Hormonal differences between psychotic and non-psychotic melancholic depression
Hormonal differences between psychotic and non-psychotic melancholic depression
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DOI：
10.1016/j.jad.2006.09.021
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发表时间：
2007-06-01
影响因子：
6.6
通讯作者：
Parker, Gordon
中科院分区：
文献类型：
--
作者：
Contreras, Fernando;Menchon, Jose M.;Parker, Gordon
背景：与非精神病性抑郁症相比，地塞米松抑制试验（DST）是精神病性抑郁症的主要激素紊乱。然而，虽然有许多研究的个别激素轴在抑郁症，很少有多轴的研究报告。本研究的目的是通过三个功能性激素测试：DST，促甲状腺激素对甲状腺释放激素（TSH-TRF）和生长激素对生长激素释放因子（GH-GRF）的反应，检查这些患者组之间的激素差异。方法：40例符合DSM-III-R标准的抑郁症发作伴精神分裂症（21例非精神病性和19例精神病性）进行了研究。结果：80.0%的患者至少有一个激素轴紊乱，40.0%的患者两个激素轴紊乱，5.0%的患者三个激素轴均紊乱。基础和地塞米松后皮质醇水平显着高于精神病患者比非精神病患者。在精神病性抑郁症患者中，地塞米松后皮质醇与GH-GRF反应减弱之间存在关联。GH钝化率为62.5%，DST无抑制率为37.5%，TSH钝化率为25.0%（在精神病患者和非精神病患者之间没有发现差异）。局限性：样本仅限于精神分裂症，未知因素可能影响激素对应激的反应。当研究几个轴时，抑郁症中的激素紊乱更明显，HPA和GH轴是最明显的。精神病性抑郁症的HPA轴紊乱明显高于非精神病性抑郁症。讨论了HPA对GH轴的影响。(C)2006 Elsevier B. V.保留所有权利。
Background: The dexamethasone suppression test (DST) is the main hormonal disturbance in psychotic depression compared to non-psychotic depression. However, although there have been many studies of individual hormonal axes in depression, few multiaxial studies have been reported. This study aims to examine hormonal differences between these groups of patients through three functional hormonal tests: DST, thyroid stimulating hormone response to thyroid releasing hormone (TSH-TRF) and growth hormone response to growth hormone releasing factor (GH-GRF).Methods: Forty inpatients meeting DSM-III-R criteria for major depressive episode with melancholia (21 non-psychotic and 19 psychotic) were studied. Dexamethasone suppression test, TSH-TRF and GH-GRF tests were undertaken for all patients.Results: In the whole melancholic sample, 80.0% showed disturbances in at least one hormonal axis, 40.0% in two axes and 5.0% in all three axes. Basal and post-dexamethasone cortisol levels were significantly higher in psychotic than in non-psychotic patients. An association between post-dexamethasone cortisol and blunted GH-GRF response was demonstrated in those with psychotic depression. In the whole sample, GH blunting was found in 62.5% of patients, DST non-suppression in 37.5% and TSH blunting in 25.0% (no differences were found between psychotic and non-psychotic patients).Limitations: Sample was restricted to melancholia and unknown factors may influence hormonal responses to stress.Conclusions: Hormonal disturbances in depression are more evident when studying several axes, being the HPA and the GH axes the most prominents. Psychotic depression showed more HPA disturbance than non-psychotic depression. Influence of the HPA on the GH axis is discussed. (C) 2006 Elsevier B.V. All rights reserved.