title: Prediction of medium-term outcome by cortisol response to the combined dexamethasone-CRH test in patients with remitted depression.
abstract: 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.
authors.affiliation: Max Planck Institute of Psychiatry, Munich, Germany. zobel@mpipsykl.mpg.de
authors.forename: A W
authors.initials: AW
authors.lastname: Zobel
authors.forename: A
authors.initials: A
authors.lastname: Yassouridis
authors.forename: R M
authors.initials: RM
authors.lastname: Frieboes
authors.forename: F
authors.initials: F
authors.lastname: Holsboer
mesh_terms: 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
chemical_list: D003907:Dexamethasone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone