Hypothalamus-Pituitary-Adrenal Axis Hypersuppression Is Associated with Gastrointestinal Symptoms in Major Depression

Background/Aims: Gastrointestinal symptoms and hypothalamus-pituitary-adrenal (HPA) axis dysfunction are frequently observed in patients with major depression. The primary aim of the study was to investigate the relationship between HPA-axis function and self-perceived functional gastrointestinal symptoms in major depression.Methods: Patients with major depression (n = 73) and controls representative of the general population (n = 146) underwent a weight-adjusted very low dose dexamethasone suppression test (DST). Patients and controls completed the Gastrointestinal Symptom Rating Scale-Irritable Bowel Syndrome (GSRS-IBS) and the Hospital Anxiety Depression Scale. Medical records of the patients were screened over a ten year period for functional gastrointestinal disorder and pain conditions.Results: Patients with high GSRS-IBS scores (above median) exhibited HPA-axis hypersuppression more often than controls (defined by the lowest 10% cutoff of the post-DST cortisol values among controls, adjusted OR 7.25, CI 1.97-26.7) whereas patients with low GSRS-IBS scores did not differ from controls concerning their post-DST cortisol values. Patients who had consulted primary care for functional gastrointestinal disorder (P= 0.039), lumbago (P = 0.006) and chronic multifocal pain (P= 0.057) also exhibited an increased frequency of hypersuppression.Conclusions: HPA-axis hypersuppression is associated with functional gastrointestinal symptoms in patients with major depression.

Wikgren, MikaelUmeå universitet,Medicin,Psykiatri(Swepub:umu)penmel02 (författare)
Adolfsson, RolfUmeå universitet,Psykiatri(Swepub:umu)road0001 (författare)
Norrback, Karl-FredrikUmeå universitet,Psykiatri(Swepub:umu)kaknok96 (författare)
Umeå universitetMedicin (creator_code:org_t)

Ingår i:Journal of neurogastroenterology and motility: The Korean Society of Neurogastroenterology and Motility22:2, s. 292-3032093-08792093-0887

Av författaren/redakt...: Karling, Pontus; Wikgren, Mikael; Adolfsson, Rolf; Norrback, Karl-F ...

Om ämnet

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Psykiatri

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