MK4MDD

Study Report

Reference
CitationBrouwer, 2005 PubMed
Full InfoBrouwer, J.P., Appelhof, B.C., Hoogendijk, W.J., Huyser, J., Endert, E., Zuketto, C., Schene, A.H., Tijssen, J.G., Van Dyck, R., Wiersinga, W.M. et al. (2005) Thyroid and adrenal axis in major depression: a controlled study in outpatients. Eur J Endocrinol, 152, 185-191.

Study
Hypothesis or Background Major depressive disorder has been associated with changes in the hypothalamus-pituitary-thyroid (HPT) axis and with hypercortisolism. However, the changes reported have been at variance, probably related to in- or outpatient status, the use of antidepressant medication and the heterogeneity of depression. We therefore conducted a controlled study in unipolar depressed outpatients who had been free of antidepressants for at least 3 months.
Sample InformationWe assessed endocrine parameters in 113 depressed outpatients and in 113 sex- and age-matched controls
Method DetailPatients were included if they had a major depression according to a Structural Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (DSM), fourth edition (SCID-IV) and if they had a 17-item Hamilton rating scale for depression (HRSD) score of > or =16. Endocrine parameters contained serum concentrations of TSH, (free) thyroxine, tri-iodothyronine, cortisol, thyroid peroxidase (TPO) antibody titre and 24-h urinary excretion of cortisol.
Method Keywordsblood analysis
ResultThe serum concentration of TSH was slightly higher in depressed patients as compared with controls (P < 0.001), independent of the presence of subclinical hypothyroidism and/or TPO antibodies (n = 28). All other HPT axis parameters were similar in both groups. The 24-h urinary cortisol excretion was similar in patients and controls. In atypical depression, serum cortisol was lower than in non-atypical depression (P = 0.01). Patients with neither melancholic depression nor severe depression (HRSD > or =23) had altered endocrine parameters. Finally, serum TSH values could not be related to cortisol values.
ConclusionsWhen compared with matched control subjects, outpatients with major depression had slightly higher serum TSH, while urinary cortisol levels were similar. Furthermore, we observed lower serum cortisol in atypical depression than in non-atypical depression.

Relationships reported by Brouwer, 2005