Hypothalamus-Pituitary-Adrenal Axis Hypersuppression Is Associated with Gastrointestinal Symptoms in Major Depression.
- Author:
Pontus KARLING
1
;
Mikael WIKGREN
;
Rolf ADOLFSSON
;
Karl Fredrik NORRBACK
Author Information
- Publication Type:Original Article
- Keywords: Depression; Dexamethasone; Hypocortisolism; Hypothalamo-hypophyseal system; Irritable bowel syndrome
- MeSH: Anxiety; Axis, Cervical Vertebra*; Depression*; Dexamethasone; Gastrointestinal Diseases; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Irritable Bowel Syndrome; Low Back Pain; Medical Records; Primary Health Care
- From:Journal of Neurogastroenterology and Motility 2016;22(2):292-303
- CountryRepublic of Korea
- Language:English
- Abstract: 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-iritable 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.
