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The TRH-test in depression: a review.

F Christiaens, M Maes

Acta Neuropsychiatrica

|March 10, 2016

Summary

The thyrotropin releasing hormone (TRH)-test aids in diagnosing major depression but has limitations. Lower basal thyroid-stimulating hormone (TSH) secretion may replace TRH-testing in the future.

Area of Science:

Endocrinology
Psychiatry
Neuroscience

Background:

The thyrotropin releasing hormone (TRH)-test has been studied in patients with depression.
Its utility as a diagnostic criterion and predictor of treatment response is under review.

Purpose of the Study:

To review the literature on the TRH-test in depression.
To evaluate its diagnostic accuracy, clinical utility, and underlying pathophysiology.

Main Methods:

Literature review of studies investigating the TRH-test in depressive patients.
Analysis of test sensitivity, specificity, and correlation with clinical diagnoses and treatment outcomes.

Main Results:

The TRH-test shows some utility in validating major depression diagnoses, particularly melancholic vs. minor depression.

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Low sensitivity (±50%) and abnormal results in non-depressive disorders limit its clinical use.

The test may predict response to biological therapies and has value for depressive episode outcomes.

Abnormal TRH-tests are linked to noradrenergic/serotonergic dysfunctions, hypercortisolemia, and thyroid hormone abnormalities.

Depression-linked abnormal TRH-tests correlate with lower basal TSH secretion.

Conclusions:

The TRH-test has a limited role in diagnosing depression due to sensitivity issues and non-specific findings.
It may serve as a predictor for treatment response and outcome.
Lower basal TSH secretion is a potential future replacement for TRH-testing in depression assessment.