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Lower Serum Cortisol Level After DST Predict Therapeutic Response and their Difference between Patients with Agitated and Retardation Depression

Jin Haiying1, Xu Min1, Gao Zhihan2, Sun Fengli3, Jin Weidong4*

Background: Major Depressive Disorder (MDD) is one of the most common and debilitating mental disorders; however, its aetiology remains unclear. As for depression, retardation depression and agitated depression, which have different syndrome types and also maybe different in Hypothalamic-Pituitary-Adrenal (HPA).

Methods: 30 retardation depression patients and 30 agitated depression patients were involved. The Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were assessed in all depressive patients and Dexamethasone Suppression (DST) was completed at began of study. These all patients were observed for 4 weeks, during which the combination treatment of Traditional Chinese Medicine (TCM) and western medicine were carried out and symptoms change with HAMA and HAMD.

Results: The both blood cortisol of patients with agitated depression before dexamethasone were higher significantly than that of retardation depression. The suppression ratio of patients with agitated depression was lower than that of retardation depression.

HAMD, HAMA of patients with agitated depression was significantly different from that of retardation depression.

The suppression ratio negatively correlated significantly with HAMA relative change at 2nd weekend, HAMA relative change at 4th weekend.

Conclusion: The lower cortisol level after Dexamethasone Suppression Test (DST) indicate better the response to therapy, especially in patients with agitated depression. The two syndrome of depression was different in some clinical symptom, response to treatment and Hypothalamic-Pituitary-Adrenal (HPA) regulation function.

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