Depression Research Today is a free monthly online journal that collates and summarizes the latest research about Depression, including details on clinical depression, medication, symptoms, treatment, counselling, therapy. | ||||||||
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The DEX/CRH neuroendocrine test and the prediction of depressive relapse in remitted depressed outpatients.Aubry JM, Gervasoni N, Osiek C, Perret G, Rossier MF, Bertschy G, Bondolfi G Department of Psychiatry, Adult Psychiatric Service - Secteur-2, 16-18 Boulevard St-Georges, CH-1205 Geneva, Switzerland. jean-michel.aubry@hcuge.ch Hypothalamo-pituitary-adrenal (HPA) system dysfunction is the most characteristic biological alteration found in a majority of depressed patients. Accumulating evidence suggests that the combined dexamethasone (DEX)/corticotropin-releasing hormone (CRH) test is highly sensitive to detect HPA system abnormalities. The aim of this study was to evaluate whether the DEX/CRH test has a predictive value for the risk of depressive relapse in outpatients who are in clinical remission from a major depressive episode. Thirty-eight depressed outpatients (23 women, 15 men) in remission (MADRS score < or =8) underwent the DEX/CRH test and were followed up for 12 months regarding the occurrence of a new depressive episode. In parallel we recruited 24 controls (13 men and 11 women). The main result is a statistically significant difference concerning the delta and AUC numbers for cortisol plasmatic values between the group of patients who relapsed during the 1-year follow-up and control subjects, but not between the group of patients with prolonged remission and controls. These results suggest that in outpatients who are in clinical remission from a major depressive episode, high delta and AUC values in the DEX/CRH test compared to controls subjects can be associated with a higher risk of relapse. Published 12 December 2006 in J Psychiatr Res, 41(3): 290-4.
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