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Hypothalamus-Pituitary-Adrenal Axis Hypersuppression Is Associated with Gastrointestinal Symptoms in Major Depression
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.ORCID iD: 0000-0002-8114-7615
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
2016 (English)In: Journal of neurogastroenterology and motility, ISSN 2093-0879, Vol. 22, no 2, 292-303 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2016. Vol. 22, no 2, 292-303 p.
Keyword [en]
Depression, Dexamethasone, Hypocortisolism, Hypothalamo-hypophyseal system, Irritable bowel syndrome
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:umu:diva-112721DOI: 10.5056/jnm15064ISI: 000373662200016PubMedID: 26507800OAI: oai:DiVA.org:umu-112721DiVA: diva2:882261
Available from: 2015-12-14 Created: 2015-12-14 Last updated: 2016-06-08Bibliographically approved

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Karling, PontusWikgren, MikaelAdolfsson, RolfNorrback, Karl-Fredrik
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