TY  - JOUR
PY  - 2009//
TI  - Prediction of relapse in melancholic depressive patients in a 2-year follow-up study with corticotropin releasing factor test
JO  - Progress in neuro-psychopharmacology and biological psychiatry
A1  - Pintor, Luis
A1  - Torres, Xavier
A1  - Navarro, Victor
A1  - Martinez de Osaba, M. A. Jesús
A1  - Matrai, Silvia
A1  - Gasto, Cristobal
SP  - 463
EP  - 469
VL  - 33
IS  - 3
N2  - PURPOSE: To study the power of CRF stimulation test to predict relapse in a sample of melancholic depressive patients in depressed phase, followed-up over a two-year period from the moment they achieved complete remission of depressive symptoms.  METHODS: Fifty-one outpatients diagnosed with unipolar depressive disorder with melancholic features according to DSM-IV were assessed with the CRF test. The Structured Clinical Interview for DSM-IV (SCID-IV) was used for diagnosis. Monthly follow-up visits were held over a two-year period after remission; relapse was established using HDRS according to Frank's criteria [Frank E, Prien RF, Jarret RB, Keller MB, Kupfer DJ, Lavori PW, et al. Conceptualization and rationale for consensus definitions of terms in major depressive disorder: remission, recovery, relapse, and recurrence. Arch Gen Psychiatry 1991;48:851-5]. Forty-three patients completed the study. Non-controlled antidepressant treatment protocols were used. Predictive statistical analysis was performed through logistic regression.  FINDINGS: The final predictive model included three variables: net area under cortisol curve (NAUCC), previous suicide attempt, and stress during follow-up. Sensitivity was of 89%, and specificity was of 92%. NAUCC has shown a predictive power of 80%, with an optimal cut-off point of 251.24 microg/ml/min.  CONCLUSIONS: Cortisol is the hormone of the HPA axis which shows the highest power to predict relapse. NAUCC is the most relevant variable. The complete predictive model is a complex combination of biological, clinical and psychoenvironmental variables (NAUCC, previous suicide attempts, and stress during follow-up). Further studies with better control of the psychoenvironmental variables are required to obtain more precise neuroendocrine findings.<p /> <p>Language: en</p>
LA  - en
SN  - 0278-5846
UR  - http://dx.doi.org/10.1016/j.pnpbp.2009.01.008
ID  - ref1
ER  -