Decreased Dexamethasone Suppression in endogenously depressed patients with normal basal plasma levels of cortisol

Halbreich, Uriel; Naor, Simona; Asnis, Gregory M.; Gasparini, Frank; Goldstein, Susanna; Vital-Herne, J; Kang, Byung-Jo

doi:10.1016/0006-3223(86)90336-7

Cited by 5 publications

(1 citation statement)

References 17 publications

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“…It should be stressed, however, that approximately 50 per cent of those patients showing cortisol hypersecretion show a normal response to dexamethasone cortisol suppression. 47 The relationship between circulating glucocorticoids and the glucocorticoid receptors on lymphocytes has been studied by several groups of investigators who showed that depressed patients have fewer glucocorticoid receptors than normal subjects. Such receptors also show a reduced sensitivity to dexamethasone stimulation in vitro, which could re¯ect a decreased sensitivity to cortisol in vivo.…”

Section: Stress±depression and Immune± Endocrine Interrelationshipsmentioning

confidence: 99%

Changes in the Immune–Endocrine Interrelationships in Anxiety and Depression

Leonard

Song

1997

Stress Med.

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Evidence from clinical studies suggests that chronic exposure to physical and/or psychological stress profoundly affects the mental state and may be causally involved in anxiety and depressive disorders. Corticotropin releasing factor (CRF), which is released by any stressor, is known to regulate peripheral glucocorticoid function and also to influence central neurotransmitter activity by activating specific CRF receptors located in limbic regions of the brain. Whereas peptides other than CRF undoubtedly play a role in the peripheral and central changes initiated by stress, it would appear that the CRF plays a central role in orchestrating these changes. Besides the alterations in endocrine and neurotransmitter function that are characteristic of anxiety states and major depressive disorders, it is also known that the immune system is profoundly disturbed in these conditions. Psychoneuroimmunology has developed as a speciality to explain the link between the immune, endocrine and neurotransmitter systems. This review summarizes the evidence which suggests that severe anxiety and depression may be considered as a maladaptation to chronic stress in which the immune and endocrine systems play a principal role. Such a hypothesis may enable new types of anti‐anxiety and antidepressant drugs to be developed which act on the underlying maladapted endocrine and immune processes that cause the neurotransmitter malfunction which characterize these disorders. © 1997 John Wiley & Sons, Ltd.

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Section: Stress±depression and Immune± Endocrine Interrelationshipsmentioning

confidence: 99%

Changes in the Immune–Endocrine Interrelationships in Anxiety and Depression

Leonard

Song

1997

Stress Med.

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Age and gender effects on the diagnostic power of the DST

Ansseau

Depauw²,

Charles³

et al. 1987

Journal of Affective Disorders

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Among 365 major and 158 minor depressive inpatients, the dexamethasone suppression test (DST) yielded an overall diagnostic sensitivity of 50%, a specificity of 85%, and a confidence level of 88%. Age was significantly correlated with the post-dexamethasone cortisol levels in the whole sample (r = 0.11; P less than 0.01); however, this low relationship disappeared when all subgroups defined by gender or diagnostic were considered. Gender did not appear to influence DST results; however, among the patients between 30 and 39 years, the diagnostic performance of the DST was significantly lower among female as compared to male patients, suggesting possible interferences with endocrine variables.

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