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.
Carpenter
Linda L
LL
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
Ross
Nicole S
NS
Tyrka
Audrey R
AR
Anderson
George M
GM
Kelly
Megan
M
Price
Lawrence H
LH
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