The dexamethasone corticotropin releasing hormone test in healthy and depressed women with and without childhood adversity

• Published in: Psychoneuroendocrinology 2018-01, Vol.87, p.147-151
• Main Authors: Spitzer, Carsten, Otte, Christian, Kuehl, Linn K., May, Anita, Schultebraucks, Katharina, Hellmann-Regen, Julian, Wingenfeld, Katja
• Format: Article
• Language: English
• Subjects: Adrenocorticotropic Hormone; Adult; Adverse childhood experiences (ACE); Corticotropin-Releasing Hormone - analysis; Corticotropin-Releasing Hormone - blood; Corticotropin-Releasing Hormone - metabolism; Depression - metabolism; Depression - physiopathology; Depressive Disorder, Major - metabolism; Depressive Disorder, Major - physiopathology; Dexamethasone - analysis; Dexamethasone - blood; Dexamethasone - metabolism; Dexamethasone/corticotropin-releasing hormone (DEX/CRH) test; Female; Humans; Hydrocortisone - metabolism; Hypothalamic-pituitary-adrenal (HPA) axis; Hypothalamo-Hypophyseal System - physiopathology; Life Change Events; Major depressive disorder (MDD); Middle Aged; Pituitary-Adrenal System - physiopathology; Saliva - chemistry; Women
• ISSN: 0306-4530; 1873-3360
• DOI: 10.1016/j.psyneuen.2017.10.016

•To disentangle the effects of childhood adversity (ACE) and major depression (MDD) on HPA axis functioning.•144 women (either with or without MDD and ACE, respectively) underwent the DEX/CRH test.•Free salivary cortisol responses were not significantly different between the four groups.•There was no evidence for a dysregulation of the HPA axis in depressed and healthy women with and without ACE, respectively. Alterations of the hypothalamic-pituitary-adrenal (HPA) axis are a prominent finding in patients with major depressive disorder (MDD). Inconsistencies regarding a hyper- or hypoactive HPA axis may be explained by the moderating effect of childhood adverse experiences (ACE) which are associated with both HPA axis dysfunction and MDD in adulthood. We aimed to systematically disentangle the effects of ACE and MDD on HPA axis by comparing healthy women with and without childhood adversity and women with MDD with and without ACE. The dexamethasone/corticotropin-releasing hormone (DEX/CRH) test was administered in 35 women with MDD and ACE as determined by a clinical interview (SCID, Early Trauma Inventory), 51 women with MDD without ACE, 21 women with ACE but no current or lifetime MDD and 37 healthy women without either MDD or ACE. There were no group differences in age, smoking, body mass index, and intake of oral contraceptives. Free salivary cortisol responses were not significantly different between the four groups. This study shows no evidence for a dysregulation of the HPA axis as measured by the DEX/CRH test in depressed women with and without childhood adversity as compared to mentally healthy women with or without early life stress. Our results do not support the assumption of distinct neuroendocrine endophenotypes in MDD with regard to ACE.