NEUROENDOCRINE AND CLINICAL CHARACTERISTICS OF MAJOR DEPRESSED-PATIENTS EXHIBITING SLEEP-ONSET REM

Background: Previous reports suggest an association between sleep-onse t REM (SOREM) and some clinical characteristics in depressive illness such as age, psychosis, and depression severity. The present study is aimed at further investigating clinical and neuroendocrine correlates of SOREM, controlling for the age-related variability in clinical data . Methods: Thyroid-stimulating hormone response to thyrotropin-releasi ng hormone, postdexamethasone cortisol levels, and clinical characteri stics of 25 major depressive (MD) patients exhibiting SOREM in at leas t one of three consecutive recording nights were compared to those of 25 age- and sex-matched MD patients with three REM latencies above 50 min. Results: SOREM patients experienced more affective episodes leadi ng to hospitalization and a shorter duration of current episode than p atients with three REM latencies above 50 min. No association between psychosis and SOREM could be demonstrated and hypothalamic-pituitary-a drenal or -thyroid axis disturbances were not more prevalent in SOREM patients. Conclusions: Our results suggest that clinical history rathe r than cross-sectional clinical characteristics relates to the occurre nce of SOREM in major depressed patients. (C) 1998 Society of Biologic al Psychiatry.