Biological classification of depressive illness

British Journal of Clinical Pharmacology
A Coppen, K Wood

Abstract

1 A number of biological criteria have been used for refining clinical classification to identify patients who will respond to antidepressant treatment. 2 Subtypes of depressive illness have been postulated to occur depending on whether there is a relative deficiency of central noradrenaline or 5-hydroxytryptamine. However, antidepressants having selective effects on amine systems have similar therapeutic effects and inhibition of re-uptake of these amines does not correlate with clinical outcome. 3 An abnormal response to thyrotrophin-releasing hormone has not been confirmed as specific for depressive illness. Failure to control for age and sex may account for some of the discordant findings. 4 It has been suggested that depressed patients secrete less growth hormone to a variety of stimuli. It appears that the predictive value of a growth hormone response for the diagnosis of endogenous depression is 53%. 5 The dexamethasone suppression test appears to have high sensitivity for the diagnosis of endogenous depression but low specificity and should therefore be used only in conjunction with clinical assessments.

References

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Citations

Dec 16, 1998·Trends in Pharmacological Sciences·D SpinaS Harrison
Sep 2, 2008·Nature Reviews. Drug Discovery·György HaskóPál Pacher
Dec 12, 2002·Current Opinion in Pulmonary Medicine·Domenico Spina
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May 1, 1993·Medicinal Research Reviews·R M Pinder, J H Wieringa

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