Corticotropin-releasing hormone challenge in prepubertal major depression.
This study investigates cortisol and ACTH (corticotropin) responses to an infusion of human CRH (corticotropin-releasing hormone) in prepubertal children with major depressive disorder (MDD). Following a period of 24 hours of adaptation to the laboratory environment with an intravenous catheter in place, 34 children with MDD and 22 healthy controls received 1 microgram/kg of human CRH at 5:00 PM. Blood samples for cortisol and ACTH were measured at baseline and post-CRH. Overall, there were no significant differences between the MDD and the normal controls in baseline or post CRH stimulation values of either cortisol or ACTH. Melancholic (n = 4) patients had significantly higher baseline cortisol levels than nonmelancholic (n = 24) patients. Compared with the outpatients and the nonmelancholics, the inpatients (n = 10) and the melancholics showed significantly lower total ACTH secretion (effect size: 0.9 and 1.4, respectively) after CRH infusion. These results are consistent with a broad literature suggesting that the HPA axis abnormalities occur less frequently in early-onset depression than reported in adult studies. The pattern of results in the subgroups of inpatients and in melancholic children, however, raise questions about possible continuities with adult studies.
Birmaher
B
B
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA 15213, USA.
Dahl
R E
RE
Perel
J
J
Williamson
D E
DE
Nelson
B
B
Stull
S
S
Kaufman
J
J
Waterman
G S
GS
Rao
U
U
Nguyen
N
N
Puig-Antich
J
J
Ryan
N D
ND
D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D002648:Child; D002940:Circadian Rhythm / Q000502:physiology; D003346:Corticotropin-Releasing Hormone; D003866:Depressive Disorder / Q000097:blood / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D007262:Infusions, Intravenous; D008297:Male; D010552:Personality Assessment; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D011627:Puberty / Q000097:blood*
D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone