The oCRH stimulation test before and after clinical recovery from depression

Jay D. Amsterdam, Greg Maislin, Andrew Winokur, Neil Berwish, Mitchell Kling, Philip Gold

Research output: Contribution to journalArticlepeer-review

71 Scopus citations

Abstract

A substantial body of data suggests that excessive cortisol secretion in depression may result from a dysregulation at several sites within the hypothalamic-pituitary-adrenocortical (HPA) axis. These alterations in regulatory mechanisms are thought to be the result of a hypothalamic 'overdrive' of corticotropin-releasing hormone (CRH). Previous studies have demonstrated a diminished adrenocorticotropin (ACTH) secretory response, as well as a heightened adrenocortical responsiveness after ovine-CRH administration in depressed patients. In the present investigation, we examined pituitary and adrenocortical responsiveness after an ovine-CRH stimulation test before and during clinical recovery in seven depressed patients. Cumulative ACTH responses increased significantly during clinical recovery (P=0.014). Paradoxically, maximum and peak cortisol responses increased after recovery, suggesting that heightened adrenocortical responsiveness to ACTH during depression may take longer to 'normalize' than abnormal pituitary responsiveness to ovine-CRH stimulation.

Original languageEnglish (US)
Pages (from-to)213-222
Number of pages10
JournalJournal of Affective Disorders
Volume14
Issue number3
DOIs
StatePublished - 1988
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Clinical Psychology
  • Psychiatry and Mental health

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