Blunted acth response to hypoglycemic stress in depressed patients but not in patients with schizophrenia

In this study, 7 hospitalized patients with major depression (MD), 5 hospitalized patients with schizophrenia (S), and 13 control subjects (C) were administered 0.15 units/kg of regular insulin at 1600 h by intravenous bolus infusion. ACTH, cortisol, and glucose levels were measured intermittently f...

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Bibliographic Details
Published in:Journal of psychiatric research 1992-04, Vol.26 (2), p.103-116
Main Authors: Kathol, Roger G., Gehris, Timothy L., Carroll, Brendan T., Samuelson, Stephen D., Pitts, Andrew F., Meller, William H., Carter, Jerry L.
Format: Article
Language:English
Subjects:
Adrenocorticotropic Hormone - blood
Adult
Adult and adolescent clinical studies
Biological and medical sciences
Blood Glucose - metabolism
Depressive Disorder - blood
Depressive Disorder - diagnosis
Depressive Disorder - psychology
Dexamethasone
Humans
Hydrocortisone - blood
Hypoglycemia - blood
Insulin
Male
Medical sciences
Mood disorders
Personality Assessment
Prospective Studies
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Schizophrenia - blood
Schizophrenia - diagnosis
Schizophrenic Psychology
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Summary:In this study, 7 hospitalized patients with major depression (MD), 5 hospitalized patients with schizophrenia (S), and 13 control subjects (C) were administered 0.15 units/kg of regular insulin at 1600 h by intravenous bolus infusion. ACTH, cortisol, and glucose levels were measured intermittently for 2h following infusion. Baseline ACTH, cortisol and glucose levels were similar in Cs, MDs, and Ss. The mean glucose nadir was equivalent for Cs, patients with MD, and patients with S. Patients with MD had a blunted ACTH response ( F=3.28; df=12,126; p=.0004) and cortisol response ( F=4.20; df=12,132; p=.0001) to hypoglycemia when compared to Cs and patients with S. Carroll Depression Rating Scale scores in patients with S (23±10) were similar to patients with MD (30 ± 8) and significantly higher than in controls (1 ± 2) ( F = 55.2; df = 2,22; p = .0001). These findings suggest that patients with MD show different ACTH and cortisol responses to hypoglycemic stress which are not explained by negative feedback of baseline ACTH or cortisol, glucose nadir, or the number of depressive symptoms per se.
ISSN:0022-3956
1879-1379
DOI:10.1016/0022-3956(92)90002-6