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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study was designed to assess the extent to which DST nonsuppression in bulimic women could be predicted by the incidence of major depression in the patient and her family and by other factors known to affect DST results, such as suboptimal weight. The DST was administered to 33 women who met DSM-III criteria for bulimia. Subjects were given a complete psychiatric and psychological assessment, including the National Institute of Mental Health Diagnostic Interview Schedule, a personal and family medical history questionnaire, the Hopkins SCL-90, and the Eating Disorders Inventory. Ideal weight was determined with Metropolitan Life tables. The rate of DST nonsuppression was 58%. Nonsuppression was more frequent among women who suffered from major depression and those who maintained a suboptimal weight. Depression and suboptimal weight were unrelated and thus appear to contribute independently to the high rate of DST abnormalities commonly seen in bulimia.
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PMID:The dexamethasone suppression test in bulimia: nonsuppression associated with depression and suboptimal weight. 334 3

The effects of four subtypes of major depressive disorder on four sleep EEG variables obtained in 153 depressed inpatients were analyzed taking into account the effects of age, gender, DST response and severity of depression. We have found that age significantly affected slow wave sleep. Sleep efficiency and total sleep time were shown to vary with age and severity of depression. Such effects were not detected for REM latency which was influenced by the endogenous subtype and the gender. Our data indicate that in depressed patients sleep EEG measures are influenced by multiple factors.
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PMID:Multivariate study of sleep EEG in depression. 338 84

Hypercortisolism due to Cushing's syndrome or glucocorticoid therapy induces disturbances in several other endocrine systems and may also cause mental changes, predominantly depression of various degrees. On the other hand, it has repeatedly been shown that endogenous depression is often accompanied by hypercortisolemia, usually of a modest degree, and/or by changes in other hormonal systems similar to those observed in Cushing's syndrome and during treatment with glucocorticoids. Research performed at the MPIP on 327 psychiatric patients and 103 healthy subjects has demonstrated that, in contrast to Cushing's syndrome, the circadian rhythm in depression is usually well preserved, and that diurnal variation in mood is correlated with that rhythm. Furthermore, it was found that a modest hyperactivity of the HPA system, as indicated by enhanced UFC excretion and nonsuppression in the DST, is not specific for depression in general or its endogenous subtype. It can also be observed in many other psychiatric disorders and seems to mirror stress and the influence of other factors, such as weight loss due to anorexia, rather than a particular nosology. TSH blunting in the TRH test appears as a consequence of hypercortisolemia in psychiatric disorders as is the case in Cushing's syndrome and in the course of glucocorticoid therapy. Differences in the patterns of neuroendocrine abnormalities in depressives and other psychiatric patients probably reflect differences in the individual responsiveness of the various hormonal axes to stress rather than nosological subtypes of the disorder. A comparison of these results with the past and current literature reveals remarkable changes in the concepts of neuroendocrine dysfunctions in depression and leads to suggestions of new strategies for research on this subject.
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PMID:Neuroendocrinological studies on depression with special reference to research at the Max-Planck-Institute of Psychiatry. 354 21

Platelet MAO activity was measured in 75 hospitalized depressed patients and in 31 healthy subjects. Plasmas post dexamethasone cortisol levels were examined in 73 patients. Results indicate that higher platelet MAO activity does not occur in all, but only in male major depressed patients. No relationship between changes of MAO activity and specific clinical subtypes was found. Platelet MAO activity is not different between DST suppressors and DST non suppressors. The authors suggest that platelet MAO activity may be related to non specific factors such as sex, age, but not to diagnosis of depression.
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PMID:Platelet MAO activity in clinical subtypes of depression and DST suppression. 360 29

To gain further insight into clinical associations seen in depression, the authors investigated the effect of interrupted night-time sleep on the HPA axis and mood in 20 psychiatric house officers taking overnight call. Specific interest was in whether multiple awakenings could induce a positive DST. No statistically significant association emerged between number of nocturnal awakenings, number of hours of sleep deprivation or temporal occurrence of sleep deprivation and cortisol, DST or mood. The results suggest that cortisol and DST changes are not likely to be causally linked to, or epiphenomenon of disrupted sleep. The implications of these findings for major depression are discussed.
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PMID:Effect of interrupted sleep patterns and partial sleep deprivation on DST and mood in psychiatric house officers. 361 84

