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A Combined Study of Cortisol, ACTH and Dexamethasone Concentrations in Major Depression

Multiple Time-Point Sampling

Published online by Cambridge University Press:  02 January 2018

B. G. Charlton ,
A. Leake ,
C. Wright ,
H. W. Griffiths  and
I. N. Ferrier
B. G. Charlton
Affiliation:
MRC Neuroendocrinology Unit
A. Leake
Affiliation:
MRC Neuroendocrinology Unit
C. Wright
Affiliation:
MRC Neuroendocrinology Unit
H. W. Griffiths
Affiliation:
Royal Victoria Infirmary, Newcastle upon Tyne
I. N. Ferrier*
Affiliation:
MRC Neuroendocrinology Unit
*
MRC Neuroendocrinology Unit, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne NE4 6BE
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Abstract

The pathophysiology of hypercortisolaemia in major depression was examined. ACTH was measured using a novel immunoradiometric assay of high specificity and sensitivity. Twenty-eight patients with major depression and 18 control subjects were studied. Blood samples for basal hormone concentration were taken at 09:00, 16:00 and 23:00 on day 1, followed by administration of 1 mg dexamethasone at 23:00. Further samples were taken at 09:00 and 16:00 on day 2. Dexamethasone concentration was measured in day 2 samples and no significant difference was found between the depressed group and control subjects. In the depressed group Cortisol concentration was elevated at 23:00 on day 1, and ACTH concentrations were elevated in post-dexamethasone samples. ACTH and Cortisol concentrations were not directly correlated in individual patients. The elevated plasma Cortisol associated with major depression is not solely mediated by changes in ACTH.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 150 , Issue 6 , June 1987 , pp. 791 - 796
Copyright
Copyright © 1987 The Royal College of Psychiatrists 

