OBJECTIVE: In clinical guidelines, risk factors for a malignant illness course include 3 or more lifetime episodes of depression. Our aim was to investigate the activation of the hypothalamic-pituitary-adrenal hormonal axis in treatment-refractory affective disorder in pauciepisodic (one or two episodes) versus multiepisodic (three or more episodes) patients. METHODS: We evaluated the HPA axis in 37 patients with treatment-refractory affective disorder and in 27 healthy volunteers by measuring adrenocorticotropin hormone (ACTH) and cortisol responses following administration of corticotropin-releasing hormone (CRH). In retrospective life charts was recorded every previous illness episode for each patient. RESULTS: Seven of the patients were pauciepisodic and 30 were multiepisodic. The pauciepisodic patients had significantly larger peak and total ACTH responses to CRH compared to the multiepisodic patients as well as to the control group. Multiepisodic patients showed no difference compared to controls in ACTH secretion pre- and post-CRH. Cortisol secretion was the same in all three groups. CONCLUSIONS: The pituitary adrenocortical responses were stronger in pauciepisodic patients than in multiepisodic patients and in volunteers. This cross-sectional study suggests that the HPA axis, in refractory multiepisodic affective disorders, might weaken its original activity as the illness recurs with more episodes.
OBJECTIVE: In clinical guidelines, risk factors for a malignant illness course include 3 or more lifetime episodes of depression. Our aim was to investigate the activation of the hypothalamic-pituitary-adrenal hormonal axis in treatment-refractory affective disorder in pauciepisodic (one or two episodes) versus multiepisodic (three or more episodes) patients. METHODS: We evaluated the HPA axis in 37 patients with treatment-refractory affective disorder and in 27 healthy volunteers by measuring adrenocorticotropin hormone (ACTH) and cortisol responses following administration of corticotropin-releasing hormone (CRH). In retrospective life charts was recorded every previous illness episode for each patient. RESULTS: Seven of the patients were pauciepisodic and 30 were multiepisodic. The pauciepisodic patients had significantly larger peak and total ACTH responses to CRH compared to the multiepisodic patients as well as to the control group. Multiepisodic patients showed no difference compared to controls in ACTH secretion pre- and post-CRH. Cortisol secretion was the same in all three groups. CONCLUSIONS: The pituitary adrenocortical responses were stronger in pauciepisodic patients than in multiepisodic patients and in volunteers. This cross-sectional study suggests that the HPA axis, in refractory multiepisodic affective disorders, might weaken its original activity as the illness recurs with more episodes.
Authors: J Kaufman; B Birmaher; J Perel; R E Dahl; P Moreci; B Nelson; W Wells; N D Ryan Journal: Biol Psychiatry Date: 1997-10-15 Impact factor: 13.382
Authors: Georg Nikisch; Aleksander A Mathé; Adelheid Czernik; Jutta Thiele; Jürgen Bohner; Chin B Eap; Hans Agren; Pierre Baumann Journal: Psychopharmacology (Berl) Date: 2005-09-29 Impact factor: 4.530
Authors: Pui Hing Chau; Paul Siu Fai Yip; Ho Yin Eric Lau; Yee Ting Ip; Frances Yik Wa Law; Rainbow Tin Hung Ho; Angela Yee Man Leung; Janet Yuen Ha Wong; Jean Woo Journal: Int J Environ Res Public Health Date: 2020-05-15 Impact factor: 3.390