The thyrotropin-releasing hormone test may predict recurrence of clinical depression within ten years after discharge.
OBJECTIVE
The underlying pathogenic mechanisms and predictors of recurrence in major depressive disorder are still largely unknown. Hypothalamic-pituitary-thyroid (HPT) axis and hypothalamus-pituitary-adrenocortical (HPA) axis dysregulation are thought to be related to the development and course of depression.


METHODS
Over a ten-year period, we investigated whether the results of thyrotropin-releasing hormone (TRH) testing and combined dexamethasone/corticotropin-releasing hormone (DEX/CRH) testing could be correlated with the recurrence of depression in 25 outpatients with clinically remitted major depression for at least 10 years.


METHODS
Twenty-five patients (16 women and 9 men, 48.1 years of age, SD=11.4, range 22-84) with major depressive disorder were available for evaluation during hospitalization. TRH and DEX/CRH tests were administered at admission.


RESULTS
Patients who recurred within ten years after remission exhibited significantly higher thyroid stimulating hormone (TSH) responses to TRH at the time of admission compared to those who did not recur. There was no significant correlation between recurrence and DEX/CRH levels after controlling for age, sex, and body mass index.


CONCLUSIONS
The findings of this study suggest that the TRH test may predict future recurrence in patients with depression.
Department of Neuropsychiatry, Oita University Faculty of Medicine, Oita, Japan. akiyoshi@oita-u.ac.jp.
Jusen
J
Tsuru
Yoshinobu
Y
Ishitobi
Taiga
T
Ninomiya
Masayuki
M
Kanehisa
Junko
J
Imanaga
Ayako
A
Inoue
Shizuko
S
Okamoto
Yoshihiro
Y
Maruyama
Haruka
H
Higuma
Yoshihiro
Y
Tanaka
Hiroaki
H
Hanada
Koichi
K
Isogawa
Jotaro
J
Akiyoshi
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003346:Corticotropin-Releasing Hormone; D003866:Depressive Disorder / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D003907:Dexamethasone; D005260:Female; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010912:Pituitary-Adrenal Function Tests; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D012008:Recurrence; D013972:Thyrotropin / Q000097:blood*; D013973:Thyrotropin-Releasing Hormone
D013973:Thyrotropin-Releasing Hormone; D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D013972:Thyrotropin; D003346:Corticotropin-Releasing Hormone