Depressive behavior and hyperactive adrenocortical function

Abstract

This study examined relationships between depressive subtypes, clinical-behavioral characteristics, and hypothalamic-pituitary-adrenocortical (HPA) function in 132 hospitalized depressed patients. There were significant positive correlations between several pre- and postdexamethasone plasma cortisol measures and anxiety, psychomotor disturbance, distressed expression, and sleep disturbance. Few significant relationships were seen between illness severity and HPA function. Virtually no endocrine differences were seen between endogenous and nonendogenous subtypes or between psychotic and nonpsychotic subtypes. These results and the previous literature suggest a profile of depressed patients with HPA overactivation; they are likely to be anxious, to have sleep and psychomotor disturbances, to have lost weight in the current episode, and to be older.

Does the Dexamethasone Suppression Test Reliably Discriminate Between Psychotic and Nonpsychotic Major Depression?

“…Anxiety severity also was significantly higher in PMD compared with NMD patients at baseline. Previous research shows a relationship between DST nonsuppression and general anxiety and “stress” (Calloway et al, 1984; Kocsis et al, 1985; Mellsop et al, 1985). The relationship between the DST and anxiety may be particularly relevant in DST studies of PMD, as these patients tend to experience greater anxiety severity in general and often more anxiety disorder comorbidity compared with NMD patients (Charney & Nelson, 1981; Gaudiano et al, in press-a; Lattuada et al, 1999).…”