Combined dexamethasone/CRF test in remitted outpatients with recurrent major depressive disorder.
BACKGROUND
Hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis is a prominent neurobiological finding during a major depressive episode, reflecting a state dependent factor. An issue under investigation is whether the dysfunction of the HPA axis has also a role to play as a state-independent or trait factor for major depressive disorder (MDD). In relation to this, it is important to examine HPA axis function in patients who are clinically remitted from depression.


METHODS
Twenty-three remitted outpatients with recurrent MDD and 23 age- and gender-matched control individuals without a history of MDD participated in the sensitive combined dexamethasone/corticotropin-releasing factor (DEX/CRF) test.


RESULTS
Free salivary cortisol responses were not significantly different between the two groups, although three patients (13%) displayed extremely elevated cortisol responses after CRF.


CONCLUSIONS
Limited sample size. All but one patient were under treatment with an antidepressant.


CONCLUSIONS
This study shows no evidence for a disturbed DEX/CRF test as a state-independent factor in recurrent MDD on a group level. However, MDD is a complex and heterogenic disorder. Probably, there is a subgroup of patients who show a disturbed DEX/CRF test due to an inherited and/or acquired predisposition or as a biological scar after previous depressive episodes.
Van Den Eede
Filip
F
Collaborative Antwerp Psychiatric Research Institute, Universiteitsplein 1 B-2610 Antwerpen, University of Antwerp, Belgium.
Van den Bossche
Bart
B
Hulstijn
Wouter
W
Sabbe
Bernard G C
BG
Cosyns
Paul
P
Claes
Stephan J
SJ