RESUMO
Mediante una batería neuroendocrina que incluye la prueba de supresión por dexamotasona, la prueba de estimulación con TRH y respuestas hormonales a apomorfina (PRL, GU, ACTH y cortisol) se estudian 86 pacientes hospitalizados, sin medicación, con los diagnósticos según DSM-IV con Depresión Mayor, esquizofrenia y trastorno esquizoafectivo y 18 controles. Se establecen las diferencias hormonales de los diversos grupos clínicos mediante el análisis factorial de correspondencia, lo que permite formular las posibles procesos fisiopatológicos subyacentes y la identificación de terapias farmacológicas apropiadas. Los resultados sugieren una disregulación cronobiológica del eje hipotálamo-hipófisis-tiroides en la depresión y una disregulación dopaminérgica en presencia de síntomas psicóticos productivos
Assuntos
Humanos , Masculino , Feminino , Adulto , Transtornos Mentais/metabolismo , Sistemas Neurossecretores/fisiopatologia , Hormônio Adrenocorticotrópico/metabolismo , Apomorfina/metabolismo , Estudos de Casos e Controles , Transtorno Depressivo/metabolismo , Dexametasona/metabolismo , Biomarcadores/análise , Receptores do Hormônio Liberador da Tireotropina/metabolismo , Esquizofrenia/metabolismoRESUMO
The dexamethasone suppression test (DST) and the clonidine stimulation test (CST) were studied in 47 depressed patients. Issues addressed included (1) the usefulness of both tests as markers of major depression; (2) the relationship between the two tests and the pathophysiology underlying this relationship; and (3) the psychopathological correlates of both tests. The widely reported link between abnormal DST results and melancholic depression was confirmed. The DST and the CST showed extensive overlap, suggesting a relationship in major depression between the biological abnormalities indexed by each test (i.e., hypothalamic-pituitary-adrenal axis and noradrenergic system). Finally, the psychopathological correlates of various subgroups categorized on the basis of test responses (e.g., normal test results, blunted CST results, and both abnormal DST and CST results) confirmed significant differences between groups on two items of the Hamilton Rating Scale for Depression: psychic anxiety and somatic anxiety. The results suggest that particular patterns of neuroendocrine abnormalities may be associated with particular profiles of depressive symptomatology.