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Related Experiment Videos

Hypothalamic-pituitary-adrenal axis function in patients with chronic depression.

S Watson1, P Gallagher, D Del-Estal

  • 1Stanley Foundation Research Centre, School of Neurosciences and Psychiatry, University of Newcastle, Royal Victoria Infirmary, Newcastle upon Tyne.

Psychological Medicine
|September 7, 2002
PubMed
Summary

Hypothalamic-pituitary-adrenal (HPA) axis function appears normal in chronic depression. The dexamethasone/corticotropin releasing hormone (dex/CRH) test is more sensitive than the dexamethasone suppression test (DST) for detecting subtle HPA axis changes.

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Area of Science:

  • Neuroendocrinology
  • Psychiatry
  • Clinical Medicine

Background:

  • Previous studies using the dexamethasone suppression test (DST) indicated normal hypothalamic-pituitary-adrenal (HPA) axis function in chronic depression.
  • This study investigates HPA axis function in chronic depression using both the DST and the more sensitive dexamethasone/corticotropin releasing hormone (dex/CRH) test.

Purpose of the Study:

  • To determine if HPA axis abnormalities are present in patients with chronic depression.
  • To compare the sensitivity of the DST and the dex/CRH test in this patient group.
  • To compare findings with previous studies on depression.

Main Methods:

  • HPA axis function was examined in 29 patients with major depressive disorder (chronic subtype) and 28 matched controls.

Related Experiment Videos

  • Both the DST and the dex/CRH test were administered to assess cortisol response.

    • Main Results:

    • No significant differences in cortisol response to either the DST or the dex/CRH test were found between patients and controls.
    • A trend suggested more patients than controls had an abnormal response to the dex/CRH test (P = 0.052).
    • Neither abnormal response nor magnitude of response was predictable by illness or demographic variables.

    Conclusions:

    • The HPA axis is not overtly abnormal in chronic depression, contrasting with findings in acute depression and bipolar disorder.
    • This may indicate HPA axis abnormalities resolve during the progression to chronic depression or that a subgroup with less dysfunction progresses to chronicity.
    • The dex/CRH test demonstrates greater sensitivity than the DST for assessing HPA axis function in chronic depression, with implications for treatment and prognosis.