PREDICTION OF DEPRESSIVE RELAPSE IN REMITTED BIPOLAR PATIENTS USING CORTICOTROPIN-RELEASING HORMONE CHALLENGE TEST

Abnormalities in corticotrophin (ACTH) and cortisol levels before and after corticotrophin-releasing hormone (CRH) stimulation have been rep orted in depressed bipolar patients. The ACTH and free cortisol respon se to the injection of 100 mu g of synthetic human CRH and plasma cort isol-binding globulin (CBG) levels were measured in 42 lithium-treated patients suffering from RDC bipolar-I disorder in remission, and in 2 1 age- and sex-matched control subjects. A 1-year follow-up was conduc ted in order to assess any possible relationship between outcome and t he hormonal response. Bipolar patients showed higher baseline and peak ACTH concentrations than controls. A lower net area under the ACTH co ncentration curve after CRH stimulation predicted depressive relapse w ithin 6 months by multiple regression analysis. The CRH challenge test could be a potentially good predictor of depressive relapse in remitt ed bipolar patients.