Jun;156(6):949-51.

Prediction of medium-term outcome by cortisol response to the combined dexamethasone-CRH test in patients with remitted depression.

Author information

  • 1Max Planck Institute of Psychiatry, Munich, Germany. zobel@mpipsykl.mpg.de

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.

PMID:
10360139
[PubMed - indexed for MEDLINE]
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