Kuss, H J; Zhao, D Y; Laakmann, G; Kuhn, K; Haag, C; Daffner, C; Baghai, T Author Information

The purpose of this investigation was to evaluate whether in healthy subjects the GH response following stimulation with releasing hormones is dependent on the spontaneous GH secretion within 24 hr prior to the stimulation test. In 18 male and 9 female healthy subjects (21-59 years) GH was measured every 15 min over 26 hr. Twenty-four hours after the beginning of blood sampling, a GH stimulation test was performed by using a combined releasing hormone test. Sleep was recorded in three consecutive nights. A positive correlation was found between the AUCs of the 24-hr GH secretion and the AUCs of GH stimulation, which could not be explained by an age effect only. This study demonstrates that subjects with comparatively high amounts of GH secreted within 24 hr also show good GH secretory responses when immediately after the 24-hr sampling period a stimulation test is undertaken. Therefore, a low GH response to stimulation cannot be explained by feedback effects of high GH amounts secreted during the 24 hr before the test or by empty pituitary GH storages.

Auf der Suche nach einem biologischen Marker für psychische Erkrankungen gewinnen neuroendokrinologische Untersuchungen zunehmend an Bedeutung. Es konnte gezeigt werden, daß endogen depressive Patienten Störungen der Wachstumshormon (GH)- (Laakmann u. Benkert 1978; Laakmann 1987), Adrenokortikotropin(ACTH)/Kortisol- (Gold et al. 1984; Holsboer et al. 1985) und Thyreotropin-(TSH)-Sekretion (Prange et al. 1972) aufweisen. Aufgrund dieser Untersuchungsbefunde wird deutlich, daß bei endogen depressiven Patienten Störungen mehrerer hypothalamo-hypophysärer Hormonachsen vorliegen.

This is a report of one of the few cases of an adult form of metachromatic leukodystrophy with almost exclusively psychiatric symptoms. This should point out the importance of a careful organic diagnostic assessment in all patients with the first manifestation of a psychiatric disease. In this case an investigation of the patient's family confirmed the heterozygote genetic origin of the disease.

In recent years, psychoneuroendocrinological interest has focused on the releasing and inhibiting hormones which regulate the secretion of anterior pituitary hormones (APH). In psychiatric research, thyroid-stimulating hormone (TSH) secretion, growth hormone (GH) secretion, the hypothalamus-pituitary-adrenal (HPA) axis, and the prolactin stimulation induced by neuroleptic drugs have been of special interest in the context of depressive disorder and addiction.

Pharmacoendocrinological studies have shown that psychotropic drugs with different actions have different effects on anterior pituitary hormone secretion in man. Substances with different effects on the central nervous system are characterized by a different pharmacoendocrinological profile. Studies with various receptor blockers have shown varying influences on the DMI-induced growth hormone, prolactin, and ACTH/cortisol secretion. Growth hormone stimulation was shown to be mediated by alpha 2-receptors and inhibited by beta-receptors. Investigations in male and female endogenous depressive patients demonstrated a significantly blunted growth hormone response to DMI compared with age- and sex-matched healthy subjects. A comparative study in male endogenous depressive patients showed a significantly diminished growth hormone stimulation both after DMI and after growth hormone-releasing hormone compared to healthy male subjects. In further tests a simultaneous application of four releasing hormones (GHRH, CRH, GnRH, TRH) was used. These investigations showed a significantly lower GH stimulation in endogenous depressive patients compared with age- and sex-matched healthy subjects, but not in neurotic depressive or schizophrenic patients. Cortisol stimulation was similar in all groups of patients and healthy subjects. TSH stimulation was significantly lower in endogenous depressive and schizophrenic patients than in healthy subjects. Somatomedin-C concentrations were significantly elevated in endogenous depressed patients compared with healthy subjects. The blunted growth hormone response in endogenous depression could be explained by inhibitory influences such as increased somatomedin-C concentrations or a hyperactivity of central beta-adrenergic-receptors.

Within the last 20 years neuroendocrinological investigations have become increasingly relevant in the context of depression research. The secretion of growth hormone (GH), ACTH/cortisol, and thyroid-stimulating hormone (TSH) have been studied extensively. The present paper primarily refers to the stimulation of GH secretion following the administration of tricyclic antidepressants and releasing hormones in depressive patients.