NEUROENDOCRINE AND ANTHROPOMETRIC MEASURES IN MAJOR DEPRESSION - THE EFFECT OF ANTIDEPRESSANT TREATMENT

It has been suggested that weight change might be associated with cert ain neuroendocrine abnormalities often observed in patients suffering from a depressive illness. This preliminary study examined whether obj ective measures of weight change were associated with dexamethasone su ppression test (DST) results or plasma levels of thyroid hormones, and whether they correlated with clinical improvement. Specific measures included plasma cortisol following dexamethasone, plasma free thyroxin e (T4) and triiodothyronine (T3), as well as anthropometric measures ( skinfolds, percentage body fat, body density). The majority of patient s (75 per cent) showed some weight gain after treatment. A strong posi tive correlation was observed between weight gain and plasma tricyclic levels (P < 0.005) but only a weak correlation was found between plas ma tricyclic levels and therapeutic response (r = 0.14). A gender diff erence was seen in the relationship between weight gain and therapeuti c response, with weight gain being associated with less improvement in men and more improvement in women. Therefore, weight gain during trea tment may not necessarily indicate clinical improvement for all patien ts. The only variable that reliably predicted treatment response was f ree T4. High levels of free T4 prior to treatment were highly correlat ed with better clinical status as indicated by HAMD scores (r = 0.87, P < 0.005). Following treatment with imipramine, plasma cortisol level s after dexamethasone administration were reduced in treatment respond ers but not in nonresponders. Overall, patients that showed the larges t decreases in post-dexamethasone cortisol levels from before to after treatment also showed the largest decreases in HAMD total scores (r = 0.37) and, especially, somatic anxiety scores (r = 0.58; p < 0.05). T hese effects were stronger in women than men. (C) 1997 John Wiley and Sons, Ltd.