Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-19T13:29:27.241Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuroendocrine Challenge Studies in Puerperal Psychoses

Dexamethasone Suppression and TRH Stimulation

Published online by Cambridge University Press:  02 January 2018

E. S. Paykel ,
A. Martin Del Campo ,
W. White  and
R. Horton
E. S. Paykel*
Affiliation:
Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge CB2 2QQ
A. Martin Del Campo
Affiliation:
Department of Psychiatry, University of Cambridge
W. White
Affiliation:
Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital
R. Horton
Affiliation:
St George's Hospital Medical School, London
*
∗Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

Subjects admitted to hospital with post-partum psychoses were compared with matched normal postpartum controls using two neuroendocrine challenge tests: dexamethasone suppression of Cortisol and TRH stimulation of TSH. Post-dexamethasone Cortisol levels were significantly elevated. There were less-clear hints of blunting of TSH response. In the small samples there was no obvious association of abnormalities with any particular diagnoses within the range of mania, psychotic depression and schizoaffective disorders.

Type
Papers
Information
The British Journal of Psychiatry , Volume 159 , Issue 2 , August 1991 , pp. 262 - 266
Copyright
Copyright © 1991 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association Task Force on Laboratory Tests in Psychiatry (1987) The Dexamethasone Suppression Test: an overview of its current status in psychiatry. American Journal of Psychiatry, 144, 1253–1262.Google Scholar
Amino, N., Miyai, K., Onishi, T., et at (1976) Transient hypothyroidism after delivery in autoimmune thyroiditis. Journal of Clinical Endocrinology Metabolism, 42, 296–301.Google Scholar
Amino, N., Mori, H., Iwatani, Y., et al (1982) High prevalence of transient post-partum thyrotoxicosis and hypothyroidism. New England Journal of Medicine, 306, 849–852.CrossRefGoogle ScholarPubMed
Arana, G. W., Barrera, P. J., Cohen, B. M., et al (1983) The Dexamethasone Suppression Test in psychotic disorders. American Journal of Psychiatry, 140, 1521–1523.Google Scholar
Braddock, L. (1986) The Dexamethasone Suppression Test: fact and artefact. British Journal of Psychiatry, 148, 363–374.Google Scholar
Brockington, I. F., Martin, C., Brown, G. W. et al (1990) Stress and puerperal psychosis. British Journal of Psychiatry, 157, 331–334.Google Scholar
Burrow, G. N. (1985) The management of thyrotoxicosis in pregnancy. New England Journal of Medicine, 313, 562–565.CrossRefGoogle ScholarPubMed
Clark, P. M. S. & Price, C. P. (1986) Enzyme amplified immunoassay: a new ultrasensitive assay of thyrotropin evaluated. Clinical Chemistry, 32, 88–92.Google Scholar
Dean, C., Williams, R. J. & Brockington, I. F. (1989) Is puerperal psychosis the same as bipolar manic-depressive disorder? A family study. Psychological Medicine, 19, 637–647.CrossRefGoogle ScholarPubMed
Dowlatshahi, D. & Paykel, E. S. (1990) Life events and social stress in puerperal psychoses: absence of effect. Psychological Medicine, 20, 655–662.CrossRefGoogle ScholarPubMed
Extein, I., Pottash, A. L. C., Gold, M. S., et al (1982) Using the Protirelin Test to distinguish mania from schizophrenia. Archives of General Psychiatry, 39, 77–81.Google Scholar
Extein, I., Pottash, A. L. C., Gold, M. S., et al (1984) Changes in TSH response to TRH in affective illness. In Neurobiology of Mood Disorders (eds Post, R. M. & Ballenger, J. C.). Baltimore and London: Williams & Wilkins.Google Scholar
Freeman, R., Rosen, H. & Thysen, B. (1986) Incidence of thyroid dysfunction in an unselected postpartum population. Archives of International Medicine, 146, 1361–1364.Google Scholar
Garbutt, J. C., Loosen, P. T., Tipermas, A., et al (1983) The TRH test in borderline personality disorder. Psychiatry Research, 9, 107–113.Google Scholar
