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Relative Hypo-and H...
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Maripuu, MartinUmeå universitet,Psykiatri
(författare)
Relative Hypo-and Hypercortisolism Are Both Associated with Depression and Lower Quality of Life in Bipolar Disorder : A Cross-Sectional Study
- Artikel/kapitelEngelska2014
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2014-06-16
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Public Library of Science (PLoS),2014
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electronicrdacarrier
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LIBRIS-ID:oai:DiVA.org:umu-91276
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-91276URI
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https://doi.org/10.1371/journal.pone.0098682DOI
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Språk:engelska
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Sammanfattning på:engelska
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Background: Depression in unipolar and bipolar disorders is associated with hypothalamic-pituitary-adrenal-axis (HPA-axis) hyperactivity. Also, unipolar disorder has recently been shown to exhibit HPA-axis hypoactivity. We studied for the first time how HPA-axis hypo-and hyperactivity relate to depression and disease burden in bipolar disorder. We were interested in studying hypocortisolism; characterized by increased HPA-axis negative feedback sensitivity and lower basal cortisol levels together with the opposite HPA-axis regulatory pattern of hypercortisolism. Methods: This cross-sectional study includes 145 type 1 and 2 bipolar outpatients and 145 matched controls. A dexamethasone-suppression-test (DST) measures the negative feedback sensitivity and a weight-adjusted very-low-dose DST was employed, which is sensitive in identifying hypocortisolism and hypercortisolism. The 25th and 75th percentiles of control post-DST values were used as cut-offs identifying patients exhibiting relative hypo-, and hypercortisolism. Self-report questionnaires were employed: Beck-Depression-Inventory (BDI), Montgomery-Asberg-Depression-Rating-Scale (MADRS-S), World-Health-Organization-Quality-of-Life-Assessment-100 and Global-Assessment-of-Functioning. Results: Patients exhibiting relative hypocortisolism expectedly exhibited lowered basal cortisol levels (p = 0.046). Patients exhibiting relative hypercortisolism expectedly exhibited elevated basal levels (p<0.001). Patients exhibiting relative hypocortisolism showed 1.9-2.0 (BDI, p = 0.017, MADRS-S, p = 0.37) and 6.0 (p<0.001) times increased frequencies of depression and low overall life quality compared with patients exhibiting mid post-DST values (eucortisolism). Adjusted Odds Ratios (OR:s) for depression ranged from 3.8-4.1 (BDI, p = 0.006, MADRS-S, p = 0.011) and was 23.4 (p<0.001) for life quality. Patients exhibiting relative hypercortisolism showed 1.9-2.4 (BDI, p = 0.017, MADRS-S, p = 0.003) and 4.7 (p<0.001) times higher frequencies of depression and low overall life quality compared with patients exhibiting eucortisolism. Adjusted OR: s for depression ranged from 2.2-2.7 (BDI, p = 0.068, MADRS-S, p = 0.045) and was 6.3 (p = 0.008) for life quality. Limitations: The cross-sectional design and lack of pre-established reference values of the DST employed. Conclusions: Relative hypocortisolism and relative hypercortisolism were associated with depression and lower life quality, providing novel insights into the detrimental role of stress in bipolar disorder.
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Biuppslag (personer, institutioner, konferenser, titlar ...)
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Wikgren, MikaelUmeå universitet,Psykiatri(Swepub:umu)penmel02
(författare)
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Karling, PontusUmeå universitet,Medicin(Swepub:umu)peakag84
(författare)
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Adolfsson, RolfUmeå universitet,Psykiatri(Swepub:umu)road0001
(författare)
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Norrbäck, Karl-FredrikUmeå universitet,Psykiatri(Swepub:umu)kaknok96
(författare)
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Umeå universitetPsykiatri
(creator_code:org_t)
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Ingår i:PLOS ONE: Public Library of Science (PLoS)9:61932-6203
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