PERSISTENT NEUROENDOCRINE DYSREGULATION IN MAJOR DEPRESSIVE DISORDER - A MARKER FOR EARLY RELAPSE

  • 1 January 1984
    • journal article
    • research article
    • Vol. 19  (3) , 305-318
Abstract
Neuroendocrine challenge studies, including the dexamethasone suppression test (DST) and TRH stimulation test, were given to 86 patients meeting DSM-III [Diagnostic and Statistical Manual of Mental Disorders-III] criteria for major depressive disorder. Of 33 patients, 25 revealed normalization of abnormal DST at the time of symptomatic improvement, and 9 of 26 patients (35%) revealed normalization of blunted TSH responses to TRH injection. Patients with normalized function revealed treatment responsiveness and low relapse rates (11%) similar to patients who had had normal neuroendocrine function at the time of admission. Of 23 patients with persistent dysregulation on either test, 11 relapsed within 6 mo. in contrast to 3 of 28 patients with normalized function (P < 0.01) and 5 of 35 patients with normal neuroendocrine function on admission (P < 0.02). Persistent dysregulation may be a valuable prognostic marker reflecting partial treatment responsiveness in some patients which predisposes themn to early relapse. Both the DST and TRH tests appear to reflect neuroendocrine trait deficits which are independent of but interact with a coexisting predisposition to depressive disorder.