オオツボ　テンペイ   Ootsubo Tenpei   大坪　天平    所属   医学部 医学科（附属足立医療センター）    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Assessment of the dexamethasone/CRH test as a state-dependent marker for hypothalamic-pituitary-adrenal (HPA) axis abnormalities in major depressive episode: a Multicenter Study.
掲載誌名	正式名：Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology 略　 称：Neuropsychopharmacology ISSNコード：0893133X/0893133X
掲載区分	国外
巻・号・頁	31(1),pp.212-20
著者・共著者	Kunugi Hiroshi, Ida Itsuro, Owashi Toshimi, Kimura Mahito, Inoue Yumiko, Nakagawa Shin, Yabana Takafumi, Urushibara Takako, Kanai Rie, Aihara Masako, Yuuki Naoya, Otsubo Tempei, Oshima Akihiko, Kudo Koutaro, Inoue Takeshi, Kitaichi Yuji, Shirakawa Osamu, Isogawa Koichi, Nagayama Haruo, Kamijima Kunitoshi, Nanko Shinichiro, Kanba Shigenobu, Higuchi Teruhiko, Mikuni Masahiko
発行年月	2006/01
概要	There is compelling evidence for the involvement of hypothalamic-pituitary-adrenal (HPA) axis abnormalities in depression. Growing evidence has suggested that the combined dexamethasone (DEX)/corticotropin-releasing hormone (CRH) test is highly sensitive to detect HPA axis abnormalities. We organized a multicenter study to assess the DEX/CRH test as a state-dependent marker for major depressive episode in the Japanese population. We conducted the DEX/CRH test in 61 inpatients with major depressive episode (Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV)) and 57 healthy subjects. In all, 35 patients were repeatedly assessed with the DEX/CRH test on admission and before discharge. The possible relationships between clinical variables and the DEX/CRH test were also examined. Significantly enhanced pituitary-adrenocortical responses to the DEX/CRH test were observed in patients on admission compared with controls. Such abnormalities in patients were significantly reduced after treatment, particularly in those who underwent electroconvulsive therapy (ECT) in addition to pharmacotherapy. Age and female gender were associated with enhanced hormonal responses to the DEX/CRH test. Severity of depression correlated with DEX/CRH test results, although this was explained, at least in part, by a positive correlation between age and severity in our patients. Medication per se was unrelated to DEX/CRH test results. These results suggest that the DEX/CRH test is a sensitive state-dependent marker to monitor HPA axis abnormalities in major depressive episode during treatment. Restoration from HPA axis abnormalities occurred with clinical responses to treatment, particularly in depressed patients who underwent ECT.
DOI	10.1038/sj.npp.1300868
PMID	16123748