Because of the methodologic differences and limited data, the sensitivity and specificity of the dexamethasone suppression test in children are in question. In our study we used 0.5 mg of dexamethasone and a 4 p.m. cortisol sample to perform the DST on 32 hospitalized prepubertal children diagnosed by a structured interview (DICA) and DSM-III criteria. Cortisols differed significantly by ANOVA among principal diagnoses, with highest values in children with major depression (MDE) or separation anxiety (SAD) and lowest in those with behavior disorders (BD). Using 5.0 micrograms/dl as a cutoff value for positive DST, MDE and SAD are positively and BD negatively associated with positive DST results. Rating scales for anxiety and depression showed no significant association with cortisol level. We conclude that the DST in this sample shows excellent sensitivity but its specificity is limited to distinguishing depressed or anxious children from those with pure behavior disorder.
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PMID:Depression, anxiety and the dexamethasone suppression test in hospitalized prepubertal children. 365 43

Pre- and post-dexamethasone prolactin and cortisol levels of 40 endogenous and non-endogenous depressive patients and of 20 controls were studied. Dexamethasone had a suppressive effect on prolactin levels, which was expressed more in normal controls and in non-endogenous depressive patients than in endogenous depression. A "prolactin suppression test" by dexamethasone was constructed and provided comparable results to the usual DST. However, it failed to be a specific marker for endogenous depression. There are close relationships between various endocrine axes, which might be altered in depression.
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PMID:Prolactin response to dexamethasone: a study on normal controls and depressed patients. 367 36

To assess the behavior of two putative neuroendocrine markers of depression in chronic pain, the authors determined plasma cortisol and prolactin concentrations before and after dexamethasone in 52 hospitalized male chronic pain patients. Their psychiatric diagnoses by Research Diagnostic Criteria (RDC) were: major depression (N = 24; 44.2%), minor depression (N = 10; 19.2%), another RDC diagnosis (N = 7; 13.5%) and not mentally ill (N = 12; 21.6%). Failure to suppress cortisol after dexamethasone (a positive DST) occurred in 43.5% of those with major depression, 20% of those with minor depression, 42.8% of those with other psychiatric diagnoses and in 8.3% of patients without a psychiatric disorder. The frequency of non-suppression was significantly different only for patients with major depression compared to those without diagnosable psychiatric disorder. Mean basal cortisol concentrations at 08.00, 16.00 and 23.00 h did not differ among psychiatric diagnostic groups of pain patients, or between these groups and healthy volunteers. Levels of prolactin, but not cortisol, were significantly correlated with the severity of mood disturbances. These findings suggest strategies using multiple endocrine markers to distinguish pain from depression should be explored.
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PMID:Basal and post-dexamethasone cortisol and prolactin concentrations in depressed and non-depressed patients with chronic pain syndromes. 371 87

Endogenous depressive and schizophrenic patients demonstrated the same frequency of pathological DST results after admission. After 3 weeks of psychopharmacological treatment the percentage of abnormal DST results was significantly reduced in both groups, although the treatment conditions were different. A correlation between the DST non-suppression and intensity of depression was observed only in the depressive group, not in the schizophrenic group. Normalization of DST results in depressive patients was mostly associated with an improvement of depressive scores. Other course patterns of DST results did not seem to be combined with psychopathological changes. From this data it has to be concluded that DST non-suppression is in some part related to depressive symptoms, but is not characteristic or specific for endogenous depression or for depressivity.
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PMID:The dexamethasone suppression test in depressive and schizophrenic patients under controlled treatment conditions. 373 36

L-tryptophan (L-TRP), the competing amino acids (CAA) valine and leucine and the cortisol levels taken at 8 a.m. after administration of dexamethasone on the previous day, were determined in 160 patients suffering from depression. The ratio between the L-TRP values and the sum of the competing amino acids was calculated. The clinical relevance of the L-TRP/CAA ratio in the case of major depression (DSM-III) versus minor depression (dysthymic disorder, atypical depression and adaptation disorder with depressive mood) was studied in comparison with the DST. Patients suffering from major depression showed a significantly decreased (p = 0.0006) L-TRP/CAA ratio. The combination of a decreased L-TRP/CAA ratio (cut off point less than or equal to 0.130) or an abnormal DST (cut off point greater than or equal to 3.5 micrograms/dl) is the best criterion which allows 59.0% of the patients suffering from major depression to be identified correctly with a specificity of 90.9%; the above-mentioned criterion permits 70.0% of the patients to be classified correctly into their actual group.
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PMID:The diagnostic performance of the L-tryptophan/competing amino acids ratio in major depression. 375 49


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