The thyrotropin-releasing hormone test may predict recurrence of clinical depression within ten years after discharge.
The thyrotropin-releasing hormone test may predict recurrence of clinical depression within ten years after discharge.
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2013
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通讯作者：
Jusen Tsuru;Yoshinobu Ishitobi;Taiga Ninomiya;Masayuki Kanehisa;Junko Imanaga;Ayako Inoue;Shizuko Okamoto;Yoshihiro Maruyama;Haruka Higuma;Yoshihiro Tanaka;Hiroaki Hanada;K. Isogawa;J. Akiyoshi
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作者：
Jusen Tsuru;Yoshinobu Ishitobi;Taiga Ninomiya;Masayuki Kanehisa;Junko Imanaga;Ayako Inoue;Shizuko Okamoto;Yoshihiro Maruyama;Haruka Higuma;Yoshihiro Tanaka;Hiroaki Hanada;K. Isogawa;J. Akiyoshi
抑郁症的潜在发病机制和复发的预测因素在很大程度上仍然是未知的。下丘脑-垂体-甲状腺（HPT）轴和下丘脑-垂体-肾上腺皮质（HPA）轴的失调被认为与抑郁症的发生和发展有关。设计和设置在10年的时间里，我们调查是否促甲状腺激素释放激素（TRH）测试和联合地塞米松/促肾上腺皮质激素释放激素（DEX/CRH）测试的结果可能与抑郁症的复发在25个门诊患者临床缓解至少10年。材料与方法25例重度抑郁症患者（16例女性和9例男性，48.1岁，SD=11.4，范围22-84）在住院期间可用于评估。入院时进行TRH和DEX/CRH检测。结果与未复发患者相比，缓解后10年内复发的患者在入院时对TRH的促甲状腺激素（TSH）反应显着升高。在控制年龄、性别和体重指数后，复发与DEX/CRH水平无显著相关性。结论TRH检测可预测抑郁症患者的复发。
OBJECTIVES 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. DESIGN AND SETTING 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. MATERIALS AND 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. CONCLUSION The findings of this study suggest that the TRH test may predict future recurrence in patients with depression.