THE TRH-STIMULATION TEST IN DSM-III PERSONALITY-DISORDER

The authors examined thyrotropin-releasing hormone (TRH) stimulation t esting in the neuroendocrine evaluation of DSM-III major depressive di sorder in 26 consecutive medication-free, medically healthy patients m eeting a primary DSM-III diagnosis of axis II personality disorder. Th yroid-stimulating hormone (TSH) responses to TRH challenge were not si gnificantly different between patients with or without major depressio n at time of study, or between patients with or without a life history of major affective disorder. Further, TSH responses to TRH among 11 h ealthy male nonpsychiatric controls were not significantly different f rom those in patients with personality disorders. Comparison of those patients with blunted TSH responses (<7.0 muU/ml) versus those without blunted response (less-than-or-equal-to 7.0 muU/ml) also did not reve al a significant difference. In addition, the TSH response to TRH did not correlate with dimensional assessments of state or trait depressio n, anxiety, or with past history of suicide attempt or alcohol abuse. These data suggest that TRH stimulation testing has limited utility in the evaluation of major depression or other relevant affective states /traits in personality-disordered patients. Affective symptoms in pers onality-disordered patients do not seem to be associated with dysregul ation of the hypothalamic-pituitary-thyroid axis.