Persistent cortisol non-suppression after clinical recovery predicts symptomatic relapse in unipolar depression.
We assessed the length and the quality of remission of 13 unipolar endogenous depressed patients, DST non-suppressors before treatment, in a 2-year prospective study. During this period, we recorded stressful life events. Persistent dexamethasone non-suppression, after treatment and complete clinical recovery, correlated highly with early clinical relapse. All six non-normalizers but only one normalizer were rehospitalized within the following 2 years for a major depressive relapse. Persistent DST non-suppression was unrelated to any impact of drug discontinuation, the occurrence of stressful life events or the length of illness-free intervals in the patient's prior course of illness. Persistent DST non-suppression appears to have significant prognostic value.
Charles
G A
GA
Centre Hospitalier Vincent Van Gogh, Charleroi, Belgium.
Schittecatte
M
M
Rush
A J
AJ
Panzer
M
M
Wilmotte
J
J
D000328:Adult; D000368:Aged; D000639:Amitriptyline / Q000627:therapeutic use; D003866:Depressive Disorder / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D003891:Desipramine / Q000627:therapeutic use; D003907:Dexamethasone; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012307:Risk Factors
D000639:Amitriptyline; D003907:Dexamethasone; D003891:Desipramine; D006854:Hydrocortisone