Dex/CRH test cortisol response in outpatients with major depression and matched healthy controls.
BACKGROUND
The dexamethasone/corticotropin releasing hormone (Dex/CRH) test has been proposed as a potential tool for identifying endophenotypes relevant to mood disorders. An exaggerated cortisol response to the test during major depressive episodes has been demonstrated for inpatients with melancholic or psychotic features. A diminished hormone response has been observed in chronically depressed outpatients.


METHODS
Following a battery of self-report and interview assessments, 68 adults completed the Dex/CRH test. Thirty-four met structured interview criteria for current major depressive disorder and 34 age- and sex-matched control subjects had no current or lifetime DSM-IV depressive disorder. Effect of diagnosis on cortisol response to the Dex/CRH test was examined in a repeated measures general linear model.


RESULTS
The matched groups were equivalent with regard to childhood adversity. Cortisol response to the Dex/CRH test among subjects with current MDD was not significantly different from that seen in matched healthy controls. Independent of diagnosis, an exploratory analysis showed a trend-level association between maltreatment history and diminished cortisol response; no interactive effects with depression diagnosis were detected.


CONCLUSIONS
The results do not support the hypothesis that elevated cortisol response to the Dex/CRH test represents a marker for major depressive episodes.
Department of Psychiatry and Human Behavior, Mood Disorders Research Program and Laboratory for Clinical Neuroscience, Brown Medical School, Butler Hospital, 345 Blackstone Blvd., Providence, RI 02906, USA. Linda_Carpenter_MD@Brown.edu
Linda L
LL
Carpenter
Nicole S
NS
Ross
Audrey R
AR
Tyrka
George M
GM
Anderson
Megan
M
Kelly
Lawrence H
LH
Price
D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002649:Child Abuse / Q000523:psychology; D003346:Corticotropin-Releasing Hormone / Q000494:pharmacology*; D003865:Major Depressive Disorder / Q000097:blood* / Q000175:diagnosis; D003907:Dexamethasone / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000187:drug effects*
D003907:Dexamethasone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone