Targum S D
Biol Psychiatry. 1984 Mar;19(3):305-18.
Neuroendocrine challenge studies, including the dexamethasone suppression test (DST) and thyrotropin-releasing hormone (TRH) stimulation test, were administered to 86 patients meeting DSM-III criteria for major depressive disorder. Of 33 patients, 25 (76%) revealed normalization of abnormal DSTs at the time of symptomatic improvement, and 9 out of 26 patients (35%) revealed normalization of blunted TSH responses to TRH injection. Patients with normalized function revealed treatment responsiveness and low relapse rates (11%) similar to patients who had had normal neuroendocrine function at the time of admission. However, 11 of 23 patients with persistent dysregulation on either test (48%) relapsed within 6 months in contrast to 3 of 28 patients with normalized function (p less than 0.01) and 5 of 35 patients with normal neuroendocrine function on admission (p less than 0.02). These findings suggest that persistent dysregulation may be a valuable prognostic marker reflecting partial treatment responsiveness in some patients which predisposes them to early relapse. Both the DST and TRH tests appear to reflect neuroendocrine trait deficits which are independent of but interact with a coexisting predisposition to depressive disorder.
对86名符合《精神疾病诊断与统计手册》第三版（DSM-III）重性抑郁障碍标准的患者进行了神经内分泌激发试验，包括地塞米松抑制试验（DST）和促甲状腺激素释放激素（TRH）刺激试验。在33名患者中，25名（76%）在症状改善时显示异常DST恢复正常，26名患者中有9名（35%）显示对TRH注射反应迟钝的促甲状腺激素（TSH）反应恢复正常。功能恢复正常的患者显示出治疗反应性和低复发率（11%），类似于入院时神经内分泌功能正常的患者。然而，23名在任何一项试验中持续存在调节异常的患者中有11名（48%）在6个月内复发，相比之下，28名功能恢复正常的患者中有3名（p<0.01），35名入院时神经内分泌功能正常的患者中有5名（p<0.02）。这些发现表明，持续的调节异常可能是一个有价值的预后指标，反映了一些患者部分治疗反应性，使他们易患早期复发。DST和TRH试验似乎都反映了神经内分泌特征缺陷，这些缺陷独立于但与共存的抑郁症易感性相互作用。
