Atypical depression in growth hormone deficient adults, and the beneficial effects of growth hormone treatment on depression and quality of life

Abstract

Objective: Some growth hormone deficient adults (GHDAs) have an impaired quality of life, which may improve with growth hormone (GH) treatment. The objective of our study was to make an in-depth psychiatric evaluation of patients with adult-onset (AO) and childhood-onset (CO) GH deficiency (GHD), and to assess the time course of changes in their quality of life and symptoms of depression in response to GH treatment. Design: The study design was a 4-month, double-blind, cross-over, placebo-controlled trial of GH therapy. Methods: We used a detailed psychiatric interview to characterise 25 patients with proven GHD at baseline. They were reassessed at monthly intervals during treatment with GH or placebo, using the Nottingham Health Profile and two well-recognised depression rating scales. Results: 11/18 (61%) of the patients with AO-GHD, but 0/7 of the patients with CO-GHD, were found to have atypical depression at baseline. There were significant improvements in the depression rating scale scores after 2 months of GH therapy, with significant improvements in emotional reaction and social isolation scores from 1 month, and in energy levels and sleep disturbance from 2 and 3 months respectively. Conclusions:The results of our study confirm that a large proportion of GHDAs have unequivocal psychiatric morbidity, and suggest that a response to treatment can be seen after a short trial of GH therapy. We hypothesise that this rapid improvement of symptoms of atypical depression represents a direct central effect of GH therapy.European Journal of Endocrinology 151 325-332

Central regulation of feeding behavior during social isolation of rat: evidence for the role of endogenous CART system

“…11 Moreover, in times of abundant food supply, isolated rat tends to overeat to relieve boredom of its situations that resulted in weight gain. 2 Isolated rats showed low levels of physical activity, and ate more than those at moderate levels of activity 1 as also observed in this study. It was also speculated that, increased feeding and reduced energy expenditure might cause weight gain in socially isolated animals.…”

“…28,30 Such condition increases the risk of development of atypical depression that accompanies hyperphagia and weight gain. 1,2,8,18 The rats were housed in acrylic cages (24 Â 17 Â 12 cm) under a constant room temperature (25 ± 2 1C), relative humidity (50 ± 5%) and maintained under a controlled 12:12 h dark-light cycle (lights on at 0000 h). Rat chow food pellets (provide 3.30 kcal g -1 with 72.1% carbohydrate, 23.4% protein and 4.5% fat) and drinking water were available ad libitum.…”

“…1,2 Numerous studies have reported an increase in food intake and body weight following social isolation of weaning or adult rodents. [3][4][5][6][7][8][9] On the other hand, re-socialization of isolation-reared rats resulted in the decreased food consumption and body weight.…”

Prevalence of Pituitary Hormone Dysfunction, Metabolic Syndrome, and Impaired Quality of Life in Retired Professional Football Players: A Prospective Study

“…Specifically, because it relates to the findings of GHD and hypogonadism in this study, GH replacement is known to improve QoL in patients with adult-onset GHD and helps reduce fat mass and improve exercise capacity. 51,52,54,55,[74][75][76][77][78][79][80] The benefits of testosterone therapy for men are clear and considered standard practice. 50,57,81 In addition, the high prevalence of MetS in retired football players is important because lifestyle changes may reverse some of these findings and improve the cardiovascular and metabolic disease risks that are associated with MetS.…”

Depression following Traumatic Brain Injury Associated with Isolated Growth Hormone Deficiency: Two Case Reports

“…GHD is associated not only with changes in body composition (i.e., decrease in lean body mass, increase in percent body fat, reduced volume of extracellular water) but also with impaired quality of life and depression [5]. Moreover, symptoms of depression in adults with GHD might improve with GH replacement treatment [6]. It is reasonable to assume that GHD might be the neuroendocrinological link in depression following TBI, particularly because a decrease in the synthesis of new neurons in the adult hippocampus might be linked to major depressive disorder [7] as well as to GHD [8].…”