Hostname: page-component-848d4c4894-wzw2p Total loading time: 0 Render date: 2024-06-05T23:31:22.041Z Has data issue: false hasContentIssue false
  • English
  • Français

Endocrine changes and clinical profiles in depression: II. The thyrotropin-releasing hormone test

Published online by Cambridge University Press:  09 July 2009

S. P. Calloway ,
R. J. Dolan ,
P. Fonagy ,
V. F. A. De Souza  and
A. Wakeling
S. P. Calloway*
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital, London
R. J. Dolan
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital, London
P. Fonagy
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital, London
V. F. A. De Souza
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital, London
A. Wakeling
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital, London
*
1 Address for correspondence: Dr S. P. Calloway, Academic Department of Psychiatry, Royal Free Hospital, Pond Street, London NW3 2QG
Get access Rights & Permissions [Opens in a new window]

Synopsis

Thirty-one (43%) of 68 patients with primary depression were found to have a blunted thyroid-stimulating hormone (TSH) response to thyrotropin-releasing hormone (TRH). Increased thyroid activity, as measured by the free thyroxine index (FTI), was present in 16 (24%) of the patients. Patients with blunted responses had a higher mean FTI level than those with normal responses. Patients with blunted responses were significantly more likely to exhibit the symptoms of depersonalization, derealization and agitation. There was no clear association between blunting and any particular diagnostic category of depression.

Patients with blunted responses and high FTI values were more likely to report significant long-term environmental difficulties than patients with blunted responses and normal FTI values. It is suggested that there may be more than one mechanism responsible for blunting of the TSH response in depressed patients. In some patients blunting may be due to negative feedback from increased output of thyroid hormones, possibly released as part of a stress response. In other patients blunting may be due to a different mechanism, possibly involving pituitary gland dysfunction. These mechanisms would not necessarily be mutually exclusive in any one patient.

Type
Research Article
Information
Psychological Medicine , Volume 14 , Issue 4 , November 1984 , pp. 759 - 765
Copyright
Copyright © Cambridge University Press 1984

