Prediction of medium-term outcome by cortisol response to the combined dexamethasone-CRH test in patients with remitted depression.
OBJECTIVE
Current hypotheses hold that mechanisms underlying abnormal hypothalamic-pituitary-adrenocortical (HPA) function are causal factors in the precipitation of depression. If this is the case, then normalization of initially disturbed HPA regulation should indicate a good prognosis and persistent HPA dysregulation should be associated with a greater likelihood of relapse or chronicity.


METHODS
The combined dexamethasone/corticotropin-releasing hormone test was administered twice to inpatients with major depression (N = 40), once after initiation of treatment and once after remission, shortly before discharge.


RESULTS
Patients with a high cortisol response on both occasions or with a substantially increased cortisol response at discharge were at much higher risk for relapse within the next 6 months than those with low cortisol responses.


CONCLUSIONS
An easy-to-administer neuroendocrine test allows the prediction of medium-term outcome in patients with remitted depression.
Zobel
A W
AW
Max Planck Institute of Psychiatry, Munich, Germany. zobel@mpipsykl.mpg.de
Yassouridis
A
A
Frieboes
R M
RM
Holsboer
F
F
D000328:Adult; D000368:Aged; D003346:Corticotropin-Releasing Hormone; D003866:Depressive Disorder / Q000097:blood / Q000175:diagnosis*; D003907:Dexamethasone; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence
D003907:Dexamethasone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone