Clinical Subtypes of Depression Are Associated with Specific Metabolic Parameters and Circadian Endocrine Profiles in Women: The Power Study

Major depressive disorder (MDD) has been associated with adverse medical consequences, including cardiovascular disease and osteoporosis. Patients with MDD may be classified as having melancholic, atypical, or undifferentiated features. The goal of the present study was to assess whether these clinical subtypes of depression have different endocrine and metabolic features and consequently, varying medical outcomes.Premenopausal women, ages 21 to 45 years, with MDD (N = 89) and healthy controls (N = 44) were recruited for a prospective study of bone turnover. Women with MDD were classified as having melancholic (N = 51), atypical (N = 16), or undifferentiated (N = 22) features. Outcome measures included: metabolic parameters, body composition, bone mineral density (BMD), and 24 hourly sampling of plasma adrenocorticotropin (ACTH), cortisol, and leptin.Compared with control subjects, women with undifferentiated and atypical features of MDD exhibited greater BMI, waist/hip ratio, and whole body and abdominal fat mass. Women with undifferentiated MDD characteristics also had higher lipid and fasting glucose levels in addition to a greater prevalence of low BMD at the femoral neck compared to controls. Elevated ACTH levels were demonstrated in women with atypical features of depression, whereas higher mean 24-hour leptin levels were observed in the melancholic subgroup.Pre-menopausal women with various features of MDD exhibit metabolic, endocrine, and BMD features that may be associated with different health consequences.ClinicalTrials.gov NCT00006180

Is sexual motivational state linked to dopamine release in the medial preoptic area?

The medial preoptic area (mPOA) is a key site for the dopaminergic enhancement of male sexual behavior. Dopamine release increases in the rat mPOA with mating, supporting the critical stimulatory role played by preoptic dopamine on male sexual behavior. However, it has been questioned whether dopamine is specifically related to the occurrence of male sexual behavior and not simply involved in general arousal. To address this question, we ask whether dopamine release in the mPOA is linked to the production of male sexual behavior in Japanese quail, a species that exhibits a much shorter temporal pattern of copulation than rats and does not have an intromittent organ, resulting in a very different topography of their sexual response. Extracellular samples from the mPOA of adult sexually experienced male quail were collected every six minutes before, during, and after exposure to a female using in vivo microdialysis and analyzed using HPLC-EC. Extracellular dopamine significantly increased in the presence of a female and returned to baseline after removal of the female. However, subjects who failed to copulate did not display this increased release. These findings indicate that it is not solely the presence of a female that drives dopamine release in males, but how a male responds to her. Further, in subjects that copulated, dopamine release did not change in samples collected during periods of no copulation. Together, these findings support the hypothesis that dopamine action in the mPOA is specifically linked to sexual motivation and not only copulatory behavior or physical arousal

Circadian profiles of plasma ACTH, cortisol, and leptin.

<p>Circadian profiles of plasma ACTH, cortisol, and leptin.</p

Metabolic, body composition, and bone mineral density measures.

<p>Values are reported as mean ± SD or percent.</p><p>Sample size in parenthesis, unless otherwise indicated.</p><p>Significant comparisons, assessed as p≤.05 nominal value.</p>a<p>Atypical differs from control.</p>b<p>Melancholic differs from control.</p>c<p>Undifferentiated differs from control.</p

Clinical characteristics of depressive subtypes of women with unipolar MDD.

<p>Values are reported as mean ± SD or percent.</p><p>Sample size in parenthesis, unless otherwise indicated.</p><p>Significant comparisons, assessed as p≤.05 nominal value.</p>b<p>Atypical differed from undifferentiated.</p

Demographic characteristics of depressive subtypes of women with unipolar MDD.

<p>Values are reported as mean ± SD or percent.</p><p>Sample size in parenthesis, unless otherwise indicated.</p><p>Significant comparisons, assessed as p≤.05 nominal value.</p><p><b>Overall</b>: overall test.</p>a<p>Atypical differs from control.</p>b<p>Undifferentiated differs from control.</p

Synopsis of significant findings in the three subtypes of depression vs. healthy controls.

<p>Synopsis of significant findings in the three subtypes of depression vs. healthy controls.</p