5 research outputs found
The dexamethasone suppression test and sleep electroencephalogram in nonbipolar major depressed inpatients: A multivariate analysis
Background: The present study further examined relationships between
postdexamethasone cortisol plasma values and sleep electroencephalogram
(EEG) parameters.
Methods: The dexamethasone suppression test (DST) and polysomnographic
recordings were performed in a sample of 300 inpatients with primary
major depressive disorder (MDD) (102 men and 198 women, mean age 44 +/-
12 years, range 20-74 years) consecutively admitted to Erasme Hospital
(Brussels, Belgium) between 1981 and 1992.
Results: The DST was abnormal in 40% of the sample. Postdexamethasone
cortisol plasma values at 4:00 PM were significantly influenced by age,
but not by gender. They were also significantly and positively
correlated with weight loss, total scares on the Hamilton Depression
Rating Scale, total scores on the Newcastle Scale, percentage of
awakenings during sleep, and percent of stage 1. They were significantly
and negatively correlated with percent of stage 2, slow-wave sleep, and
REM sleep. Multiple regression analyses were conducted in two successive
steps. First among clinical variables, only age and depressive symptom
severity remained correlated with postdexamethasone plasma cortisol
values. In the second step, with age and severity held constant,
postdexamethasone plasma cortisol values were positively associated with
amount of wake time and stage 1, and negatively with amount of slow-wave
sleep.
Conclusions: These findings provide further indirect support for an
overarousal state in MDD with sympathoadrenal system hyperactivity and
impaired sleep continuity. They also underline the importance of taking
into account various clinical confounding factors in the interpretation
of both DST and sleep EEG results. (C) 1998 Society of Biological
Psychiatry
TSH RESPONSE TO TRH AND EEG SLEEP IN NON-BIPOLAR MAJOR DEPRESSION - A MULTIVARIATE APPROACH
The TSH response to TRH and selected sleep EEG variables were studied in
a homogeneous sample of 280 non-bipolar major depressed inpatients (95
males and 185 females). The TSH response to TRH was blunted in 28% of
the sample. Delta max TSH was correlated negatively with age, Hamilton
rating scale, Newcastle scale, percentage of wake, and positively with
basal TSH, percentage of stage II, slow wave sleep, REM sleep and REM
latency. Delta max TSH was also lower in male patients and in patients
suffering from an endogenous or a psychotic subtype of major depression.
Basal TSH was only correlated negatively with the Newcastle score.
In view of intercorrelations between all these variables, and because of
the confounding effect of age, gender and severity on both the TSH
response to TRH and sleep EEG variables, a multiple regression analysis
was performed and demonstrated that basal TSH and gender were the two
variables with the highest contribution to the Delta max TSH variance,
followed by age and the presence of psychotic symptoms. When controlling
strictly for these significant effects, correlation with the severity or
with the endogenous character of depression, and with sleep EEG
parameters disappeared