MK4MDD

Genetic/Epigenetic Locus Search Cross Data Search

Study Report

Reference

Citation	Jabben, 2011 PubMed
Full Info	Jabben, N., Nolen, W.A., Smit, J.H., Vreeburg, S.A., Beekman, A.T. and Penninx, B.W. (2011) Co-occurring manic symptomatology influences HPA axis alterations in depression. J Psychiatr Res, 45, 1208-1213.

Study

Hypothesis or Background	Although dysfunctioning of the HPA axis is considered to be a core pathophysiological process in mood disorders, the evidence with regard to depression remains conflicting. This could partly be due to the large heterogeneity within mood disorders, since HPA axis abnormalities may also be associated with the extent of co-occurring manic symptomatology as is seen in bipolar disorder.
Sample Information	304 healthy controls, 1,134 patients with pure unipolar depressive disorder (UP), and 133 bipolar spectrum disorder patients (BD spectrum)
Method Detail	In this study, patients with depressive disorder and bipolar spectrum disorders were studied with regard to their HPA axis functioning. In subjects, cortisol was measured in 7 saliva samples to determine the 1 h cortisol awakening response (CAR), evening cortisol levels and cortisol suppression after a 0.5 mg dexamethasone suppression test.
Method Keywords	salivary analysis
Result	Both patient groups had overall higher CAR levels compared to controls, but only UP patients showed a higher increase over time in the CAR. A linear association was found between increasing bipolarity and cortisol diurnal slope: BD spectrum patients had a significantly higher diurnal slope than UP patients. Dexamethasone suppression did not differ between mood disorder diagnoses.
Conclusions	The heterogeneity in HPA axis functioning in patients with depression can partially be explained by co-existing manic symptomatology, since an increase in the CAR appears to be more specific for pure depression whereas the presence of bipolarity is associated with an increase in the diurnal slope of cortisol.

Relationships reported by Jabben, 2011