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The thyrotropin-releasing hormone test in depressed and non-depressed psychiatric patients

Published online by Cambridge University Press:  28 April 2020

M. Maes ,
P. Hobin ,
M. De Ruyter  and
E. Suy
M. Maes
Affiliation:
Psychiatrie Center St-Jozef, Abdijstraat, 2, 3751Munsterbilzen, Belgium
P. Hobin
Affiliation:
Psychiatrie Center St-Jozef, Abdijstraat, 2, 3751Munsterbilzen, Belgium
M. De Ruyter
Affiliation:
Psychiatrie Center St-Jozef, Abdijstraat, 2, 3751Munsterbilzen, Belgium
E. Suy
Affiliation:
Psychiatrie Center St-Jozef, Abdijstraat, 2, 3751Munsterbilzen, Belgium
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Summary

The thyrotropin-releasing hormone (TRH) test was carried out in 231 depressed patients undergoing a dexamethasone suppression test (DST), and in 63 psychiatric control patients. The patients were classified according to DSM-III. Thyrotropin-secreting hormone (TSH) was determined in basal conditions, 20 and 60 min after the administration of 200 μg TRH. The Δ max TSH values (peak TSH response minus basal TSH) showed no significant difference between psychiatrie Controls and patients with major depression (296.00X2, 296.00X3, 296.00X4) or with depression (major and minor depression; 300,40, 296,82, 309.00). Consequently, the TRH test is not specifie either for depression or for major depression. Within the selected group of depressive patients, major depressives showed significantly (P<0.005) lower Δ max TSH responses than minor depressives. The TRH test could barely be used as a clinical diagnostic aid for major depression, since the predictive value for a positive test resuit was too low (maximal 70.2%). To separate major from minor depression, a single DST was more suitable than the TRH test or the combination of both tests. Age showed a negative correlation (P<0.005) with the Δ max TSH responses and could be considered as a predisposing factor for a blunted TSH response to TRH in depressive patients.

Résumé

Résumé

Le test au TRH (hormone thyréotrope hypothalamique) a été réalisé chez 231 malades déprimés et 63 patients psychiatriques témoins chez qui un test à la dexaméthasone (DST) avait été pratiqué. Les diagnostics des malades étaient faits selon le DSM III. La sécrétion de thyrotropine (TSH) était mesurée à l‘état basal 20 et 60 min après l‘administration de 200 ng de TRH. Le Δ max TSH (valeur maximale moins valeur basale) ne montre aucune différence entre les cas témoins, les patients présentant les épisodes dépressifs majeurs (296.X2, 296.X3, 296.X4) ou des troubles dépressifs: 300.40, 296.82, 309.00. Il semble donc que le test au TRH ne soit spécifique ni des troubles dépressifs ni des troubles dépressifs majeurs. Parmi le groupe de troubles dépressifs, il semble exister un Δ max de la réponse TSH plus bas chez les épisodes «majeurs» (P<0,005). Le test peut donc difficilement être utilisé comme une aide au diagnostic clinique des troubles dépressifs majeurs car la valeur prédictive d‘un test positif est basse (maximum 70,2%). Un seul résultat du DST est capable de séparer les épisodes majeurs et mineurs mieux que le test au TRH ou la combinaison de 2 tests. L‘âge est négativement corrélé au Δ max de la réponse TSH (P<0,005) et doit donc être considéré comme un facteur prédisposant les sujets âgés à une réponse TSH au TRH diminuée dans les troubles dépressifs.

Keywords

depressionthyrotropin-releasing hormone testdexamethasone suppression testdépressionhormone thyréotrope hypothalamiquetest de freinage par la dexaméthasone
Type
Original article
Information
Psychiatry and Psychobiology , Volume 3 , Issue 6 , 1988 , pp. 373 - 379
Copyright
Copyright © European Psychiatric Association 1988

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