Assessment of the Dexamethasone/CRH Test as a State-Dependent Marker for Hypothalamic-Pituitary-Adrenal (HPA) Axis Abnormalities in Major Depressive Episode: A Multicenter Study

Kunugi, Hiroshi; Ida, Itsuro; Owashi, Toshimi; Kimura, Mahito; Inoue, Yumiko; Nakagawa, Shin; Yabana, Takafumi; Urushibara, Takako; Kanai, Rie; Aihara, Masako; Yuuki, Naoya; Otsubo, Tempei; Oshima, Akihiko; Kudo, Koutaro; Inoue, Takeshi; Kitaichi, Yuji; Shirakawa, Osamu; Isogawa, Koichi; Nagayama, Haruo; Kamijima, Kunitoshi; Nanko, Shinichiro; Kanba, Shigenobu; Higuchi, Teruhiko; Mikuni, Masahiko

doi:10.1038/sj.npp.1300868

Cited by 200Stress Responses and CortisolAdrenal Hormones and DisordersTreatment of Major Depression

Assessment of the Dexamethasone/CRH Test as a State-Dependent Marker for Hypothalamic-Pituitary-Adrenal (HPA) Axis Abnormalities in Major Depressive Episode: A Multicenter Study

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Kunugi, Hiroshi, Ida, Itsuro, Owashi, Toshimi, Kimura, Mahito, Inoue, Yumiko, Nakagawa, Shin, Yabana, Takafumi, Urushibara, Takako +16 more·2006·Neuropsychopharmacology

DOI 10.1038/sj.npp.1300868

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Abstract

There is compelling evidence for the involvement of hypothalamic-pituitary-adrenal (HPA) axis abnormalities in depression. Growing evidence has suggested that the combined dexamethasone (DEX)/corticotropin-releasing hormone (CRH) test is highly sensitive to detect HPA axis abnormalities. We organized a multicenter study to assess the DEX/CRH test as a state-dependent marker for major depressive episode in the Japanese population. We conducted the DEX/CRH test in 61 inpatients with major depressive episode (Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV)) and 57 healthy subjects. In all, 35 patients were repeatedly assessed with the DEX/CRH test on admission and before discharge. The possible relationships between clinical variables and the DEX/CRH test were also examined. Significantly enhanced pituitary-adrenocortical responses to the DEX/CRH test were observed in patients on admission compared with controls. Such abnormalities in patients were significantly reduced after treatment, particularly in those who underwent electroconvulsive therapy (ECT) in addition to pharmacotherapy. Age and female gender were associated with enhanced hormonal responses to the DEX/CRH test. Severity of depression correlated with DEX/CRH test results, although this was explained, at least in part, by a positive correlation between age and severity in our patients. Medication per se was unrelated to DEX/CRH test results. These results suggest that the DEX/CRH test is a sensitive state-dependent marker to monitor HPA axis abnormalities in major depressive episode during treatment. Restoration from HPA axis abnormalities occurred with clinical responses to treatment, particularly in depressed patients who underwent ECT.

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Authors: Kunugi, H., Ida, I., Owashi, T., Kimura, M., Inoue, Y., Nakagawa, S., Yabana, T., Urushibara, T., Kanai, R., Aihara, M., Yuuki, N., Otsubo, T., Oshima, A., Kudo, K., Inoue, T., Kitaichi, Y., Shirakawa, O., Isogawa, K., Nagayama, H., Kamijima, K., Nanko, S., Kanba, S., Higuchi, T., & Mikuni, M.
Affiliations: Teikyo University (JP)
Gunma University (JP)
SHOWA Medical University (JP)
Nippon Medical School (JP)
University of Yamanashi (JP)
Hokkaido University (JP)
National Center of Neurology and Psychiatry (JP)
Kobe University (JP)
Oita University (JP)
Kyushu University (JP)
Corresponding author: Kunugi, Hiroshi
ORCID: Kunugi, Hiroshi
Kimura, Mahito
Nakagawa, Shin
Otsubo, Tempei
Inoue, Takeshi
Shirakawa, Osamu
Higuchi, Teruhiko
Venue: Neuropsychopharmacology
Publisher: Springer Science and Business Media LLC
Published: 2005-08-17
Volume: 31
Issue: 1
Pages: 212-220
ISSN: 0893-133X (ISSN-L)
1740-634X
DOI: 10.1038/sj.npp.1300868
OpenAlex: W2165668731
Cited by: 200
References: 52
Citations by year: 2026: 2 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 2 · 2021: 9 · 2020: 11 · 2019: 11 · 2018: 14 · 2017: 8 · 2016: 12 · 2015: 15 · 2014: 8 · 2013: 7 · 2012: 18
FWCI: 4.59
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
Locations: Neuropsychopharmacology (publishedVersion)
PubMed (publishedVersion)
Institutional Repositories DataBase (IRDB) (submittedVersion, cc-by-nc-nd)
Topics: Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords: dexamethasone/corticotropin-releasing hormone test, hypothalamic-pituitary-adrenal axis, major depressive episode, depression, electroconvulsive therapy, depression severity, age and sex differences, treatment response monitoring, Japanese patients
MeSH terms: Adult, Age Factors, Corticotropin-Releasing Hormone, Major Depressive Disorder, Depressive Disorder, Major, Dexamethasone, Female, Humans, Hypothalamo-Hypophyseal System, Male, Middle Aged, Pituitary-Adrenal System, Psychiatric Status Rating Scales, Sex Characteristics

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Assessment of the Dexamethasone/CRH Test as a State-Dependent Marker for Hypothalamic-Pituitary-Adrenal (HPA) Axis Abnormalities in Major Depressive Episode: A Multicenter Study

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