Hypothalamic-Pituitary-Adrenal Axis Activity in Depressive Illness

Combined biological tests for suicide prediction

“…Briefly, 78 individuals with Research Diagnostic Criteria ) unipolar (n = 59), bipolar I (n=10), bipolar II (n = 9) or schizoaffective (n = 2) depression entered the NIMH Collaborative Depression Study (CDS) as inpatients at the Iowa site between 1978 and 1981 and, during their hospitalization, underwent a 1 mg. DST. The DST was not included among CDS assessments but many of the subjects also participated in a concurrent study of the diagnostic correlates of dexamethasone suppression (Schlesser et al, 1980). In other cases attendings obtained the test for clinical purposes.…”

Depression in Patients With Epilepsy

“…Later studies (Sachar et al 1973) found that the abnormal HPA function was not simply a result of nonspecific stress, but reflected the depressive syndrome itself. Although Carroll and associates have produced much of the data on the DST, its use as a diagnostic tool for depression, and not just psychosis, has been confirmed by other centres Schlesser et al 1980). Rothschild et al (1982) confirmed previous work by demonstrating that post DST plasma cortisol levels were significantly higher for psychotic unipolar major depressives than for psychotic bipolar depressives, psychotic schizophrenics , "atypical" psychotics and controls.…”

“…There was, in addition, no association between cortisol non-suppressio n and any genetic subgroup of affective disorder. Others (Brown and Shuey 1980;Schlesser et al 1980) have also reported normal suppression in patients with secondary depressive illness.…”

“…In patients with mania, both normal suppression (Schlesser et al 1980) and non-suppressio n (Shulman and Diewold 1977;Graham et al 1982) have been reported.…”

“…-65 - Schlesser et al (1980) reported normal suppression in schizophrenic patients, while others have demonstrated escape from normal suppression in patients with schizophrenia (Shulman and Diewold 1977;Dewan et al 1982;Meltzer et al 1982) and schizo-affective psychosis (Meltzer et al 1982). Coppen et al (1983), moreover, found escape from suppression in approximately one third of Ty]:,e II schizophrenics, that is, with "negative" symptoms (flattening of affect, poverty of speech and loss of drive), but in only one tenth of those with Ty]:,e I, with "positive" symptoms (delusions, hallucinations and thought disorder).…”