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References

Al Dujaili, E. A. S., Hope, J., Esttvariz, F. E., Lowry, P. J. & Edwards, C. R.W. (1981) Circulating human pituitary pro-7-melanotropin enhances the adrenal response to ACTH. Nature, 291, 156–158.CrossRefGoogle ScholarPubMed
American, Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. Washington, DC: APA.Google Scholar
Amsterdam, J. D., Winokur, A., Abelman, E., Lucki, I. & Rickel, K. (1983) Cosynotropin (ACTH 1-24) stimulation test in depressed patients and healthy subjects. American Journal of Psychiatry, 140, 907–909.Google ScholarPubMed
Arana, G. W. & Baldessarini, R. J. & Ornsteen, M. (1985) The dexamethasone suppression test for diagnosis and prognosis in psychiatry. Archives of General Psychiatry, 42, 1193–1204.CrossRefGoogle ScholarPubMed
Bereiter, D. A, Plotsjcy, P. M. & Gann, D. S. (1982) Tooth pulp stimulation potentiates the adrenocroticotropin response to haemorrhage in cats. Endocrinology, 111, 1127–1132.Google Scholar
Berger, M., Pirke, K. M., Doerr, P., Krieg, J. C. & Zerssen, D.V. (1984) The limited utility of the dexamethasone suppression test for the diagnostic process in psychiatry. British Journal of Psychiatry, 145, 372–382.Google Scholar
Bowie, P. C. & Beaini, A. Y. (1985) Normalisation of the dexamethasone suppression test. British Journal of Psychiatry, 147, 30–35.Google Scholar
Carney, M. W.P., Roth, M. & Garside, R. F. (1965) The diagnosis of depressive syndromes and the prediction of ECT response. British Journal of Psychiatry, 111, 659–674.Google Scholar
Carney, M. Carroll, B. J. (1982) The dexamethasone suppression test for melancholia. British Journal of Psychiatry, 140, 292–304.Google Scholar
Carney, M. Schroeder, K., Mukhopadhyay, S., Greden, J. F., Feinberg, M., Ritchie, J. & Tarika, J. (1980) Plasma dexamethasone concentrations and Cortisol suppression response in patients with endogenous depression. Journal of Clinical Endocrinology and Metabolism, 51, 433–437.Google Scholar
Feinberg, M., Greden, J. F., Tarika, J., Albala, A. A., Haskett, R. F., James, N. M., Kronfol, Z., Lohr, N., Steiner, M., Vigne, J. P. D. & Young, E. (1981) A specific laboratory test for the diagnosis of melancholia. Archives of General Psychiatry, 38, 15–22.Google Scholar
Christie, J. E., Whalley, L. J., Dick, H., Blackwood, D.M. R., Blackburn, I. M. & Fink, G. (1986) Raised plasma Cortisol concentrations a feature of drug-free psychotics and not specific for depression. British Journal of Psychiatry, 148, 58–65.CrossRefGoogle Scholar
Coryell, W. (1982) Hypothalamic-pituitary-adrenal axis abnormality and ECT response. Psychiatry Research, 6, 283–291.Google Scholar
Demisch, K., Demisch, L., Bochnik, H. J. & Schulz, F. (1983) Comparison of the ACTH suppression test and dexamethasone suppression test in depressed patients. American Journal of Psychiatry, 140, 1511–1512.Google Scholar
Fang, V. S., Tricou, B. J., Robertson, A. & Meltzer, H. Y. (1981) Plasma ACTH and Cortisol levels in depressed patients.Google Scholar
Fehm, H. L., Klein, E., Holl, R. & Voigt, K. H. (1984) Evidence for extrapituitary mechanisms mediating the morning peak of plasma Cortisol in man. Journal of Clinical Endocrinology and Metabolism, 58, 410–414.CrossRefGoogle ScholarPubMed
Feibel, J., Kelly, M., Lee, L. & Woolf, P. (1983) Loss of adrenocortical suppression after acute brain injury. Journal of Clinical Endocrinology and Metabolism, 57, 1245–1250.CrossRefGoogle ScholarPubMed
Gann, D. S. (1979) Cortisol secretion after haemorrhage. Nephron, 23, 119–124.Google Scholar
Gold, P. W. (1985) Corticotropin-releasing factor stimulation in hypercortisolaemic psychiatric states. In Clinical applications of corticotropin-releasing factor (moderator Chrousos, G. P.). Annals of Internal Medicine, 102, 352–355.Google Scholar
Hallstrom, T. J., Samuelsson, S., Balldin, J., Walinder, J., Bengtsson, C, Nyström, E., Andersch, B., Lindstedt, G. & Lundberg, P. A. (1983) Abnormal dexamethasone test in normal females. British Journal of Psychiatry, 142, 489–497.Google Scholar
Hamilton, M. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–62.Google Scholar
