Urinary free cortisol excretion in elderly persons with minor and major depression

Oldehinkel, Albertine J.; Berg, Marjan D van den; Flentge, F.; Bouhuys, Antoinette L.; Horst, Gert J. Ter; Ormel, Johan

doi:10.1016/s0165-1781(01)00300-6

Cited by 77 publications

(50 citation statements)

References 28 publications

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“…How can it be explained that hypercortisolemic depression in particular is associated with a higher prevalence of metabolic syndrome? Previous findings from this and other aging studies have suggested that late-life depression may be associated with high as well as low levels of cortisol (Morrison et al, 2000;Oldehinkel et al, 2001;Penninx et al, submitted). A number of studies provided some evidence that hypocortisolemic depression is associated with physical frailty and conditions characterized by fatigue and pain (Gur et al, 2004;Fries et al, 2005;Penninx et al, submitted), whereas hypercortisolemic depression is linked with more severe symptoms of depression (Nelson and Davis, 1997;Penninx et al, submitted).…”

Section: Discussionsupporting

confidence: 52%

Hypercortisolemic depression is associated with the metabolic syndrome in late-life

Vogelzangs

Suthers

Ferrucci

et al. 2007

Psychoneuroendocrinology

193

168

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Section: Discussionsupporting

confidence: 52%

Hypercortisolemic depression is associated with the metabolic syndrome in late-life

Vogelzangs

Suthers

Ferrucci

et al. 2007

Psychoneuroendocrinology

193

168

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“…[80][81][82][83] Thus, if antidepressants interfered with our measurements, this would have led to an underestimation of the observed difference between controls and patients with mood disorders with regard to the activation of their CRF-expressing neurons in the PVN. Furthermore, antidepressants did not influence AVP mRNA or OXT mRNA levels in PVN and SON in an animal experimental study.…”

Section: Avpmentioning

confidence: 99%

Gene expression analysis in the human hypothalamus in depression by laser microdissection and real-time PCR: the presence of multiple receptor imbalances

et al. 2008

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Hyperactivity of corticotropin-releasing factor (CRF) neurons in the paraventricular nucleus (PVN) of the hypothalamus is a prominent feature in depression and may be important in the etiology of this disease. The activity of the CRF neurons in the stress response is modulated by a number of factors that stimulate or inhibit CRF expression, including (1) corticosteroid receptors and their chaperones, heat shock proteins 70 and 90, (2) sex hormone receptors, (3) CRF receptors 1 (CRFR1) and 2, (4) cytokines interleukin 1-b and tumor necrosis factor-a, (5) neuropeptides and receptors, vasopressin (AVP), AVP receptor 1a (AVPR1A) and oxytocin and (6) transcription factor cAMP-response element-binding protein. We hypothesized that, in depression, the transcript levels of those genes that are involved in the activation of the hypothalamo-pituitary-adrenal (HPA) axis are upregulated, whereas the transcript levels of the genes involved in the inhibition of the HPA axis are downregulated. We performed laser microdissection and real-time PCR in the PVN and as a control in the supraoptic nucleus. Snap-frozen post-mortem hypothalami of seven depressed and seven matched controls were used. We found significantly increased CRF mRNA levels in the PVN of the depressed patients. This was accompanied by a significantly increased expression of four genes that are involved in the activation of CRF neurons, that is, CRFR1, estrogen receptor-a, AVPR1A and mineralocorticoid receptor, while the expression of the androgen receptor mRNA involved in the inhibition of CRF neurons was decreased significantly. These findings raise the possibility that a disturbed balance in the production of receptors may contribute to the activation of the HPA axis in depression.

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“…This concept might also be applicable to affective disorders, since a neuroendocrinological distinction has been suggested in depression, based on chronicity and duration of illness. Patients with chronic MDD have more often a normal or low HPA activity than non chronic patients (Shah et al, 1998;Oldehinkel et al, 2001;Watson et al, 2002). In addition, it has been noted that MDD patients with multiple depressive episodes have lower HPA axis activity than patients with fever depressive episodes (Ehnvall et al, 2004).…”

Section: Hypocortisolism Mechanismsmentioning

confidence: 99%

“…The majority of studies indicate a hyperactivity of the HPA-axis in patients with an ongoing depression (Plotsky et al, 1998;Pariante, 2003;Claes, 2004). However, low HPA-axis activity has been suggested in depression with atypical features (Antonijevic, 2006), as well as in multiepisodic and chronic depressive disorders (Shah et al, 1998;Oldehinkel et al, 2001;Watson et al 2002;Ehnvall et al, 2004). Among suicide attempters, patients with axis II personality disorders display lower cortisol levels than the ones without such a diagnosis .…”

Section: Introductionmentioning

confidence: 99%

Salivary cortisol and suicidal behavior—A follow-up study

Lindqvist

Isaksson

Lil-Träskman-Bendz

et al. 2008

Psychoneuroendocrinology

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IntroductionHyperactivity of the Hypothalamic-Pituitary-Adrenal (HPA) axis is a common finding in Major DepressiveDisorder. Similar studies on suicide attempters are less abundant, and the results are divergent. The main aim of the present study was to investigate HPA-axis parameters by the time of a suicide attempt and at follow-up in search for associations between HPA axis function and suicidal behavior. MethodsThirty-five suicide attempters and 16 non-suicidal controls were admitted to a psychiatric ward between the years of 1986 an 1992. Corticotrophin-releasing hormone (CRH) in cerebrospinal fluid and urinary cortisol were obtained for the suicide attempters. The patients were followed up approximately 12 years after the index admission. Cortisol was measured in saliva, and additional suicide attempts and current psychiatric symptoms were registered. ResultsAt follow up, evening salivary cortisol was lower in suicide attempters compared to controls. Low cortisol levels at follow up were associated with severe psychiatric symptoms. Among women, repeated suicide attempts were associated with low morning and lunch salivary cortisol, and in this subgroup we also found significant correlations between salivary cortisol at follow up, and CRH as well as urinary cortisol at index. ConclusionWe found evidence for an association between low HPA axis activity and suicidal behavior. This could be due to long lasting and severe psychiatric morbidity, which in turn has exhausted the HPA axis of these patients. The potential role of hypocortisolism should be given more attention in studies on suicidal patients.

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Urinary free cortisol excretion in elderly persons with minor and major depression

Cited by 77 publications

References 28 publications

Hypercortisolemic depression is associated with the metabolic syndrome in late-life

Hypercortisolemic depression is associated with the metabolic syndrome in late-life

Gene expression analysis in the human hypothalamus in depression by laser microdissection and real-time PCR: the presence of multiple receptor imbalances

Salivary cortisol and suicidal behavior—A follow-up study

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