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Psychoneuroendocrinology. 2009 Sep;34(8):1208-13. doi: 10.1016/j.psyneuen.2009.03.009. Epub 2009 Apr 17.

Dex/CRH test cortisol response in outpatients with major depression and matched healthy controls.

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  • 1Department of Psychiatry and Human Behavior, Mood Disorders Research Program and Laboratory for Clinical Neuroscience, Brown Medical School, Butler Hospital, 345 Blackstone Blvd., Providence, RI 02906, USA. Linda_Carpenter_MD@Brown.edu



The dexamethasone/corticotropin releasing hormone (Dex/CRH) test has been proposed as a potential tool for identifying endophenotypes relevant to mood disorders. An exaggerated cortisol response to the test during major depressive episodes has been demonstrated for inpatients with melancholic or psychotic features. A diminished hormone response has been observed in chronically depressed outpatients.


Following a battery of self-report and interview assessments, 68 adults completed the Dex/CRH test. Thirty-four met structured interview criteria for current major depressive disorder and 34 age- and sex-matched control subjects had no current or lifetime DSM-IV depressive disorder. Effect of diagnosis on cortisol response to the Dex/CRH test was examined in a repeated measures general linear model.


The matched groups were equivalent with regard to childhood adversity. Cortisol response to the Dex/CRH test among subjects with current MDD was not significantly different from that seen in matched healthy controls. Independent of diagnosis, an exploratory analysis showed a trend-level association between maltreatment history and diminished cortisol response; no interactive effects with depression diagnosis were detected.


The results do not support the hypothesis that elevated cortisol response to the Dex/CRH test represents a marker for major depressive episodes.

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