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Adrenocorticotropin hormone, β-endorphin and cortisol responses to oCRF in melancholic patients

Published online by Cambridge University Press:  09 July 2009

M. Maes ,
M. Claes ,
M. Vandewoude ,
C. Schotte ,
M. Martin ,
P. Blockx  and
P. Cosyns
M. Maes*
Affiliation:
Department of Psychiatry, Department of Internal Medicine, and Department of Nuclear Medicine, University Hospital of Antwerp, Belgium
M. Claes
Affiliation:
Department of Psychiatry, Department of Internal Medicine, and Department of Nuclear Medicine, University Hospital of Antwerp, Belgium
M. Vandewoude
Affiliation:
Department of Psychiatry, Department of Internal Medicine, and Department of Nuclear Medicine, University Hospital of Antwerp, Belgium
C. Schotte
Affiliation:
Department of Psychiatry, Department of Internal Medicine, and Department of Nuclear Medicine, University Hospital of Antwerp, Belgium
M. Martin
Affiliation:
Department of Psychiatry, Department of Internal Medicine, and Department of Nuclear Medicine, University Hospital of Antwerp, Belgium
P. Blockx
Affiliation:
Department of Psychiatry, Department of Internal Medicine, and Department of Nuclear Medicine, University Hospital of Antwerp, Belgium
P. Cosyns
Affiliation:
Department of Psychiatry, Department of Internal Medicine, and Department of Nuclear Medicine, University Hospital of Antwerp, Belgium
*
1Address for correspondence: Dr M. Maes, Department of Psychiatry, University Hospital of Cleveland, 2040 Abington Road, Cleveland, Ohio 44106, USA.
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Synopsis

Several authors have reported attenuated adrenocorticotropin hormone (ACTH) responses to corticotropin releasing factor (CRF) administration in melancholic patients as compared with healthy controls. In order to explore the integrity of the hypothalamic–pituitary–adrenal (HPA)-axis in melancholics, we examined the following parameters in 98 subjects: the ACTH; β-endorphin; and cortisol responses to ovine CRF (oCRF) (100 μg/i.v.); and the postdexamethasone cortisol values. We found significant lower CRF-induced ACTH responses in melancholic patients as opposed to healthy controls and minor depressives, while major depressives occupied an intermediate position. The psychopathological correlates of the blunted CRF-induced ACTH responses were feelings of worthlessness, self-reproach, or excessive guilt. The CRF-stimulated β-endorphin and cortisol response did not differ between the study samples. Higher baseline plasma cortisol was associated with attenuated CRF-induced ACTH responses, but these effects were not pertinent to melancholia. There were no relationships between the disordered oCRF test results, and postdexamethasone cortisol values, age, body size, sex and severity of illness. The diagnostic power of the oCRF and the dexamethasone suppression test for melancholia is enhanced when both test results are combined.

Type
Original Articles
Information
Psychological Medicine , Volume 22 , Issue 2 , May 1992 , pp. 317 - 329
Copyright
Copyright © Cambridge University Press 1992

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