Journal
PSYCHIATRY RESEARCH
Volume 270, Issue -, Pages 246-252Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.psychres.2018.09.047
Keywords
ACTH; Adrenocorticotropic hormone; HPA axis; Major depressive disorder; Patient Health Questionnaire; PHQ-9
Categories
Funding
- Original Technology Research Program for Brain Science through the National Research Foundation of Korea (NRF) - Ministry of Education, Science and Technology [NRF-2016M3C7A1947307]
- Bio & Medical Technology Development Program of the NRF - Korean government, MSIP [NRF-2017M3A9F1027323]
- Samsung Medical Center grant [SMO1161491]
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Previous studies have reported dysfunction in the hypothalamic-pituitary-adrenal (HPA) axis in patients with major depressive disorder (MDD). Outpatients diagnosed with MDD (n = 199) underwent psychological evaluation, and were followed up with a phone interview after 6 months, using the Patient Health Questionnaire (PHQ-9). At 6-month follow-up, 59 out of 199 patients with MDD were still depressed (29.5%), as shown by scores >= 10 on the PHQ-9. The depressed group at follow-up showed significantly higher anxiety and suicidality levels at baseline than the non-depressed group at follow-up. Among the complete blood counts, lipid profiles, and hormone levels, adrenocorticotropic hormone (ACTH) was the only parameter that was significantly increased in the still depressed group. Levels higher than 40 pg/mL of ACTH at baseline were associated with higher depression scores at follow-up. Multiple linear regression analyses revealed that ACTH and cortisol predicted depression scores at follow-up, after controlling for baseline depression scores. Increased ACTH level at baseline may predict ongoing symptoms and severity of depression at follow-up, suggesting the role of dysfunctional HPA axis in MDD prognosis.
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