Endocrine changes and clinical profiles in depression: I. The dexamethasone suppression test

Calloway, S. P.; Dolan, Raymond J.; Fonagy, Peter; Souza, V. F. De; Wakeling, A.

doi:10.1017/s0033291700019711

Cited by 34 publications

(10 citation statements)

References 56 publications

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“…The fact that plasma cortisol concentrations were raised up to 3 months after the onset of a severely threatening life-event implies a resetting of the control of the HPA axis and not just a stress response. Similar conclusions can be drawn from the report that depressed patients with recent history of life-events and chronic difficulties excrete more cortisol 56 and have higher plasma cortisol concentrations 57 than matched depressed patients without life-events and chronic difficulties.…”

Section: Neuroendocrine Studies Of Life-events -Human Studiessupporting

confidence: 83%

The neuroendocrinology of depression and chronic stress

Checkley¹

1996

British Medical Bulletin

284

147

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This chapter will review basic and clinical studies of the social, genetic and developmental influences upon the reactivity of the hypothalamic pituitary adrenal (HPA) axis and the relationship of these to depression. Significant advances have taken place in each of these areas and it is now possible to interlink many of these areas of work. In order to do so, this chapter will be organised into five sections.The first section will show how the neuroendocrinology of chronic stress is characterised by an up-regulation of the central drive to the HPA axis in conjunction with downregulation of its negative feedback control.The second will show that very similar processes occur in depressive illness.The third section will describe social, developmental and genetic influences on the HPA axis both in experimental animals and in man.The fourth will show how activation of the HPA axis can influence the development of animal models of depression as well as the onset and perpetuation of clinical depression.The final section will draw together an overall hypothesis and indicate the potential for new treatments for depression that arise from this work. The neuroendocrinology of acute and chronic stressThe secretion of corticosteroid hormones (predominantly cortisol in man and corticosterone in the rat) is the most important endocrine component of the response to stress and the one that is most necessary for successful adaptation: the acute response has a time course of 1-2 h and the chronic response one of days or weeks. HPA activation in response to acute stress -animal studiesThe central drive to the stress response of the HPA axis is organised by the parvocellular component of the paraventricular nucleus (PVN) of the hypothalamus. Some of these cells synthesise corticotropin releasing Postal address: hormone (CRH) alone and some both CRH and arginine vasopressin Prof Stuart chockley, (AVP), but both types of cells project to the external zone of the median institute of Psychiatry, eminence and release their hormones into the hypophyseal portal system Denmark HiTLndo'n wm ch carries the hormones to the anterior pituitary gland. In response to SE5 8AF, UK an acute stress there is an increase in the synthesis of CRH mRNA and

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Section: Neuroendocrine Studies Of Life-events -Human Studiessupporting

confidence: 83%

The neuroendocrinology of depression and chronic stress

Checkley¹

1996

British Medical Bulletin

284

147

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“…Moreover, the post-dexamethasone UFC results in the two studies were remarkably similar with the NIMH study reporting levels of 59 @tgms per 24 hours, (and 65 @tgmper 24 hours in patients with unipolar depression), as compared to 65.4 @tgm per 24 hours in our study of mainly unipolar depressed patients (Calloway et al, 1984).…”

supporting

confidence: 88%

Depression and Urinary Free Cortisol

Calloway

Dolan

1986

Br J Psychiatry

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after their partners' death (Bornstein & Clayton, 1972) probably are common, though are mostly so mild as not to require the attention of psychiatrists. My own study suggests that age-correspondence precipitated reactions are rare. When they do occur it is important that they be recognised as such, since they can sometimes present as florid psychotic states (Hilgard & Newman, 1959). I would be interested to know if any readers have experience of one.

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“…The concept of endophenotypes is increasingly being applied to studies of psychiatric nosology, in recognition of the fact that genetic or biological markers may map more closely onto specific symptoms than onto traditional diagnoses 45,47,49,57 . For example, in several studies, cortisol hypersecretion (or DST nonsuppression) in depression has been related to specific symptoms, of sleep disturbance (especially initial insomnia), decreased attention and memory, psychosis, psychomotor disturbance (agitation or retardation), and anxiety, 32,58–68 more so than to global depression or to more “psychological” symptoms, such as guilt, worthlessness, helplessness, or hopelessness (Table 1). Other symptoms that have been related to cortisol hyperactivity in depression, but less consistently so, include decreased energy, suicidal thoughts and decreased libido.…”

Section: Correlational Evidence For Glucocorticoid Involvement In Psymentioning

confidence: 99%

Glucocorticoids

Wolkowitz

Burke²,

Epel³

et al. 2009

Annals of the New York Academy of Sciences

157

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Elevated circulating levels of glucocorticoids are associated with psychiatric symptoms across several different conditions. It remains unknown if this hormonal abnormality is a cause or an effect of the psychiatric conditions. For example, the hypercortisolemia observed in a subset of patients with depression may have a direct impact on the symptoms of depression, but it is also possible that the hypercortisolemia merely reflects the stress associated with depression. Further, rather than causing depression, hypercortisolemia could represent a homeostatic attempt to overcome glucocorticoid resistance. Each of these possibilities will be considered, and correlational and causal evidence will be reviewed. This article will focus on the relationships between glucocorticoids and psychiatric symptoms in Cushing's syndrome, major depression, and steroid psychosis/steroid dementia, as well as the effects of exogenously administered glucocorticoids in normal volunteers. Similarities and differences in the relationship of glucocorticoid hormones to psychiatric symptoms in these conditions will be reviewed. Possible mediators of glucocorticoid effects on the brain and behavior, as well as possible "pro-aging" effects of glucocorticoids in certain cells of the body, will be reviewed. The article concludes with a conceptual model of glucocorticoid actions in the brain that may lead to novel therapeutic opportunities.

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Endocrine changes and clinical profiles in depression: I. The dexamethasone suppression test

Cited by 34 publications

References 56 publications

The neuroendocrinology of depression and chronic stress

The neuroendocrinology of depression and chronic stress

Depression and Urinary Free Cortisol

Glucocorticoids

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