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Biol Psychiatry. 2006 Apr 15;59(8):696-701. Epub 2005 Dec 20.

Glucocorticoids and relapse of major depression (dexamethasone/corticotropin-releasing hormone test in relation to relapse of major depression).

Author information

1
Department of Endocrinology and Metabolism, Academic Medical Center of the University of Amsterdam, The Netherlands. b.c.appelhof@amc.iva.nl

Abstract

BACKGROUND:

Knowledge of pathogenic mechanisms and predictors of relapse in major depressive disorder is still limited. Hypothalamic-pituitary-adrenocortical (HPA) axis dysregulation is thought to be related to the development and course of depression.

METHODS:

We investigated whether dexamethasone/corticotropin-releasing hormone (DEX/CRH) test parameters were related to the occurrence of relapse in 45 outpatients with clinically remitted major depression. The DEX/CRH test was administered before and after 8 weeks of antidepressant treatment.

RESULTS:

Posttreatment maximal adrenocorticotropic hormone (ACTH) and maximal cortisol levels, as well as delta ACTH and delta cortisol levels, were significantly higher (all p < .05) among patients who relapsed (n = 22) compared with patients in whom no relapse occurred (n = 23). Higher posttreatment maximal cortisol response on the DEX/CRH test was associated with shorter "relapse-free survival" (p = .05).

CONCLUSIONS:

In outpatients with clinically remitted major depression, higher posttreatment maximal cortisol levels on the DEX/CRH test were associated with relapse of major depression.

PMID:
16368077
DOI:
10.1016/j.biopsych.2005.09.008
[Indexed for MEDLINE]
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