Hodgkinson, S. C, Allolio, B., Landon, J. & Lowry, P. J. (1984) Development of a non-extracted two-site immuno radiometric assay for corticotropin utilising extreme amino and carboxyterminally directed antibodies. Biochemistry Journal, 218, 703–711.Google Scholar
Holden, N. L. (1983) Depression and the Newcastle scale. British Journal of Psychiatry, 142, 505–507.Google Scholar
Johnson, G., Hunt, G., Kerr, K. & Caterson, I. (1984) Dexamethasone suppression test and plasma dexamethasone levels in depressed patients. Psychiatry Research, 13, 305–313.Google Scholar
Kalin, N. H., Weiler, S. J. & Sheldon, S. E. (1982) Plasma ACTH and Cortisol concentration before and after dexamethasone. Psychiatry Research, 7, 87–92.Google Scholar
Klein, H. E., Bender, W., Mayr, H., Niederschweiberer, A. & Schmauss, M. (1984) The DST and its relationship to psychiatric diagnosis, symptoms and treatment outcome. British Journal of Psychiatry, 145, 591–599.Google Scholar
Kream, J., Mulay, S., Fukushima, D. K. & Solomon, S. (1983) Determination of plasma dexamethasone in the mother and the newborn after administration of the hormone in a clinical trial. Journal of Clinical Endocrinology and Metabolism, 57, 127–133.CrossRefGoogle Scholar
Krieger, D. T. (1979) Plasma ACTH and corticosteroids. In Endocrinology (ed. Degroot, L. J.). New York: Grime and S trat ton.Google Scholar
Linkowski, P., Mendlewicz, J., Leclerq, R., Brasseur, M., Mubain, P., Golstein, J., Copinschi, G. & Cauter, E. V. (1985) The 24 hour profile of adrenocorticotropin and Cortisol in major depressive illness. Journal of Clinical Endocrinology and Metabolism, 61, 429–438.Google Scholar
Lowry, P. J. (1984) Pro-opiocortin. Bioscience Reports, 4, 467–482.Google Scholar
McKeith, I. G. (1984) Clinical use of the DST in psycho geriatric population. British Journal of Psychiatry, 145, 389–393.Google Scholar
Meltzer, H. Y. & Fang, V. S. (1983) Cortisol determination and the dexamethasone suppression test. Archives of General Psychiatry, 40, 501–505.Google Scholar
Morris, M., Carr, V., Gilliland, J. & Hooper, M. (1986) Dexamethasone concentrations and the dexamethasone suppression test in psychiatric disorders. British Journal of Psychiatry, 148, 66–69.Google Scholar
Murphy, B. E. A. (1967) Some studies of the protein-binding of steroids and their application to the routine micro and ultra micro measurement of various steroids in body fluids by competitive protein-binding radioassay. Journal of Clinical Endocrinology and Metabolism, 27, 973–990.Google Scholar
Nelson, W. H., Orr, W. W., Stevenson, J. M. & Shane, S. R. (1982) Hypothalamic pituitary-adrenal axis activity and tricyclic response in major depression. Archives of General Psychiatry, 39, 1033–1036.Google Scholar
Pederson, R. C, Brownie, A. C. & Ling, N. (1980) Proadrcnocorticotropin/endorphin-dcrivcd peptides. Science, 206, 1044–1045.Google Scholar
Rees, L. H., Cook, D. M., Kendall, J. W., Allen, C. F., Kramer, R. M., Ratcliffe, J. G. & Knight, R. A. (1971) A radioimmunoassay for rat plasma ACTH. Endocrinology, 89, 254–261.Google Scholar
Reus, V. I., Marshall, J. & Dallman, M. (1983) Regulation of ACTH and Cortisol in depression. Peptides, 4, 786–788.Google Scholar
Ritchie, J. C, Carroll, B. J., Olton, P. R., Shively, V. & Feinber, M. (1985) Plasma Cortisol determination for the dexamethasone suppression test. Archives of General Psychiatry, 42, 493–497.CrossRefGoogle ScholarPubMed
Rubin, R. T. (1985) The prospects for clinical psychoneuro-endocrinology. Psychological Medicine, 15, 451–454.Google Scholar
Schoneshofer, M., Feuner, A. & Molnar, I. (1981) Heterogeneity of corticotrophin-immunoreactive compounds in human body fluids. Clinical Chemistry, 27, 1875–1877.Google Scholar
Targum, S. D. (1984) Persistant neuroendocrine dysregulation in major depressive disorder. Biological Psychiatry, 19, 305–318.Google Scholar
Wortsman, J., Frank, S., Wehrenberg, W. B., Petra, P. H. & Murphy, J. E. (1985) y3 melanocyte-stimulating hormone immuno-reactivity is a component of the neuroendocrine response to maximal stress (cardiac arrest). Journal of Clinical Endocrinology and Metabolism, 61, 355–360.Google Scholar
Yerevanian, B. G. & Woolf, P. D. (1983) Plasma ACTH levels in primary depression. Psychiatry Research, 9, 45–51.CrossRefGoogle ScholarPubMed
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