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Agren, H. & Wide, L. (1982). Pattern of depression reflected in pituitary-thyroid and pituitary-adrenal endocrine changes. Psychoneuroendocrinology 7, 309–327.CrossRefGoogle ScholarPubMed
Board, F. A., Wadeson, R. & Persky, H. (1957). Depressive affect and endocrine functions. Archives of Neurology and Psychiatry 78, 612–620.CrossRefGoogle ScholarPubMed
Calloway, S. P., Dolan, R. J., Fonagy, P., De Souza, F. V. A. & Wakeling, A. (1984). Endocrine changes and clinical profiles in depression: I. The dexamethasone suppression test. Psychological Medicine 14, 749–758.CrossRefGoogle ScholarPubMed
Davis, K. L., Hollister, L. E., Mathe, A. A., Davis, B. M., Rothpearl, A. B., Faull, K. F., Hsieh, J. Y., Barchas, J. D. & Berger, P. A. (1981). Neuroendocrine and neurochemical measurements in depression. American Journal of Psychiatry 138, 1555–1562.Google ScholarPubMed
Extein, I., Pottash, A. L. C. & Gold, M. S. (1981). Relationship of thyrotropin releasing hormone test and dexamethasone suppression test abnormalities in unipolar depression. Psychiatry Research 4, 49–53.CrossRefGoogle ScholarPubMed
Feinberg, M. & Carroll, B. J. (1982). Separation of subtypes of depression using discriminant analyses. British Journal of Psychiatry 140, 384–391.CrossRefGoogle Scholar
Ferrari, G. (1973). On some biochemical aspects of affective disorders. Rivista Sperimentale Di Freniatria E Medicina Legale Della Alienazioni Mentali 97, 1167–1175.Google Scholar
Gold, M. S., Pottash, A. L., Ryan, N., Sweeney, D. R., Davies, R. K. & Martin, D. M. (1980). TRH-induced TSH response in unipolar, bipolar and secondary depressions: possible utility in clinical assessment and differential diagnosis. Psychoneuroendocrinology 5, 147–155.CrossRefGoogle ScholarPubMed
Hatotani, N., Nomura, J., Yamaguchi, T. & Kitayam, I. (1977). Clinical and experimental studies on the pathogenesis of depression. Psychoneuroendocrinology 2, 115–130.CrossRefGoogle ScholarPubMed
Kastin, A. J., Schalch, D. S., Ehrensing, R. H. & Anderson, M. S. (1972). Improvement in mental depression with decreased thyrotropin response after administration of thyrotropin-releasing hormone. Lancet ii, 740–742.CrossRefGoogle Scholar
Kirkegaard, C. & Faber, J. (1981). Altered serum levels of thyroxine, triiodothyronines, and diidothyronines in endogenous depression. Acta Endocrinologica (Kbh) 96, 199–207.Google ScholarPubMed
Kirkegaard, G., Bjorum, N., Cogn, D. & Lauridsen, U. B. (1978). Thyrotropin-releasing hormone (TRH) stimulation test in manic-depressive illness. Archives of General Psychiatry 35, 1017–1021.CrossRefGoogle ScholarPubMed
Kirstein, L., Gold, M. S.Pottash, A. L. & Extein, I. (1981). Thyrotropin-releasing hormone test and male unipolar depression. Biological Psychiatry 16, 819–824.Google ScholarPubMed
Linkowski, P., Brauman, H. & Mendlewicz, J. (1981). Thyrotropin response to TRH in unipolar and bipolar affective illness. Journal of Affective Disorder 3, 9–16.CrossRefGoogle ScholarPubMed
Loosen, P. T. & Prange, A. J. (1982). Serum thyrotropin response to thyrotropin-releasing-hormone in psychiatric patients: a review. American Journal of Psychiatry 139, 405–416.Google ScholarPubMed
Loosen, P. T., Prange, A. J. & Wilson, I. C. (1978). Influence of cortisol on TRH-induced TSH response in depression. American Journal of Psychiatry 135, 244–246.Google ScholarPubMed
Mason, J. W. (1968). A review of psychoendocrine research on the pituitary-thyroid system. Psychosomatic Medicine 30, 666–681.CrossRefGoogle ScholarPubMed
Otsuki, M., Dakoda, M. & Baba, S. (1973). Influence of glucorticoids on TRH-induced TSH response in man. Journal of Clinical Endocrinology and Metabolism 36, 95–102.CrossRefGoogle Scholar
Prange, A. J., Wilson, I. C., Lara, P. P., Alltop, L. B. & Breese, G. R. (1972). Effects of thyrotropin-releasing hormone in depression. Lancet ii, 999–1002.CrossRefGoogle Scholar
Re, R. N., Kourides, I. A., Ridgeway, E. C., Weintraub, B. D. & Maloof, F. (1976). The effect of glucocorticoid administration on human pituitary secretion of thyrotropin and prolactin. Journal of Clinical Endocrinology and Metabolism 43, 338–346.CrossRefGoogle ScholarPubMed
Rieneris, P. M., Christodoulou, G. N., Souvatzoglou, A. M., Koutras, D. A. & Stefanis, C. N. (1978). Free-thyroxine index in psychotic and neurotic depression. Acta Psychiatrica Scandinavica 58, 56–60.Google Scholar
Snyder, P. J. & Utiger, R. D. (1972). Response to thyrotropin releasing hormone (TRH) in normal man. Journal of Clinical Endocrinology 34, 380–385.CrossRefGoogle ScholarPubMed
Targum, S. D., Sullivan, A. C. & Byrnes, S. M. (1982). Neuroendocrine interrelationships in major depressive disorder. American Journal of Psychiatry 139, 282–286.Google ScholarPubMed
Weiner, H. (1977). Psychobiology and Human Disease. Elsevier: New York.Google Scholar
Yamaguchi, T., Hatotani, N., Nomura, J. & Ushijima, Y. (1977). Functions of hypothalamo-pituitary thyroid axis in depressed patients. Folia Psychiatrica et Neurologica Japonica 31, 173–181.Google ScholarPubMed