Journal ArticleDOI
A specific laboratory test for the diagnosis of melancholia. Standardization, validation, and clinical utility.
Bernard J. Carroll,Michael Feinberg,John F. Greden,Janet Tarika,A. Ariav Albala,Roger F. Haskett,Norman McI. James,Ziad Kronfol,Naomi E. Lohr,Meir Steiner,Jean Paul de Vigne,Elizabeth A. Young +11 more
TLDR
Abnormal DST results were found with similar frequency among outpatients and inpatients with melancholia; but they were not related to age, sex, recent use of psychotropic drugs, or severity of depressive symptoms.Abstract:
• Four hundred thirty-eight subjects underwent an overnight dexamethasone suppression test (DST) to standardize the test for the diagnosis of melancholia (endogenous depression). Abnormal plasma cortisol concentrations within 24 hours after dexamethasone administration occurred almost exclusively in melancholic patients. The best plasma cortisol criterion concentration, above which a DST result may be considered abnormal, was 5 ug/dL. The optimal dose of dexamethasone was 1 rather than 2 mg. Two blood samples obtained at 4 and 11 PM after dexamethasone administration detected 98% of the abnormal test results. This version of the DST identified melancholic patients with a sensitivity of 67% and a specificity of 96%. Baseline nocturnal plasma cortisol concentrations were not useful. Abnormal DST results were found with similar frequency among outpatients and inpatients with melancholia; but they were not related to age, sex, recent use of psychotropic drugs, or severity of depressive symptoms. Extensive evidence validates this practical test for the diagnosis of melancholia.read more
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Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy.
TL;DR: Suggestions to improve the assessment of behavioral interventions include more complete delineation of the physiological mechanisms by which such interventions might work; increased use of new, more convenient "alternative" end points for behavioral intervention trials; development of specifically targeted behavioral interventions (based on profiling of patient factors); and evaluation of previously developed models of predicting behavioral change.
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The Neuroendocrinology of Stress and Aging: The Glucocorticoid Cascade Hypothesis
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Salivary cortisol in psychoneuroendocrine research: Recent developments and applications
TL;DR: An up-to-date overview of recent methodological developments, novel applications as well as a discussion of possible future applications of salivary cortisol determination are provided.
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Brain structural and functional abnormalities in mood disorders: implications for neurocircuitry models of depression
TL;DR: Because the MPFC and related limbic structures provide forebrain modulation over visceral control structures in the hypothalamus and brainstem, their dysfunction can account for the disturbances in autonomic regulation and neuroendocrine responses that are associated with mood disorders.
Journal ArticleDOI
Hippocampal atrophy in recurrent major depression
Yvette I. Sheline,Po W. Wang,Po W. Wang,Mokhtar H. Gado,John G. Csernansky,Michael W. Vannier +5 more
TL;DR: The results suggest that depression is associated with hippocampal atrophy, perhaps due to a progressive process mediated by glucocorticoid neurotoxicity.
References
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Journal ArticleDOI
Predictive Value of a Single Diagnostic Test in Unselected Populations
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