Journal ArticleDOI
Neuroendocrine regulation in depression. II. Discrimination of depressed from nondepressed patients.
TLDR
The dexamethasone suppression test may be of value as a laboratory aid in the diagnosis of "endogenous" depression as indicated by high baseline midnight plasma cortisol levels.Abstract:
• Forty-two patients with endogenomorphic depression (ED) and 42 patients with other psychiatric disorders received an overnight dexamethasone test of hypothalamopituitary-adrenal (HPA) suppressibility. Plasma and urinary cortisol measures showed that the ED patients had significantly greater HPA activity before dexamethasone and less complete HPA suppression after dexamethasone. High cortisol values after dexamethasone correlated strongly with spontaneous HPA disinhibition, as indicated by high baseline midnight plasma cortisol levels. Criteria for defining normal suppression responses were developed. All patients with depressive neuroses and most patients with other nondepressive disorders had completely normal responses to dexamethasone. About half of the ED patients had abnormal responses, whether or not they were receiving other drugs at the time of the test. Drug-free patients with depressive neuroses or other disorders showed no abnormal responses to dexamethasone. The effects of psychotropic drugs on the test require further study. Patients with two or more abnormal cortisol values after administration of dexamethasone were identified correctly as ED at confidence levels close to100%. dexa-methasone suppression test may be of value as a laboratory aid in the diagnosis of "endogenous" depression.read more
Citations
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Journal ArticleDOI
Seasonal Affective Disorder: A Description of the Syndrome and Preliminary Findings With Light Therapy
Norman E. Rosenthal,David A. Sack,J. Christian Gillin,Alfred J. Lewy,Frederick K. Goodwin,Yolande B. Davenport,Peter S. Mueller,David A. Newsome,Thomas A. Wehr +8 more
TL;DR: Preliminary studies in 11 patients suggest that extending the photoperiod with bright artificial light has an antidepressant effect and sleep recordings in nine depressed patients confirmed the presence of hypersomnia and showed increased sleep latency and reduced slow-wave (delta) sleep.
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
TL;DR: 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.
Journal ArticleDOI
Elevated concentrations of CSF corticotropin-releasing factor-like immunoreactivity in depressed patients
Charles B. Nemeroff,Erik Widerlöv,Garth Bissette,Helena Walleus,Ingvar Karlsson,Kurt Eklund,Clinton D. Kilts,Peter T. Loosen,Wylie Vale +8 more
TL;DR: Findings are concordant with the hypothesis that CRF hypersecretion is, at least in part, responsible for the hyperactivity of the hypothalamo-pituitary-adrenal axis characteristic of major depression.
Journal ArticleDOI
Limbic system mechanisms of stress regulation: hypothalamo-pituitary-adrenocortical axis.
TL;DR: The influence of the limbic system on the HPA axis is likely the end result of the overall patterning of responses to given stimuli and glucocorticoids, with the magnitude of the secretory response determined with respect to the relative contributions of the various structures.
Journal ArticleDOI
Why has it taken so long for biological psychiatry to develop clinical tests and what to do about it
TL;DR: Rather than seek biomedical tests that can ‘diagnose’ DSM-defined disorders, the field should focus on identifying biologically homogenous subtypes that cut across phenotypic diagnosis—thereby sidestepping the issue of a gold standard.
References
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