title: Blunted ACTH response to hypoglycemic stress in depressed patients but not in patients with schizophrenia.
abstract: In this study, 7 hospitalized patients with major depression (MD), 5 hospitalized patients with schizophrenia (S), and 13 control subjects (C) were administered 0.15 units/kg of regular insulin at 1600 h by intravenous bolus infusion. ACTH, cortisol, and glucose levels were measured intermittently for 2h following infusion. Baseline ACTH, cortisol and glucose levels were similar in Cs, MDs, and Ss. The mean glucose nadir was equivalent for Cs, patients with MD, and patients with S. Patients with MD had a blunted ACTH response (F = 3.28; df = 12,126; p = .0004) and cortisol response (F = 4.20; df = 12,132; p = .0001) to hypoglycemia when compared to Cs and patients with S. Carroll Depression Rating Scale scores in patients with S (23 +/- 10) were similar to patients with MD (30 +/- 8) and significantly higher than in controls (1 +/- 2) (F = 55.2; df = 2.22; p = .0001). These findings suggest that patients with MD show different ACTH and cortisol responses to hypoglycemic stress which are not explained by negative feedback of baseline ACTH or cortisol, glucose nadir, or the number of depressive symptoms per se.
authors.affiliation: University of Iowa Hospitals and Clinics, Iowa City 52242.
authors.forename: R G
authors.initials: RG
authors.lastname: Kathol
authors.forename: T L
authors.initials: TL
authors.lastname: Gehris
authors.forename: B T
authors.initials: BT
authors.lastname: Carroll
authors.forename: S D
authors.initials: SD
authors.lastname: Samuelson
authors.forename: A F
authors.initials: AF
authors.lastname: Pitts
authors.forename: W H
authors.initials: WH
authors.lastname: Meller
authors.forename: J L
authors.initials: JL
authors.lastname: Carter
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003866:Depressive Disorder / Q000097:blood* / Q000175:diagnosis / Q000523:psychology; D003907:Dexamethasone; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007003:Hypoglycemia / Q000097:blood*; D007328:Insulin; D008297:Male; D010552:Personality Assessment; D011446:Prospective Studies; D012559:Schizophrenia / Q000097:blood* / Q000175:diagnosis; D012565:Schizophrenic Psychology
chemical_list: D001786:Blood Glucose; D007328:Insulin; D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone