STRESS AND REPRODUCTIVE HORMONES IN DEPRESSED WOMEN

为了评估抑郁症中CRH过度驱动的假说，我们将评估两种解释抑郁症HPA轴异常的替代假说。这两个假设中只有一个是有效的。这些假说是：1.抑郁症患者中枢CRH分泌增加，包括PVN CRH分泌增加，这种分泌被糖皮质激素负反馈抑制。在没有甲孕酮阻断皮质醇产生的负反馈(开环系统)的情况下检查ACTH时，全天ACTH的分泌都会增加。2.抑郁症患者CRH分泌昼夜节律紊乱，伴有ACTH和皮质醇分泌昼夜节律改变。抑制HPA轴分泌的抑制回路失效发生在特定的昼夜节律阶段。

To evaluate the CRH overdrive hypothesis in depression, we will evaluate two alternative hypotheses explaining the HPA axis abnormalities in depression. Only one of these two hypotheses can be valid. These hypotheses are:1. In depression there is increased central CRH secretion, including increased PVN CRH secretion, that is dampened by glucocorticoid negative feedback. When ACTH is examined in the absence of negative feedback (open loop system), produced by metyrapone blockade of cortisol production, there will be increased ACTH secretion throughout the day. OR 2. In depression there is dysregulation of circadian driven CRH secretion accompanied by alterations in the circadian rhythm of ACTH and cortisol secretion. A failure of the inhibitory circuits to restrain HPA axis secretion occurs at a specific circadian phase, the evening.