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Vasoconstrictor response to topical beclomethasone in major depression
Paul A Cotter1, Owen F Mulligan, Sabine Landau
1Section of Metabolic Studies, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK. paul.cotter@dhh.n-i.nhs.uk
Psychoneuroendocrinology
|March 26, 2002
Summary
Depression may involve abnormal glucocorticoid receptor (GR) function, indicated by a reduced skin vasoconstrictor response to beclomethasone. This peripheral GR abnormality in depression is not directly linked to cortisol suppression levels.
Area of Science:
- Neuroendocrinology
- Psychiatry
- Dermatology
Background:
- Hypothalamic-pituitary-adrenal (HPA) axis overactivity is common in depression.
- Negative feedback defects, particularly in glucocorticoid receptor (GR) function, may cause HPA axis overactivity.
Purpose of the Study:
- To investigate peripheral glucocorticoid receptor (GR) function in major depression.
- To assess GR function using the vasoconstrictor response to topical beclomethasone.
Main Methods:
- Twenty-two individuals with major depression and matched controls received topical beclomethasone (3-100 microg/ml) on their forearms.
- Skin blanching responses were measured and compared between groups.
- Within the depressed group, responses were analyzed based on modified dexamethasone suppression test (DST) results.
Main Results:
- Depressed subjects showed a significantly blunted vasoconstrictor response to beclomethasone compared to controls (P=0.0001).
- No significant difference in vasoconstrictor response was observed between cortisol suppressors and non-suppressors within the depressed group.
Conclusions:
- Peripheral GR function appears to be impaired in major depression.
- The observed reduced vasoconstrictor response to beclomethasone in depression is not solely a consequence of HPA axis overactivity or hypercortisolaemia.