P01.87 Dexamethasone suppression test, personality disorders and stressful life events in clinical subtypes of major depression

Fountoulakis, K.N.; lacovides, Apostolos; Fotiou, Fotis; Karamouzis, M.; Demetriadou, Aphrodite; Kaprinis, G.

doi:10.1016/s0924-9338(00)94494-8

Cited by 4 publications

(8 citation statements)

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“…The positive aspects of the current paper are that it is the first study to use modern and rigid diagnostic criteria and diagnostic methodology; the clinical subtypes of depression, though reliable [31], constitute an insufficient approach, especially as there are data available on the existence of biological differences between subtypes [32-34]. It is also the first to use a biological marker (DST) to categorize patients.…”

Section: Discussionmentioning

confidence: 99%

Season of birth, clinical manifestations and Dexamethasone Suppression Test in unipolar major depression

et al. 2007

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Background: Reports in the literature suggest that the season of birth might constitute a risk factor for the development of a major psychiatric disorder, possibly because of the effect environmental factors have during the second trimester of gestation. The aim of the current paper was to study the possible relationship of the season of birth and current clinical symptoms in unipolar major depression.

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Section: Discussionmentioning

confidence: 99%

Season of birth, clinical manifestations and Dexamethasone Suppression Test in unipolar major depression

et al. 2007

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“…The current study may contribute to an understanding of the underlying reason for the observation that approximately half of depressed patients reduced suppression on the DST. Depressed patients who do not show 'nonsuppression' may not only have been exposed to SLEs, but may also have been exposed repeatedly [43] . We found no significant connection between melancholy and SLEs.…”

Section: Discussionmentioning

confidence: 99%

Enhanced Suppression of Adrenocorticotropic Hormone and Cortisol Responses to Hypothalamic-Pituitary-Adrenal Function and Thyrotropin-Releasing Hormone Tests after Stressful Life Events in Patients with Major Depressive Disorder

Hikichi

Akiyoshi²,

Ichioka³

et al. 2007

Neuropsychobiology

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Background: It is commonly believed that there exists a relationship between the outcome of thyrotropin-releasing hormone (TRH) test, the combined dexamethasone/corticotropin-releasing hormone (DEX/CRH) test and stressful life events (SLEs) in major depressive disorder. Objective: SLEs influence the TRH and DEX/CRH tests in major depressive disorder when administered at the time of admission and improvement. Methods: The TRH and DEX/CRH tests were administered to patients hospitalized for major depressive disorders – on the 4th through the 7th hospital day and at the time of improvement. We measured ΔMAX TSH, ΔMAX ACTH, ACTH AUC, ΔMAX cortisol, cortisol AUC, ΔMAX ACTH/ΔMAX TSH and ΔMAX cortisol/ΔMAX TSH. Results: SLEs were significantly negatively associated with ΔMAX ACTH, ACTH AUC and cortisol AUC at the time of admission. However, these relationships lost significance at the time of improvement. The sample (41 patients at the time of admission, 18 patients at the time of improvement) was relatively small, which may have contributed to false-negative results. Conclusion: SLEs may be negatively associated with the outcome of the DEX/CRH tests in major depressive disorder. The hypothalamic-pituitary-adrenal axis in the DEX/CRH test was modulated by SLEs.

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“…The hypothesis that depression is linked to nonsuppression was not supported. Using dexamethasone as a diagnostic tool was abandoned because only about half of the depressed patients showed cortisol suppression with dexamethasone 21…”

Section: Comparing Post‐traumatic Stress Disorder and Cortisol Insuffmentioning

confidence: 99%

“…[17][18][19][20] Although traumatized, other people with an adequate amount of cortisol did not go on to develop PTSD. 21 In fact, cortisol normally might even increase ten-fold during a traumatic event and then return to normal levels when the trauma ends. This is a healthy response to a physical or emotional stress.…”

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confidence: 99%

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Stress‐Induced Hypocortisolemia Diagnosed as Psychiatric Disorders Responsive to Hydrocortisone Replacement

Schuder

2005

Annals of the New York Academy of Sciences

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In patients of all ages, many disorders labeled as psychiatric may actually be due to hormonal insufficiencies. For example, cortisol deficiency is rarely taken into account in a medical or psychiatric work-up, so persons with mild to moderate cortisol insufficiency are for the most part relegated to receiving a psychiatric diagnosis when, in fact, the same disorder is represented. However, the symptoms of cortisol insufficiency appear to closely parallel such psychiatric disorders as post traumatic stress disorder (PTSD) and addictions. There has been some question of whether substance abuse causes a hypocortisolemic state. In reviewing the literature and obtaining detailed histories of addicted patients, it appears that childhood trauma, also known as "early life stress" (ELS), instead may elicit a hypocortisolemic state. This leads some to self-medicate with an addictive substance to quell the pain of a cortisol insufficiency, both physical and emotional. In fact, the literature supports the concept that addictive substances increase cortisol in predisposed patients. Patients with a variety of psychiatric disorders including addictions were found to have signs and symptoms of mild or moderate hypocortisolemia. Generally, an appropriate comprehensive examination supported a diagnosis of cortisol insufficiency. For the most part, these patients were successfully treated with physiologic doses of bio-equivalent hydrocortisone, along with replacement of any other deficient hormone. By correcting underlying hormonal insufficiencies, many patients improved, with some patients having a total reversal of psychiatric symptoms. It is therefore reasonable to evaluate and treat hormonal insufficiencies with hormones prior to using psychotropic medication.

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P01.87 Dexamethasone suppression test, personality disorders and stressful life events in clinical subtypes of major depression

Cited by 4 publications

References 0 publications

Season of birth, clinical manifestations and Dexamethasone Suppression Test in unipolar major depression

Season of birth, clinical manifestations and Dexamethasone Suppression Test in unipolar major depression

Enhanced Suppression of Adrenocorticotropic Hormone and Cortisol Responses to Hypothalamic-Pituitary-Adrenal Function and Thyrotropin-Releasing Hormone Tests after Stressful Life Events in Patients with Major Depressive Disorder

Stress‐Induced Hypocortisolemia Diagnosed as Psychiatric Disorders Responsive to Hydrocortisone Replacement

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