Transl Psychiatry: Adrenaline levels in adolescents with depression

Background: Depression (MDD) is a debilitating and very common mental disorder, affecting up to 20% of adolescents at some point during their teenage year.

Preliminary evidence, however, suggests that adrenal hormones, rather than cortisol, may contribute to precision medicine for psychiatric disorder.

In addition to the potential of the adrenal steroid metabolome as a diagnostic tool for MDD, it may also provide insights into the pathophysiology of MD.

Objectives: This cross-sectional study was designed to assess the serum steroid hormones (progesterone, 17-hydroxyprogesterone, 21-deoxycortisol, 11-deoxycortisol, cortisol, cortisone, deoxycorticosterone, cortisol ) and by comparing a large sample of clinically depressed adolescents with an age- and sex-matched reference cohort, the steroid ratio was chosen as a biological readout of adrenal enzyme activity for MD.

METHODS: Serum adrenal hormones (progesterone, 17-hydroxyprogesterone, 21-deoxycortisol, 11-deoxycortisol) in 261 depressed adolescents (170 women) treated in a psychiatric hospital were determined by liquid chromatography-tandem mass spectrometry cortisol, cortisol, cortisone, deoxycorticosterone, cortisol.

RESULTS: Nonparametric receiver operating characteristic (ROC) analysis was used to assess the diagnostic performance of individual steroid hormones and steroid hormone ratios for the classification of depressive statu.

Figure 1 Boxplots of all steroids and steroid proportion.

Table 1 Patient characteristic.

Table 2 Steroids and Steroid Ratios—Results

Table 3 Sorted ANOVA Results

Table 4 ROC results

Figure 2 ROC curve of corticosterone/deoxycorticosteron.

CONCLUSIONS: The adrenal steroid metabolome may serve as a biological readout for major depressive disorder in adolescents, indicating dysfunction of the hypothalamic-pituitary-adrenal axis through a distinct steroid patter.

Original source: Hirtz R, Libuda L, Hinney A, et a.