Kavoussi R J, Coccaro E F, Klar H, Lesser J, Siever L J
Clinical Neuroscience Research Unit, Medical College of Pennsylvania, Eastern Pennsylvania Psychiatric Institute, Philadelphia.
Biol Psychiatry. 1993 Aug 15;34(4):234-9. doi: 10.1016/0006-3223(93)90077-q.
The authors examined thyrotropin-releasing hormone (TRH) stimulation testing in the neuroendocrine evaluation of DSM-III major depressive disorder in 26 consecutive medication-free, medically healthy patients meeting a primary DSM-III diagnosis of axis II personality disorder. Thyroid-stimulating hormone (TSH) responses to TRH challenge were not significantly different between patients with or without major depression at time of study, or between patients with or without a life history of major affective disorder. Further, TSH responses to TRH among 11 healthy male nonpsychiatric controls were not significantly different from those in patients with personality disorders. Comparison of those patients with blunted TSH responses (< 7.0 microU/ml) versus those without blunted response (< or = 7.0 microU/ml) also did not reveal a significant difference. In addition, the TSH response to TRH did not correlate with dimensional assessments of state or trait depression, anxiety, or with past history of suicide attempt or alcohol abuse. These data suggest that TRH stimulation testing has limited utility in the evaluation of major depression or other relevant affective states/traits in personality-disordered patients. Affective symptoms in personality-disordered patients do not seem to be associated with dysregulation of the hypothalamic-pituitary-thyroid axis.
作者对26名连续的未服用药物、身体健康且符合DSM-III轴II人格障碍初步诊断的患者进行了促甲状腺激素释放激素（TRH）刺激试验，以评估DSM-III重度抑郁症的神经内分泌情况。在研究时，有或无重度抑郁症的患者之间，以及有或无重度情感障碍病史的患者之间，促甲状腺激素（TSH）对TRH刺激的反应无显著差异。此外，11名健康男性非精神科对照者对TRH的TSH反应与人格障碍患者的反应无显著差异。比较TSH反应迟钝（<7.0微单位/毫升）的患者与反应不迟钝（≤7.0微单位/毫升）的患者，也未发现显著差异。此外，TSH对TRH的反应与状态或特质抑郁、焦虑的维度评估，以及自杀未遂或酒精滥用的既往史均无相关性。这些数据表明，TRH刺激试验在评估人格障碍患者的重度抑郁症或其他相关情感状态/特质方面效用有限。人格障碍患者的情感症状似乎与下丘脑-垂体-甲状腺轴的调节异常无关。
