Cortisol Response to a Combined Dexamethasone‐Human Corticotrophin‐Releasing Hormone Challenge in Patients with Depression
Open accessAbstract
We administered a combined dexamethasone‐human corticotrophin‐releasing hormone (hCRH) challenge test to 14 in‐patients with a major depressive episode and to 14 age‐matched controls. After pretreatment with 1.5 mg dexamethasone at 2300 h the day before, 100 μg hCRH was administered iv at 1500 h. Blood samples for cortisol determinations by radioimmunoassay were drawn at 1400 h, 1430 h and 1500 h before infusion of hCRH and thereafter every 15 min until 1700 h. Cortisol secretion after injection of hCRH assessed as area under the curve was significantly increased in patients with depression when compared to controls (14.5 ± 4.3 ng × min × 1,000/ml vs 3.1 ± 2.4 ng × min × 1,000/ml). Multiple regression analysis among patients revealed a significant impact of age and severity of depression upon hCRH‐induced cortisol secretion, whereas in normal controls no significant influence of age on cortisol secretion after hCRH emerged. Our data show that in depressed patients hCRH evokes an escape from dexamethasone‐induced suppression of the pituitary‐adrenocortical activity, whereas it fails to do so among controls. This finding suggests that at the pituitary level the action of hCRH is enhanced by a factor that is less sensitive to dexamethasone suppression in depression. We postulate that this factor is vasopressin.
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The dex-CRH test increased sensitivity to identify alterations of the HPA axis with successful classification of depressed patients up to 80%.
“In fact, sensitivity to identify alterations of the HPA axis could be increased with a successful classification of depressed patients up to 80% [56, 57].”
From The HPA Axis as Target for Depression (2024) · cites this paper as [56]
The DEX-CRH test results and Discussion report increased cortisol responses in depressed patients, including those not identified as DST nonsuppressors, supporting improved detection of HPA-axis disturbance. The paper does not report an 80% successful-classification rate or a formal sensitivity estimate. (LLM, conf=0.84)
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- Authors
- von Bardeleben, U., & Holsboer, F.
- Affiliations
- University of Freiburg (DE)
- Venue
- Journal of Neuroendocrinology
- Publisher
- Wiley
- Published
- 1989-12
- Volume
- 1
- Issue
- 6
- Pages
- 485-488
- ISSN
- 0953-8194 (ISSN-L)
- 1365-2826
- OpenAlex
- W2069410124
- Cited by
- 161
- References
- 31
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 3 · 2021: 5 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 2 · 2016: 2 · 2015: 3 · 2014: 1 · 2013: 6 · 2012: 4
- FWCI
- 2.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Neuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuropeptides and Animal Physiology
- Keywords
- depression, cortisol secretion, dexamethasone suppression test, pituitary-adrenal axis, vasopressin
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