Prediction of depressive relapse in remitted bipolar patients using corticotrophin-releasing hormone challenge test.
Abnormalities in corticotrophin (ACTH) and cortisol levels before and after corticotrophin-releasing hormone (CRH) stimulation have been reported in depressed bipolar patients. The ACTH and free cortisol response to the injection of 100 micrograms of synthetic human CRH and plasma cortisol-binding globulin (CBG) levels were measured in 42 lithium-treated patients suffering from RDC bipolar-I disorder in remission, and in 21 age- and sex-matched control subjects. A 1-year follow-up was conducted in order to assess any possible relationship between outcome and the hormonal response. Bipolar patients showed higher baseline and peak ACTH concentrations than controls. A lower net area under the ACTH concentration curve after CRH stimulation predicted depressive relapse within 6 months by multiple regression analysis. The CRH challenge test could be a potentially good predictor of depressive relapse in remitted bipolar patients.
Vieta
E
E
Department of Psychiatry and Hormonal Laboratory, University of Barcelona, Spain.
Gasto
C
C
Martinez de Osaba
M J
MJ
Nieto
E
E
Canto
T J
TJ
Otero
A
A
Vallejo
J
J
D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D001714:Bipolar Disorder / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D003346:Corticotropin-Releasing Hormone; D003866:Depressive Disorder / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D016651:Lithium Carbonate / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D016896:Treatment Outcome
D016651:Lithium Carbonate; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone