Dehydroepiandrosterone Sulfate Level Varies Nonlinearly with Symptom Severity in Major Depressive Disorder
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Objective: The pathophysiology of major depressive disorder (MDD) is still not well understood. Conflicting results for surrogate biomarkers in MDD have been reported, which might be a consequence of the heterogeneity of MDD patients. Therefore, we aim to investigate how the severity of depression and various symptom domains are related to the levels of dehydroepiandrosterone sulfate (DHEA-s) in MDD patients. Methods: We recruited 117 subjects from a general practice. Depressive symptoms were assessed using the Beck Depression Inventory (BDI). Depressive symptoms were divided into three subdomains according to BDI items; somatic symptoms, guilt and failure, and mood and inhibition. Results: In subjects with very-mild-to-moderate depression, the DHEA-s level increased as BDI score did. However, the DHEA-s levels in the subjects with severe depression were significantly lower than in subjects with moderate depression (p=0.003). DHEA-s level was correlated with the BDI subscore for guilt and failure in very-mild-to-moderate depression (r=0.365, p=0.006). Conclusion: The DHEA-s level appears to be indicative of MDD severity with respect to depressive symptoms, especially regarding guilt and failure. Our findings suggest that the upregulation of DHEA-s may be a part of a compensatory process in very-mild-to-moderate depression, and the failure of this compensation mechanism may underlie the development of severe depression.
Abstract
Objective: The pathophysiology of major depressive disorder (MDD) is still not well understood. Conflicting results for surrogate biomarkers in MDD have been reported, which might be a consequence of the heterogeneity of MDD patients. Therefore, we aim to investigate how the severity of depression and various symptom domains are related to the levels of dehydroepiandrosterone sulfate (DHEA-s) in MDD patients. Methods: We recruited 117 subjects from a general practice. Depressive symptoms were assessed using the Beck Depression Inventory (BDI). Depressive symptoms were divided into three subdomains according to BDI items; somatic symptoms, guilt and failure, and mood and inhibition. Results: In subjects with very-mild-to-moderate depression, the DHEA-s level increased as BDI score did. However, the DHEA-s levels in the subjects with severe depression were significantly lower than in subjects with moderate depression (p=0.003). DHEA-s level was correlated with the BDI subscore for guilt and failure in very-mild-to-moderate depression (r=0.365, p=0.006). Conclusion: The DHEA-s level appears to be indicative of MDD severity with respect to depressive symptoms, especially regarding guilt and failure. Our findings suggest that the upregulation of DHEA-s may be a part of a compensatory process in very-mild-to-moderate depression, and the failure of this compensation mechanism may underlie the development of severe depression.
참고문헌 (43)
- Andrade L, "The epidemiology of major depressive episodes : results from the International Consortium of Psychiatric Epidemiology(ICPE)surveys", Int J Methods Psychiatr Res, 12, pp.3~21 (2003)
- Hasler G, "Pathophysiology of depression: do we have any solid evidence of interest to clinicians?", World Psychiatry, 9, pp.155~161 (2010)
- Sullivan PF, "Genetic epidemiology of major depression : review and meta-analysis", Am J Psychiatry, 157, pp.1552~1562 (2000)
- Savitz J, "5-HT(1A)receptor function in major depressive disorder", Prog Neurobiol, 88, pp.17~31 (2009)
- Kathol RG, "Pathophysiology of HPA axis abnormalities in patients with major depression : an update", Am J Psychiatry, 146, pp.311~317 (1989)
- Martinowich K, "New insights into BDNF function in depression and anxiety", Nat Neurosci, 10, pp.1089~1093 (2007)
- Leonard B, "Mechanistic explanations how cellmediated immune activation, inflammation and oxidative and nitrosative stress pathways and their sequels and concomitants play a role in the pathophysiology of unipolar depression", Neurosci Biobehav Rev, 36, pp.764~785 (2012)
- Charney DS, "Monoamine dysfunction and the pathophysiology and treatment of depression", J Clin Psychiatry, 59(Suppl 14), pp.11~14 (1998)
- Schmidt HD, "Functional biomarkers of depression: diagnosis, treatment, and pathophysiology", Neuropsychopharmacology, 36, pp.2375~2394 (2011)
- Schneider B, "Novel biomarkers in major depression", Curr Opin Psychiatry, 26, pp.47~53 (2013)
- Peixoto C, "The effects of dehydroepiandrosterone(DHEA)in the treatment of depression and depressive symptoms in other psychiatric and medical illnesses : a systematic review", Curr Drug Targets, 15, pp.901~914 (2014)
- Wolf OT, "Effects of a two-week physiological dehydroepiandrosterone substitution on cognitive performance and well-being in healthy elderly women and men", J Clin Endocrinol Metab, 82, pp.2363~2367 (1997)
- Morgan CA 3rd, "Relationships among plasma dehydroepiandrosterone and dehydroepiandrosterone sulfate, cortisol, symptoms of dissociation, and objective performance in humans exposed to underwater navigation stress", Biol Psychiatry, 66, pp.334~340 (2009)
- Russo SJ, "Neurobiology of resilience", Nat Neurosci, 15, pp.1475~1484 (2012)
- Goodyer IM, "steroid secretion and major depression in 8- to 16-year-olds, III. Influence of cortisol", DHEA ratio at presentation on subsequent rates of disappointing life events and persistent major depression, 1998, pp.28, 265~273
- Kaminska M, "Dehydroepiandrosterone sulfate (DHEAS) counteracts decremental effects of corticosterone on dentate gyrus LTP. Implications for depression", Brain Res Bull, 52, pp.229~234 (2000)
- Chen L, "Understanding the heterogeneity of depression through the triad of symptoms, course and risk factors: a longitudinal, population-based study", J Affect Disord, 59, pp.1~11 (2000)
- Sarandol A, "Major depressive disorder is accompanied with oxidative stress : short-term antidepressant treatment does not alter oxidative-antioxidative systems", Hum Psychopharmacol, 22, pp.67~73 (2007)
- Thomas AJ, "Increase in interleukin-1beta in late-life depression", Am J Psychiatry, 162, pp.175~177 (2005)
- Duivis HE, "Differential association of somatic and cognitive symptoms of depression and anxiety with inflammation : findings from the Netherlands Study of Depression and Anxiety(NESDA)", Psychoneuroendocrinology, 38, pp.1573~1585 (2013)
- Capuron L, "Cytokines and psychopathology : lessons from interferon-alpha", Biol Psychiatry, 56, pp.819~824 (2004)
- Maninger N, "Neurobiological and neuropsychiatric effects of dehydroepiandrosterone(DHEA)and DHEA sulfate(DHEAS)", Front Neuroendocrinol, 30, pp.65~91 (2009)
- Bottiglieri T, "Homocysteine and folate metabolism in depression", Prog Neuropsychopharmacol Biol Psychiatry, 29, pp.1103~1112 (2005)
- Koponen H, "Metabolic syndrome predisposes to depressive symptoms : a population-based 7-year followup study", J Clin Psychiatry, 69, pp.178~182 (2008)
- Berr C, "Relationships of dehydroepiandrosterone sulfate in the elderly with functional, psychological, and mental status, and short-term mortality: a French community-based study", Proc Natl Acad Sci U S A, 93, pp.13410~13415 (1996)
- Hahn HM, "A standardization study of Beck Depression Inventory in Korea", J Korean Neuropsychiatr Assoc, 25, pp.487~500 (1986)
- Bouman TK, "Homogeneity of Beck's Depression Inventory(BDI) : applying Rasch analysis in conceptual exploration", Acta Psychiatr Scand, 76, pp.568~573 (1987)
- Zheng P, "Neuroactive steroid regulation of neurotransmitter release in the CNS: action, mechanism and possible significance", Prog Neurobiol, 89, pp.134~152 (2009)
- Dubrovsky BO, "Steroids, neuroactive steroids and neurosteroids in psychopathology", Prog Neuropsychopharmacol Biol Psychiatry, 29, pp.169~192 (2005)
- Traish AM, "Dehydroepiandrosterone (DHEA)--a precursor steroid or an active hormone in human physiology", J Sex Med, 8, pp.2960~2982 (2011)
- Genud R, "DHEA lessens depressive-like behavior via GABA-ergic modulation of the mesolimbic system", Neuropsychopharmacology, 34, pp.577~584 (2009)
- Hu Q, "Clinical significance of decreased protein expression of dehydroepiandrosterone sulfate in the development of depression : a meta-analysis", J Affect Disord, 174, pp.416~423 (2015)
- Barrett-Connor E, "Endogenous levels of dehydroepiandrosterone sulfate, but not other sex hormones, are associated with depressed mood in older women: the Rancho Bernardo study", J Am Geriatr Soc, 47, pp.685~691 (1999)
- Kurita H, "Serum dehydroepiandrosterone(DHEA)and DHEA-sulfate(S)levels in medicated patients with major depressive disorder compared with controls", J Affect Disord, 146, pp.205~212 (2013)
- Heuser I, "Increased diurnal plasma concentrations of dehydroepiandrosterone in depressed patients", J Clin Endocrinol Metab, 83, pp.3130~3133 (1998)
- Erdinçler D, "Depression and sex hormones in elderly women", Arch Gerontol Geriatr, 39, pp.239~244 (2004)
- Lennartsson AK, "DHEA and DHEA-S response to acute psychosocial stress in healthy men and women", Biol Psychol, 90, pp.143~149 (2012)
- Izawa S, "Salivary dehydroepiandrosterone secretion in response to acute psychosocial stress and its correlations with biological and psychological changes", Biol Psychol, 79, pp.294~298 (2008)
- Rabkin JG, "Placebo-controlled trial of dehydroepiandrosterone(DHEA)for treatment of nonmajor depression in patients with HIV", AIDS, 2006, pp.163, 59~66
- Wolkowitz OM, "Dehydroepiandrosterone(DHEA)treatment of depression", Biol Psychiatry, 41, pp.311~318 (1997)
- Bloch M, "Dehydroepiandrosterone treatment of midlife dysthymia", Biol Psychiatry, 45, pp.1533~1541 (1999)
- Dayal M, "Supplementation with DHEA: effect on muscle size, strength, quality of life, and lipids", J Womens Health (Larchmt), 14, pp.391~400 (2005)
- Labrie F, "DHEA and its transformation into androgens and estrogens in peripheral target tissues : intracrinology", Front Neuroendocrinol, 22, pp.185~212 (2001)