Cortisol measures in primary major depressive disorder with hypersomnia or appetite increase

Casper, Regina C.; Kocsis, James H.; Dysken, Maurice W.; Stokes, Peter E.; Croughan, Jack; Maas, James W.

doi:10.1016/0165-0327(88)90081-x

Cited by 26 publications

(18 citation statements)

References 37 publications

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“…an activation of the HPA axis, which accompanied clinical improvement of non-melancholic depressed patients (Holsboer-Trachsler et al, 2001). Furthermore, reduced sleep (Antonijevic et al, 2000) and loss of appetite and weight (Casper et al, 1987), vegetative characteristics of severe melancholic depression, are closely related to HPA axis overactivity, whereas hypersomnia and increased appetite are related to hypocortisolism (Casper et al, 1988). Therefore, it has been suggested that the HPA axis activating effect of HE might be related to its preferable efficacy in patients with RVS (see Murck, 2003).…”

Section: Discussionmentioning

confidence: 97%

Hypericum extract in patients with MDD and reversed vegetative signs: re-analysis from data of a double-blind, randomized trial of hypericum extract, fluoxetine, and placebo

Murck¹,

Fava

Alpert

et al. 2005

Int. J. Neuropsychopharm.

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Hypericum extract (HE) might be favourably active in depressed patients with reversed vegetative signs (RVS). Therefore, we performed an exploratory subgroup analysis of a three-armed study to compare HE, fluoxetine, and placebo in patients with major depressive disorder (MDD) in a 12 wk trial. A total of 135 patients were randomized to 12 wk treatment with HE LI 160 (900 mg/d), fluoxetine (20 mg/d), or placebo. Patients with RVS were defined in two steps, according to DSM-IV. First, patients with melancholy-related vegetative signs were excluded. Secondly, patients had to have at least one score of 2 for the items 22-26 of the HAMD-28 scale, which are related to hypersomnia and hyperphagia. Twenty-seven patients remained in the group. Analysis of covariance (ANCOVA) was applied using the HAMD-17 score. Secondly a chi2 test for response was performed, using the same and further an adapted criterium as in recently published studies. ANCOVA revealed a trend to a global difference. Post-hoc analysis showed a trend to superiority of HE compared to placebo and to fluoxetine, but a very large effect size for both differences. Fluoxetine was not different from placebo. The adapted response criterium showed a significant global difference as well as a significant superiority of HE over placebo and over fluoxetine. These data are based on a small sample size and must be considered tentative. A characterization of vegetative features of patients with depression could lead to an overall increased effect size in the treatment with HE.

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Section: Discussionmentioning

confidence: 97%

Hypericum extract in patients with MDD and reversed vegetative signs: re-analysis from data of a double-blind, randomized trial of hypericum extract, fluoxetine, and placebo

Murck¹,

Fava

Alpert

et al. 2005

Int. J. Neuropsychopharm.

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“…DST suppression is the rule in depressions with atypical physical symptoms ( (Hawkins et al, 1985;Casper et al, 1988). The sensitivity and specificity of the DST and the sleep parameters show considerable variability in different age groups, within major depressive disorder and in moderate depressions.…”

Section: Hypothalamic-pituitary-adrenal (Hpa) Axismentioning

confidence: 99%

Depression and eating disorders

Casper¹

1998

Depress. Anxiety

Self Cite

107

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Both depressive disorders and eating disorders are multidimensional and heterogeneous disorders. This paper examines the nature of their relationship by reviewing clinical descriptive, family‐genetic, treatment, and biological studies that relate to the issue. The studies confirm the prominence of depressive symptoms and depressive disorders in eating disorders. Other psychiatric syndromes which occur with less frequency, such as anxiety disorders and obsessive‐compulsive disorders in anorexia nervosa, or personality disorders, anxiety disorders, and substance abuse in bulimia nervosa, also play an important role in the development and maintenance of eating disorders. Since few studies have controlled for starvation‐induced physical, endocrine, or psychological changes which mimic the symptoms considered diagnostic for depression, further research will be needed. The evidence for a shared etiology is not compelling for anorexia nervosa and is at most suggestive for bulimia nervosa. Since in contemporary cases dieting‐induced weight loss is the principal trigger, women with self‐critical or depressive features will be disproportionately recruited into eating disorders. The model that fits the data best would accommodate a relationship between eating disorders and the full spectrum of depressive disorders from no depression to severe depression, with somewhat higher rates of depression in bulimic anorectic and bulimia nervosa patients than in restricting anorexia nervosa patients, but the model would admit a specific pathophysiology and psychopathology in each eating disorder. Depression and Anxiety, Volume 8, Supplement 1:96–104, 1998.© 1998 Wiley‐Liss, Inc.

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“…The most frequently reported neuroendocrine change in major depression is the overactivity of the hypothalamus-pituitaryadrenocortical (HPA) system as measured by serum cortisol levels [11,20,36,37] or a decreased ability of dexamethasone to suppress adrenocorticotropic hormone (ACTH) and cortisol secretion, mainly in patients with ªtypicalº vegetative signs, as sleep disturbances and weight loss [3,12,33,39].…”

Section: Introductionmentioning

confidence: 99%

“…

BackgroundThe most frequently reported neuroendocrine change in major depression is the overactivity of the hypothalamus-pituitaryadrenocortical (HPA) system as measured by serum cortisol levels [11,20,36,37] or a decreased ability of dexamethasone to suppress adrenocorticotropic hormone (ACTH) and cortisol secretion, mainly in patients with ªtypicalº vegetative signs, as sleep disturbances and weight loss [3,12,33,39].We have reported earlier, that a closely related system, which has widely been neglected until recently, is the Renin-Angiotensin-Aldosterone System (RAAS), which shows even a more pronounced alteration than the HPA axis [29], even in the absence of typical vegetative signs and pronounced sleep disturbances.This finding was recently replicated independently [16]. Similarly an early study did not only show a quantitative difference in RAAS regulation in depression, but an opposite change in serum aldosterone in healthy controls in comparison to female patients with endogenous depression after dexamethasone administration [21].

…”

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confidence: 99%

Renin-Angiotensin-Aldosterone System, HPA-Axis and Sleep-EEG Changes in Unmedicated Patients with Depression after Total Sleep Deprivation

Murck¹,

Uhr²,

Ziegenbein³

et al. 2006

Pharmacopsychiatry

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Cortisol measures in primary major depressive disorder with hypersomnia or appetite increase

Cited by 26 publications

References 37 publications

Hypericum extract in patients with MDD and reversed vegetative signs: re-analysis from data of a double-blind, randomized trial of hypericum extract, fluoxetine, and placebo

Hypericum extract in patients with MDD and reversed vegetative signs: re-analysis from data of a double-blind, randomized trial of hypericum extract, fluoxetine, and placebo

Depression and eating disorders

Renin-Angiotensin-Aldosterone System, HPA-Axis and Sleep-EEG Changes in Unmedicated Patients with Depression after Total Sleep Deprivation

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