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Yıl:1998; Cilt: 9; Sayı: 2>> Özet
Türk Psikiyatri Dergisi; 1998;9(2):83-91
Majör Depresyonda Hipotalamo-Pitüiter-Adrenal ve Hipotalamo-Pitüiter-Tiroid Eksen Bulguları
M BİLİCİ, B TANELİ
Bu çalışmada, hipotalamo-pitüiter-adrenal (HPA) ve hipotalamo-pitüiter-tiroid (HPT) eksen bulgularının karşılaştırılması amacıyla 29 majör depresyonlu (MD) hastaya ve 24 sağlıklı deneğe deksametazon supresyon testi (DST) ve TRH testi uygulanmıştır. Deksametazondan önce, saat 09.00 ve 23.00 ile deksametazondan sonra ilk gün saat 16.00’da ölçülen ortalama kortizol düzeyleri MD grubunda kontrol grubuna göre anlamlı olarak yüksek bulundu. TRH’a tüm TSH yanıtları ve 'TSH değerleri, MD grubunda kontrol grubuna göre anlamlı olarak düşük bulundu. MD’da duyarlılık ve özgüllük sırasıyla DST için %44.8 ve %91.7 idi. Deksametazondan önce saat 09.00 ve 23.00’teki, deksametazondan sonra saat 16.00’daki ortalama kortizol düzeyleri ile bazal TSH ve TRH’a 30. dakikadaki TSH yanıtlarının sağlıklı deneklerle MD’lu olguları ayırt ettiği bulunmuştur. Fakat MD alt gruplarını ayırt edici herhangi bir HPA ve HPT eksen bulgusu saptanamadı.


Hypothalamic-Pituitary-Adrenal and Hypothalamic-Pituitary-Thyroid Axis Findings in Major Depression
In this study, the dexamethasone suppression test (DST) and thyroid releasing hormone (TRH) test were applied to 29 patients with major depression (MD) and 24 healthy controls to assess their hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-thyroid (HPT) axis functions. Predexamethasone 9.00 a.m. and 11.00 p.m., and post-dexamethasone 4.00 p.m. mean cortisol levels were significantly higher in MD patients, than the control group. All TSH responses to TRH and TSH values were significantly lower in MD patients. Sensitivity and specificity of TRH test were 79.3% and 100%, for DST these values were 44.8%, and 91.7% respectively. By the combination of both tests the sensitivity and specificity were %35.4 and %91.7. We found that predexamethasone at 4.00 p.m. mean cortisol levels; basal TSH and at 30 minute TSH response to TRH could distinguish the MD and healthy control groups. But we could not show any discriminative HPA and HPT axis finding for MD subgroups

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