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Thyroid and adrenal axis in major depression: a controlled study in outpatients
Jantien P Brouwer1, Bente C Appelhof, Witte J G Hoogendijk
1Department of Endocrinology, University of Amsterdam, Amsterdam, The Netherlands. j.p.brouwer@amc.uva.nl
European Journal of Endocrinology
|March 5, 2005
Summary
Major depressive disorder patients showed slightly elevated thyroid-stimulating hormone (TSH) levels compared to controls. Atypical depression was linked to lower serum cortisol, suggesting distinct endocrine profiles in depression subtypes.
Area of Science:
- Endocrinology
- Psychiatry
- Neuroscience
Background:
- Major depressive disorder (MDD) is linked to hypothalamus-pituitary-thyroid (HPT) axis and cortisol level alterations.
- Previous studies show varied results, possibly due to patient status, medication, and depression heterogeneity.
Purpose of the Study:
- To investigate HPT axis and cortisol changes in unipolar depressed outpatients.
- To compare endocrine parameters in depressed individuals free from antidepressant medication for at least 3 months against matched controls.
Main Methods:
- Assessed endocrine parameters in 113 depressed outpatients and 113 controls.
- Included patients with MDD (SCID-IV) and HRSD score ≥16.
- Measured serum TSH, free thyroxine, tri-iodothyronine, cortisol, TPO antibody titre, and 24-h urinary cortisol.
Main Results:
- Depressed outpatients had slightly higher serum TSH than controls (P < 0.001).
- No significant differences in other HPT axis parameters or 24-h urinary cortisol excretion were found.
- Serum cortisol was lower in atypical depression compared to non-atypical depression (P = 0.01).
Conclusions:
- Outpatients with MDD exhibit slightly elevated serum TSH and similar urinary cortisol levels compared to controls.
- Lower serum cortisol levels were observed in patients with atypical depression.