The corticotropin-releasing hormone stimulation test in patients with panic disorder
American Journal of PsychiatryPublished 1 July 1986
Peter Roy‐Byrne, Thomas W. Uhde, Robert M. Post, William T. Gallucci, George P. Chrousos, Philip W. Gold
Citations206
SJR quartileQ1
SJR score5.27
SNIP3.68
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The results suggest that patients with panic disorder have an element of chronic hypercortisolemia, like depressed patients, but also a more acute perturbation in ACTH secretion, not previously seen in depressed patients.
Abstract
Eight patients with panic disorder had significantly lower ACTH and cortisol responses to corticotropin-releasing hormone and a significantly lower ratio of ACTH to cortisol response than 30 normal control subjects. These responses resemble those previously reported for depressed patients except that they occurred in the face of significantly elevated basal cortisol and ACTH levels. These results suggest that patients with panic disorder have an element of chronic hypercortisolemia, like depressed patients, but also a more acute perturbation in ACTH secretion, not previously seen in depressed patients.
Keywords
PsychologyNeuroscience
Manual for the State-Trait Anxiety Inventory
25,350 Citations1970Charles D. Spielberger, Richard L. Gorsuch +1 more
Archives of General PsychiatryA Specific Laboratory Test for the Diagnosis of Melancholia
2,249 Citations1981Bernard J. Carroll
Abnormal DST results were found with similar frequency among outpatients and inpatients with melancholia; but they were not related to age, sex, recent use of psychotropic drugs, or severity of depressive symptoms.
Archives of General PsychiatryDisrupted 24-hour Patterns of Cortisol Secretion in Psychotic Depression
771 Citations1973Edward J. Sachar
The data suggest an abnormal disinhibition during depressive illness of the neuroendocrine centers regulating adrenocorticotrophic hormone release, which may be involved in the hypersecretion of cortisol in certain depressed patients.
NatureCorticotropin releasing factor produces behavioural activation in rats
760 Citations1982Richard E. Sutton, George F. Koob +3 more
It is reported here that centrally injected synthetic CRF produces a dose-dependent locomotor activation in rats, suggesting that CRF may have an activating action in the central nervous system independent of its effects on the anterior pituitary gland.
Archives of General PsychiatryTreatment of Endogenous Anxiety With Phobic, Hysterical, and Hypochondriacal Symptoms
729 Citations1980David V. Sheehan
Endogenous anxiety (anxiety hysteria, agoraphobia with panic attacks) is characterized by sudden, spontaneous panic attacks accompanied by multiple autonomic symptoms, overwhelming fear, a flight response, and polyphobic behavior.
Brain ResearchCorticotropin-releasing factor activates noradrenergic neurons of the locus coeruleus
605 Citations1983Rita J. Valentino, Stephen L. Foote +1 more
Intraventricular administration of CRF-OH, previously demonstrated to be considerably less potent in releasing ACTH, did not alter LC firing rates, and data suggest that activation of these central noradrenergic neurons may constitute an integral part of the overall 'stress response' initiated by CRF release.
Life SciencesIntraventricular corticotropin-releasing factor enhances behavioral effects of novelty
539 Citations1982Donald R. Britton, George F. Koob +2 more
Corticotropin-releasing factor altered the frequency of those behaviors which are normally expressed in response to the novel environment, and caused an increase in grooming and decreases in the amount of rearing.
American Journal of PsychiatryPsychiatric implications of basic and clinical studies with corticotropin-releasing factor
481 Citations1984P W Gold, George P. Chrousos +7 more
Clinically, experience in administering ovine CRF shows that CRF can be helpful in resolving differential diagnostic dilemmas in patients with various disorders of the hypothalamic-pituitary-adrenal axis and in furthering an understanding of the pathophysiology of conditions such as Cushing's disease and depression.
Archives of General PsychiatryLactate Provocation of Panic Attacks
378 Citations1985Michael R. Liebowitz
Lactate-induced panic attacks were regularly accompanied by biological changes consistent with hyperventilation and central noradrenergic activation and irregularly by elevation of plasma norepinephrine and cortisol levels.
New England Journal of MedicineThe Corticotropin-Releasing Factor Stimulation Test
346 Citations1984George P. Chrousos, Heinrich M. Schulte +4 more
Archives of General PsychiatryTreatment of Phobias
342 Citations1983Charlotte M. Zitrin
Although the conditions of most patients in each group showed moderate to marked improvement, the effects of imipramine were significantly superior to those of placebo in patients with spontaneous panic attacks, ie, patients with agoraphobia or mixed phobia.
NatureCorticotropin-releasing factor is a potent inhibitor of sexual receptivity in the female rat
291 Citations1983D.J.S. Sirinathsinghji, Lesley Rees +2 more
The first evidence for neurally placed CRF in the control of a specific hormone-dependent behavioural response is provided and an extremely potent suppressive effect of CRF is demonstrated on sexual behaviour in the female rat when microinfused into the arcuate–ventromedial area of the hypothalamus and the mesencephalic central grey.
Archives of General PsychiatryAdrenergic Function in Patients With Panic Anxiety
261 Citations1984Randolph M. Nesse
The results suggest that beta-adrenergic receptor response is not increased, and may be decreased, in patients with panic disorder, and receptor down-regulation could result from the increased adrenergic function that these patients demonstrate, even in the absence of panic attacks.
