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Assessment of the dexamethasone/CRH test as a state-dependent marker for hypothalamic-pituitary-adrenal (HPA) axis abnormalities in major depressive episode: a Multicenter Study.
Neuropsychopharmacology. 2006 Jan; 31(1):212-20.N

Abstract

There is compelling evidence for the involvement of hypothalamic-pituitary-adrenal (HPA) axis abnormalities in depression. Growing evidence has suggested that the combined dexamethasone (DEX)/corticotropin-releasing hormone (CRH) test is highly sensitive to detect HPA axis abnormalities. We organized a multicenter study to assess the DEX/CRH test as a state-dependent marker for major depressive episode in the Japanese population. We conducted the DEX/CRH test in 61 inpatients with major depressive episode (Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV)) and 57 healthy subjects. In all, 35 patients were repeatedly assessed with the DEX/CRH test on admission and before discharge. The possible relationships between clinical variables and the DEX/CRH test were also examined. Significantly enhanced pituitary-adrenocortical responses to the DEX/CRH test were observed in patients on admission compared with controls. Such abnormalities in patients were significantly reduced after treatment, particularly in those who underwent electroconvulsive therapy (ECT) in addition to pharmacotherapy. Age and female gender were associated with enhanced hormonal responses to the DEX/CRH test. Severity of depression correlated with DEX/CRH test results, although this was explained, at least in part, by a positive correlation between age and severity in our patients. Medication per se was unrelated to DEX/CRH test results. These results suggest that the DEX/CRH test is a sensitive state-dependent marker to monitor HPA axis abnormalities in major depressive episode during treatment. Restoration from HPA axis abnormalities occurred with clinical responses to treatment, particularly in depressed patients who underwent ECT.

Authors+Show Affiliations

Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan. hkunugi@ncnp.go.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16123748

Citation

Kunugi, Hiroshi, et al. "Assessment of the dexamethasone/CRH Test as a State-dependent Marker for Hypothalamic-pituitary-adrenal (HPA) Axis Abnormalities in Major Depressive Episode: a Multicenter Study." Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology, vol. 31, no. 1, 2006, pp. 212-20.
Kunugi H, Ida I, Owashi T, et al. Assessment of the dexamethasone/CRH test as a state-dependent marker for hypothalamic-pituitary-adrenal (HPA) axis abnormalities in major depressive episode: a Multicenter Study. Neuropsychopharmacology. 2006;31(1):212-20.
Kunugi, H., Ida, I., Owashi, T., Kimura, M., Inoue, Y., Nakagawa, S., Yabana, T., Urushibara, T., Kanai, R., Aihara, M., Yuuki, N., Otsubo, T., Oshima, A., Kudo, K., Inoue, T., Kitaichi, Y., Shirakawa, O., Isogawa, K., Nagayama, H., ... Mikuni, M. (2006). Assessment of the dexamethasone/CRH test as a state-dependent marker for hypothalamic-pituitary-adrenal (HPA) axis abnormalities in major depressive episode: a Multicenter Study. Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology, 31(1), 212-20.
Kunugi H, et al. Assessment of the dexamethasone/CRH Test as a State-dependent Marker for Hypothalamic-pituitary-adrenal (HPA) Axis Abnormalities in Major Depressive Episode: a Multicenter Study. Neuropsychopharmacology. 2006;31(1):212-20. PubMed PMID: 16123748.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of the dexamethasone/CRH test as a state-dependent marker for hypothalamic-pituitary-adrenal (HPA) axis abnormalities in major depressive episode: a Multicenter Study. AU - Kunugi,Hiroshi, AU - Ida,Itsuro, AU - Owashi,Toshimi, AU - Kimura,Mahito, AU - Inoue,Yumiko, AU - Nakagawa,Shin, AU - Yabana,Takafumi, AU - Urushibara,Takako, AU - Kanai,Rie, AU - Aihara,Masako, AU - Yuuki,Naoya, AU - Otsubo,Tempei, AU - Oshima,Akihiko, AU - Kudo,Koutaro, AU - Inoue,Takeshi, AU - Kitaichi,Yuji, AU - Shirakawa,Osamu, AU - Isogawa,Koichi, AU - Nagayama,Haruo, AU - Kamijima,Kunitoshi, AU - Nanko,Shinichiro, AU - Kanba,Shigenobu, AU - Higuchi,Teruhiko, AU - Mikuni,Masahiko, PY - 2005/8/27/pubmed PY - 2006/5/13/medline PY - 2005/8/27/entrez SP - 212 EP - 20 JF - Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology JO - Neuropsychopharmacology VL - 31 IS - 1 N2 - There is compelling evidence for the involvement of hypothalamic-pituitary-adrenal (HPA) axis abnormalities in depression. Growing evidence has suggested that the combined dexamethasone (DEX)/corticotropin-releasing hormone (CRH) test is highly sensitive to detect HPA axis abnormalities. We organized a multicenter study to assess the DEX/CRH test as a state-dependent marker for major depressive episode in the Japanese population. We conducted the DEX/CRH test in 61 inpatients with major depressive episode (Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV)) and 57 healthy subjects. In all, 35 patients were repeatedly assessed with the DEX/CRH test on admission and before discharge. The possible relationships between clinical variables and the DEX/CRH test were also examined. Significantly enhanced pituitary-adrenocortical responses to the DEX/CRH test were observed in patients on admission compared with controls. Such abnormalities in patients were significantly reduced after treatment, particularly in those who underwent electroconvulsive therapy (ECT) in addition to pharmacotherapy. Age and female gender were associated with enhanced hormonal responses to the DEX/CRH test. Severity of depression correlated with DEX/CRH test results, although this was explained, at least in part, by a positive correlation between age and severity in our patients. Medication per se was unrelated to DEX/CRH test results. These results suggest that the DEX/CRH test is a sensitive state-dependent marker to monitor HPA axis abnormalities in major depressive episode during treatment. Restoration from HPA axis abnormalities occurred with clinical responses to treatment, particularly in depressed patients who underwent ECT. SN - 0893-133X UR - https://www.unboundmedicine.com/medline/citation/16123748/Assessment_of_the_dexamethasone/CRH_test_as_a_state_dependent_marker_for_hypothalamic_pituitary_adrenal__HPA__axis_abnormalities_in_major_depressive_episode:_a_Multicenter_Study_ DB - PRIME DP - Unbound Medicine ER -