Enhanced suppression of adrenocorticotropic hormone and cortisol responses to hypothalamic-pituitary-adrenal function and thyrotropin-releasing hormone tests after stressful life events in patients with major depressive disorder.
BACKGROUND
It is commonly believed that there exists a relationship between the outcome of thyrotropin-releasing hormone (TRH) test, the combined dexamethasone/corticotropin-releasing hormone (DEX/CRH) test and stressful life events (SLEs) in major depressive disorder.


OBJECTIVE
SLEs influence the TRH and DEX/CRH tests in major depressive disorder when administered at the time of admission and improvement.


METHODS
The TRH and DEX/CRH tests were administered to patients hospitalized for major depressive disorders - on the 4th through the 7th hospital day and at the time of improvement. We measured DeltaMAX TSH, DeltaMAX ACTH, ACTH AUC, DeltaMAX cortisol, cortisol AUC, DeltaMAX ACTH/DeltaMAX TSH and DeltaMAX cortisol/DeltaMAX TSH.


RESULTS
SLEs were significantly negatively associated with DeltaMAX ACTH, ACTH AUC and cortisol AUC at the time of admission. However, these relationships lost significance at the time of improvement. The sample (41 patients at the time of admission, 18 patients at the time of improvement) was relatively small, which may have contributed to false-negative results.


CONCLUSIONS
SLEs may be negatively associated with the outcome of the DEX/CRH tests in major depressive disorder. The hypothalamic-pituitary-adrenal axis in the DEX/CRH test was modulated by SLEs.
Hikichi
Takatoshi
T
Department of Neuropsychiatry, Oita University Faculty of Medicine, Oita, Japan.
Akiyoshi
Jotaro
J
Ichioka
Shugo
S
Tanaka
Yoshihiro
Y
Tsuru
Jusen
J
Goto
Shinjirou
S
Matsushita
Hirotaka
H
Hanada
Hiroaki
H
Isogawa
Koichi
K
Nagayama
Haruo
H
D000324:Adrenocorticotropic Hormone / Q000378:metabolism*; D000328:Adult; D019540:Area Under Curve; D003346:Corticotropin-Releasing Hormone; D003865:Major Depressive Disorder / Q000378:metabolism*; D003907:Dexamethasone; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects / Q000378:metabolism*; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010912:Pituitary-Adrenal Function Tests / Q000379:methods; D010913:Pituitary-Adrenal System / Q000187:drug effects / Q000378:metabolism*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone