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Postdexamethason intact and multisequentia ACTH in melancholia

Published online by Cambridge University Press:  18 September 2015

M. Maes ,
C. Vandervorst ,
E. Suy ,
M. Martin ,
B. Minner ,
P. Blockx  and
J. Raus
M. Maes*
Affiliation:
Van het Psychiatrisch Centrum, St-Jozef, Munsterbilzen Universitair Ziekenhuis Antwerpen(UZA)
C. Vandervorst
Affiliation:
Dr. Willems Instituut, Diepenbeek
E. Suy
Affiliation:
Van het Psychiatrisch Centrum, St-Jozef, Munsterbilzen
M. Martin
Affiliation:
Universitair Ziekenhuis Antwerpen(UZA)
B. Minner
Affiliation:
Van het Psychiatrisch Centrum, St-Jozef, Munsterbilzen
P. Blockx
Affiliation:
Universitair Ziekenhuis Antwerpen(UZA)
J. Raus
Affiliation:
Dr. Willems Instituut, Diepenbeek
*
Afdeling Psychiatrie, Universitair Ziekenhuis (UZA), Wilrijkstraat 10, 2520 Edegem België
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Summary

The dexamethasone suppression test has been carried out in 111 depressed inpatients. Fasting, 8 a.m. plasma levels of Cortisol and adrenocorticotropic hormone (ACTH) were determined before and after administration of 1 mg dexamethasone. In 64 subjects multisequential (1-17,1-24,1-39) ACTH, and in 47 subjects intact (1-39) ACTH has been determined. Patients with melancholia exhibited significantly higher postdexamethasone Cortisol and intact ACTH values as compared with minor and simple major depressives. Severity of illness was significantly and positively related to postdexamethasone intact ACTH - but not to multisequential ACTH. Cortisol nonsuppressors showed higher postdexamethasone (only intact) ACTH values than Cortisol suppressors. Both postdexamethasone ACTH values were significantly and positively related with the postdexamethasone Cortisol values. We have established that Cortisol nonsuppression during melancholia is determined by an augmented escape of ACTH from suppression by dexamethasone. Intact ACTH showed the most significant clinical relevance for depression and Cortisol nonsuppression. In the clinical practice we advize the use of postdexamethasone intact ACTH in stead of plasma Cortisol or multisequential ACTH.

Keywords

depressiondexamethasone suppression testCortisoladrenocorticotropic hormonedepressiedexamethason suppressie testCortisoladrenocorticotroop hormoon
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 3 , Issue 1 , March 1991 , pp. 8 - 13
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 1991

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