The dexamethasone corticotropin releasing hormone test in healthy and depressed women with and without childhood adversity
The dexamethasone corticotropin releasing hormone test in healthy and depressed women with and without childhood adversity
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DOI：
10.1016/j.psyneuen.2017.10.016
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发表时间：
2018-01-01
影响因子：
3.7
通讯作者：
Wingenfeld, Katja
中科院分区：
文献类型：
--
作者：
Spitzer, Carsten;Otte, Christian;Wingenfeld, Katja
背景：下丘脑-垂体-肾上腺（HPA）轴的改变是重度抑郁症（MDD）患者的一个突出发现。关于HPA轴的过度活跃或功能减退的抑制可以通过儿童期不良经历（ACE）的调节作用来解释，这些不良经历与成年期HPA轴功能障碍和MDD相关。我们的目的是通过比较有和没有童年逆境的健康女性以及有和没有ACE的MDD女性来系统地解开ACE和MDD对HPA轴的影响。对35例MDD合并ACE患者进行了地塞米松/促肾上腺皮质激素释放激素（DEX/CRH）试验，结果：年龄、吸烟、体重指数、口服避孕药的摄入量无组间差异。游离唾液皮质醇反应没有显着差异四groups.Conclusions：这项研究表明，没有证据表明HPA轴失调的DEX/CRH测试测量抑郁症的妇女与儿童逆境相比，精神健康的妇女或没有早期生活压力。我们的研究结果不支持MDD中与ACE相关的不同神经内分泌内表型的假设。
Background: Alterations of the hypothalamic-pituitary-adrenal (HPA) axis are a prominent finding in patients with major depressive disorder (MDD). Inconsistencies regarding a hyper- or hypoactive HPA axis may be explained by the moderating effect of childhood adverse experiences (ACE) which are associated with both HPA axis dysfunction and MDD in adulthood. We aimed to systematically disentangle the effects of ACE and MDD on HPA axis by comparing healthy women with and without childhood adversity and women with MDD with and without ACE.Methods: The dexamethasone/corticotropin-releasing hormone (DEX/CRH) test was administered in 35 women with MDD and ACE as determined by a clinical interview (KID, Early Trauma Inventory), 51 women with MDD without ACE, 21 women with ACE but no current or lifetime MDD and 37 healthy women without either MDD or ACE.Results: There were no group differences in age, smoking, body mass index, and intake of oral contraceptives. Free salivary cortisol responses were not significantly different between the four groups.Conclusions: This study shows no evidence for a dysregulation of the HPA axis as measured by the DEX/CRH test in depressed women with and without childhood adversity as compared to mentally healthy women with or without early life stress. Our results do not support the assumption of distinct neuroendocrine endophenotypes in MDD with regard to ACE.