PHENOMENOLOGY OF MAJOR DEPRESSION

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Studies suggest that hypothalamic-pituitary-adrenal (HPA) axis dysregulation influences the presentation of depression related to specific groups of symptoms. A better understanding of the mechanisms underlying these differences could lead to novel targets for the treatment of depression, and help to explain variability among previous studies that typically included subjects with varying symptoms of depression. This study is designed to assess HPA activity and measures of acute stress responses in healthy volunteers and depressed patients as they relate to specific groups of symptoms. The hypothesis is that elevated HPA axis activity in depression is associated with insomnia, loss of appetite/weight loss, and anxiety, whereas low HPA activity is linked with fatigue, increased appetite/weight gain and lack of energy. Moreover, increased HPA activity, symptoms of insomnia, loss of appetite/weight loss and anxiety are hypothesized to correlate with a greater response to stress, whereas low HPA activity and symptoms of fatigue, increased appetite/weight gain and lack of energy are hypothesized to correlate with a decreased response to stress. These hypotheses will be tested by collection of stress hormones in the blood, urine and saliva during three separate conditions; baseline, following a diagnostic test using two FDA approved medications, and in response to a social stress test.