Goldman, J. M. (1986) Postpartum thyroid dysfunction. Archives of International Medicine, 146, 1296–1299.Google Scholar
Graham, P. M., Booth, J., Boranga, G., et al (1982) The dexamethasone suppression test in mania. Journal of Affective Disorders, 4, 201–211.Google Scholar
Greden, J. F., Kronfol, Z., Garner, R., et al (1981) Neuroendocrine evaluation of schizoaffectives with the dexamethasone suppression test. In Biological Psychiatry (eds Perris, C., Struwe, G. & Jansson, B.). Amsterdam: Elsevier/Biomedical Press.Google Scholar
Greenwood, J. & Parker, G. (1984) The Dexamethasone Suppression Test in the puerperium. Australian and New Zealand Journal of Psychiatry, 18, 282–284.CrossRefGoogle ScholarPubMed
Jansson, R. (1984) Autoimmune thyroiditis. Acta Universitatis Upsaliensis, 22–23.Google Scholar
Johannsson, A., Stanley, C. J. & Self, C. H. (1985) A fast highly sensitive colorimetric enzyme immunoassay system demonstrating benefits of enzyme amplification in clinical chemistry. Clinica Chimica Acta, 148, 119–124.Google Scholar
Katona, C. L. E. & Roth, M. (1985) The Dexamethasone Suppression Test in schizo-affective depression. Journal of Affective Disorders, 8, 107–112.Google Scholar
Kendell, R. E., Chalmers, J. C. & Platz, C. (1987) Epidemiology of puerperal psychoses. British Journal of Psychiatry, 150, 662–673.Google Scholar
Loosen, P. T. (1988) The TRH test in psychiatric disorders. In Affective Disorders (ed. Flach, F.) (Directions in Psychiatry Monograph Series). New York, London: W. W. Norton.Google Scholar
Loosen, P. T., Prange, A. J. Jr & Wilson, I. C. (1979) TRH (Protirelin) in depressed alcoholic men: behavioural changes and endocrine responses. Archives of General Psychiatry, 36, 540–547.Google Scholar
Martin, C. J., Brown, G. W., Goldberg, D. P., et al (1989) Psycho-social stress and puerperal depression. Journal of Affective Disorders, 16, 283–293.Google Scholar
Meltzer, H. Y., Fang, V. S., Tricou, B. J., et al (1982) Effect of dexamethasone on plasma prolactin and Cortisol levels in psychiatric patients. American Journal of Psychiatry, 139, 763–768.Google Scholar
Paykel, E. S., Emms, E. M., Fletcher, J., et al (1980) Life events and social support in puerperal depression. British Journal of Psychiatry, 136, 336–346.CrossRefGoogle ScholarPubMed
Protheroe, C. (1969) Puerperal psychoses: a long term study 1927–1961. British Journal of Psychiatry, 115, 9–30.Google Scholar
Saffer, D., Metcalfe, M. & Coppen, A. (1985) Abnormal Dexamethasone Suppression Test in Type II schizophrenia. British Journal of Psychiatry, 147, 721–723.CrossRefGoogle ScholarPubMed
Singh, B., Gilhotra, M., Smith, R., et al (1986) Post partum psychoses and the Dexamethasone Suppression Test. Journal of Affective Disorders, 11, 173–177.Google Scholar
Stanley, C. J., Johannsson, A. & Self, C. H. (1985) Enzyme amplification can enhance both the speed and the sensitivity of immunoassays. Journal of Immunological Methods, 83, 89–95.Google Scholar
Stewart, D. E., Addison, A. M., Robinson, G. E., et al (1988) Thyroid function in psychosis following childbirth. American Journal of Psychiatry, 145, 1579–1581.Google Scholar
Wahby, V. S., Ibrahim, G. A., Giller, E. L., et al (1988) Thyrotropin response to thyrotropin-releasing hormone in RDC schizodepressed men. Journal of Affective Disorders, 15, 81–85.CrossRefGoogle ScholarPubMed
Walfish, P. G. & Chan, J. Y. (1985) Postpartum hyperthyroidism. Clinical Endocrinology Metabolism, 14, 417–447.Google Scholar
Watson, J. P., Elliott, S. A., Rugg, A. J., et al (1984) Psychiatric disorder in pregnancy and the first postnatal year. British Journal of Psychiatry, 144, 453–462.Google Scholar
Wolkin, A., Peselow, E. D., Smith, M., et al (1984) TRH Test abnormalities in psychiatric disorders. Journal of Affective Disorders, 6, 273–281.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.