Bhagwagar Zubin, Hafizi Sepehr, Cowen Philip J
University Department of Psyhiatry, Warneford Hospital, Oxford, UK.
Am J Psychiatry. 2003 Oct;160(10):1890-1. doi: 10.1176/appi.ajp.160.10.1890.
Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis with elevated plasma cortisol levels is characteristic of acute major depression. However, it is unclear whether HPA axis abnormalities are present in fully recovered patients. An increase in salivary cortisol levels after waking provides a simple, dynamic measure of HPA axis activity. The authors measured this increase in recovered depressed patients and in a healthy comparison group.
Salivary cortisol levels were measured upon waking and at 15-minute intervals for the next hour in 31 medication-free, recovered depressed patients and in 31 matched healthy comparison subjects.
The increase in salivary cortisol levels that followed waking was significantly higher in the patients.
Greater secretion of cortisol may be present in depressed subjects after clinical recovery and withdrawal of medication. This may put patients at risk of further episodes of depression as well as comorbid medical conditions, such as coronary heart disease.
下丘脑 - 垂体 - 肾上腺（HPA）轴功能障碍伴血浆皮质醇水平升高是急性重度抑郁症的特征。然而，尚不清楚完全康复的患者是否存在HPA轴异常。醒来后唾液皮质醇水平升高提供了一种简单、动态的HPA轴活动测量方法。作者测量了康复的抑郁症患者和健康对照组的这种升高情况。
在31名未服用药物、康复的抑郁症患者和31名匹配的健康对照受试者中，测量醒来时及随后一小时内每隔15分钟的唾液皮质醇水平。
患者醒来后唾液皮质醇水平的升高明显更高。
临床康复且停药后，抑郁症患者可能存在皮质醇分泌增加的情况。这可能使患者面临进一步抑郁发作以及合并诸如冠心病等内科疾病的风险。
