Relationship between Nocturnal Urinary Cortisol Excretion and Symptom Severity in Subgroups of Patients with Depressive Episodes

Wedekind, Dirk; Preiss, Birgit; Cohrs, Stefan; Ruether, E.; Huether, Gerald; Adler, Lothar

doi:10.1159/000112953

Cited by 11 publications

(3 citation statements)

References 45 publications

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“…The association between hypothyroidism and depression might be explained by higher rates of hypercortisolism in depression [30], which might lead to changes in the hypothalamic-pituitary-thyroid/adrenal (HPT/HPA) axes [31]. Dysfunctional HPT/HPA axes regulation might be a trait in MDD patients, producing changes in the monoaminergic pathways that modulate hormonal responses [32]. Autoimmune thyroiditis which is marked by the presence of thyroid antibodies with normal or abnormal thyroid hormone level is also a major cause for MDD.…”

Section: Discussionmentioning

confidence: 99%

Relationship between the LHPP Gene Polymorphism and Resting-State Brain Activity in Major Depressive Disorder

et al. 2016

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A single-nucleotide polymorphism at the LHPP gene (rs35936514) has been reported in genome-wide association studies to be associated with major depressive disorder (MDD). However, the neural system effects of rs35936514 that mediate the association are unknown. The present work explores whether the LHPP rs35936514 polymorphism moderates brain regional activity in MDD. A total of 160 subjects were studied: a CC group homozygous for the C allele (23 individuals with MDD and 57 controls) and a T-carrier group carrying the high risk T allele (CT/TT genotypes; 22 MDD and 58 controls). All participants underwent resting-state functional magnetic resonance imaging (rs-fMRI) scanning. Brain activity was assessed using the amplitudes of low-frequency fluctuations (ALFF). MDD patients showed a significant increased ALFF in the left middle temporal gyrus and occipital cortex. The T-carrier group showed increased ALFF in the left superior temporal gyrus. Significant diagnosis × genotype interaction was noted in the bilateral lingual gyri, bilateral dorsal lateral prefrontal cortex (dlPFC), and left medial prefrontal cortex (mPFC) (P < 0.05, corrected). Results demonstrated that MDD patients with LHPP rs35936514 CT/TT genotype may influence the regional brain activity. These findings implicate the effects of the rs35936514 variation on the neural system in MDD.

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Section: Discussionmentioning

confidence: 99%

Relationship between the LHPP Gene Polymorphism and Resting-State Brain Activity in Major Depressive Disorder

et al. 2016

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“…Third, as enzyme activity may change during the day-night cycle, collection of 24-hour urine samples would have been favorable. Advantages of single nocturnal urine samples are better controllability of collection errors and a similar level of physical activity during nighttime [28,29]. Fourth, no follow-up measurement of glucocorticoid metabolism has been conducted in either patients after response or controls.…”

Section: Discussionmentioning

confidence: 99%

Cortisol Metabolism in Depressed Patients and Healthy Controls

et al. 2009

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Background: Chronic stress as well as major depressive disorders are associated with hypercortisolemia and impaired hypothalamic-pituitary-adrenocortical axis functioning. The aim of this study was to determine whether in major depression changes in the activity patterns of local modulators of glucocorticoid action might contribute to an increase in cortisol bioavailability and if they change during antidepressant treatment and clinical response. Methods: Concentrations of urinary total cortisol (UFF), urinary total cortisone (UFE), tetrahydrocortisone (THE), tetrahydrocortisol (THF) and allo-THF (5α-THF) were measured in 10-hour nocturnal urine samples of 19 depressed patients and 15 healthy controls. The activity of 11β-hydroxysteroid dehydrogenases (11β-HSD) as well as 5α- and 5β-reductases was assessed by calculating the ratios of glucocorticoid metabolites. Patients were treated for 28 days with either mirtazapine or venlafaxine. Enzyme activity was observed during the course of treatment and compared to healthy controls. Responders to treatment were selected for this analysis. Results: Depressed patients showed reduced 5α-reductase activity manifested as a significantly lower amount of 5α-THF (102.8 ± 167.2 vs. 194.6 ± 165.8 μg, p = 0.019). The increase in the UFF/UFE ratio (0.73 ± 0.32 vs. 0.29 ± 0.13, p < 0.0001) indicates reduced activity of renal 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2). During pharmacological treatment, 5α-reductase activity in patients returned to the level of the control group, while the decrease in 11β-HSD2 activity persisted until day 28. Conclusions: Our results show changes in activity of intracellular modulators of steroid action in major depressive disorders, particularly a reduced activity of the intracellular cortisol-deactivating enzymes 5α-reductase and 11β-HSD2. These changes suggest an increase in cortisol bioavailability within tissues.

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“…In the behavioral and social sciences, such subgroups within groups, or taxons (e.g., Meehl, 1992), are a very common occurrence, particularly when looking at diagnoses of mental disorders and cognitive functioning. For example, depressive episodes can be divided into monopolar depression and bipolar depression and then further subdivided into psychotic and non-psychotic episodes (e.g., Wedekind et al, 2007). Often severity of psychiatric disorders is studied in terms of (a) severity levels, (b) severity subgroups or (c) symptom-severity ratings (Helzer et al, 2006a,b).…”

Section: Introductionmentioning

confidence: 99%

Group membership prediction when known groups consist of unknown subgroups: a Monte Carlo comparison of methods

Finch¹,

Bolin²,

Kelley³

2014

Front. Psychol.

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Classification using standard statistical methods such as linear discriminant analysis (LDA) or logistic regression (LR) presume knowledge of group membership prior to the development of an algorithm for prediction. However, in many real world applications members of the same nominal group, might in fact come from different subpopulations on the underlying construct. For example, individuals diagnosed with depression will not all have the same levels of this disorder, though for the purposes of LDA or LR they will be treated in the same manner. The goal of this simulation study was to examine the performance of several methods for group classification in the case where within group membership was not homogeneous. For example, suppose there are 3 known groups but within each group two unknown classes. Several approaches were compared, including LDA, LR, classification and regression trees (CART), generalized additive models (GAM), and mixture discriminant analysis (MIXDA). Results of the study indicated that CART and mixture discriminant analysis were the most effective tools for situations in which known groups were not homogeneous, whereas LDA, LR, and GAM had the highest rates of misclassification. Implications of these results for theory and practice are discussed.

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Relationship between Nocturnal Urinary Cortisol Excretion and Symptom Severity in Subgroups of Patients with Depressive Episodes

Cited by 11 publications

References 45 publications

Relationship between the LHPP Gene Polymorphism and Resting-State Brain Activity in Major Depressive Disorder

Relationship between the LHPP Gene Polymorphism and Resting-State Brain Activity in Major Depressive Disorder

Cortisol Metabolism in Depressed Patients and Healthy Controls

Group membership prediction when known groups consist of unknown subgroups: a Monte Carlo comparison of methods

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