Life SciencesCorticotropin-releasing factor: Effects on the sympathetic nervous system and oxygen consumption
253 Citations1982Marvin R. Brown, Laurel A. Fisher +4 more
Corticotropin-releasing factor administered intracerebroventricularly produces prolonged elevation of plasma concentration of epinephrine, norepinephrine and glucose, associated with an increase in motor activity and oxygen consumption.
Journal of Clinical InvestigationEffect of synthetic ovine corticotropin-releasing factor. Dose response of plasma adrenocorticotropin and cortisol.
245 Citations1983David N. Orth, Richard V. Jackson +8 more
Data indicate that synthetic ovine CRF is a very potent and specific ACTH secretagogue in man and Administered with caution until its vasomotor effects are more fully defined, CRF promises to be a safe and very useful investigative, diagnostic, and, possibly, therapeutic agent in man.
Progress in Neuro-Psychopharmacology and Biological PsychiatryLongitudinal course of panic disorder: Clinical and biological considerations
200 Citations1985Thomas W. Uhde, Jean‐Philippe Boulenger +4 more
The longitudinal course of panic disorder and its associated symptoms were investigated in patients and the temporal relationships among panic attacks, generalized anxiety, agoraphobia and depression are described.
American Journal of PsychiatryCosyntropin (ACTH alpha 1-24) stimulation test in depressed patients and healthy subjects
164 Citations1983Jay D. Amsterdam, Andrew Winokur +3 more
Cosyntropin (ACTH alpha 1-24) infusion caused significantly higher cortisol concentrations, with earlier peak responses, in patients with endogenous depression than in normal subjects, and there was no relationship between the cortisol levels after administration of dexamethasone and cosyntropins.
The British Journal of PsychiatryThe Prognosis of Affective Disorders: the Differentiation of Anxiety States from Depressive Illnesses
146 Citations1972Kurt Schapira, Martin Roth +2 more
It was found that patients with depressive illness had a significantly better prognosis than those with anxiety states in terms of global adjustment, both during the follow-up period (outcome component) and at the time of the following interview.
Clinical ChemistryParallel Radioimmunoassay for Plasma Cortisol and 11-Deoxycortisol
130 Citations1975Michael Kao, Sandra Voina +2 more
Steroid values obtained by a competitive protein binding method were consistently higher than those of the present method, suggesting that the former is measuring total corticosteroids.
Psychiatry ResearchThe sleep of patients with panic disorder: A preliminary report
124 Citations1984Thomas W. Uhde, Peter Roy‐Byrne +5 more
Electroencephalographic sleep recordings were compared in patients with panic disorder and normal controls to determine correlation coefficients of standard sleep parameters versus ratings of anxiety, depression, and panic attack frequency.
American Journal of PsychiatryThe dexamethasone suppression test in panic disorder and agoraphobia
121 Citations1982George C. Curtis, Oliver G. Cameron +1 more
The results suggest that panic attacks and endogenous depression are separate disorders and that the antipanic properties of imipramine and phenelzine are separate from their antidepressant actions.
American Journal of PsychiatryThe DST in psychiatric outpatients with generalized anxiety disorder, panic disorder, or primary affective disorder
90 Citations1985David Avery, Tony Osgood +4 more
There were no significant differences in dexamethasone nonsuppression rates among the diagnostic groups, but scores on the Hamilton Rating Scale for Depression and a melancholia subscale were significantly higher in the depressed group than in the anxiety disorder group.
PsychopathologyFear and Anxiety: Relationship to Noradrenergic Function
88 Citations2010Thomas W. Uhde, Jean‐Philippe Boulenger +5 more
Findings expand previous research indicating that noradrenergic hyperactivity may be associated with many types of human fear and anxiety, and data demonstrating a positive correlation between plasma free MHPG and state anxiety in normal volunteers is presented.
American Journal of PsychiatryPanic attacks and the dexamethasone suppression test
82 Citations1983David V. Sheehan, J B Claycomb +4 more
Of 51 patients with panic attacks, 11.8% had a positive dexamethasone suppression test, significantly lower than the rate for melancholia, suggesting that panic attacks and major depression may be associated with different biological mechanisms.
The Journal of Clinical Endocrinology & MetabolismEFFECT OF EXOGENOUS CORTICOTROPIN ON THE HISTOCHEMICAL PATTERN OF THE HUMAN ADRENAL CORTEX AND A COMPARISON WITH THE CHANGES DURING STRESS
81 Citations1956T. Symington, William P. Duguid +1 more
A comparison of the changes which take place in the human adrenal cortex during stress with those found during administration of corticotropin forms the basis of this paper.
American Journal of PsychiatryDexamethasone suppression tests in patients with panic disorder
75 Citations1983Jeffrey A. Lieberman, Ronald Brenner +4 more
The Journal of Clinical Endocrinology & MetabolismTHE EFFECTS OF CORTICOTROPIN RELEASING FACTOR ON THE ANTERIOR PITUITARY FUNCTION OF STALK-SECTIONED CYNOMDLGUS MACAQUES: DOSE RESPONSE OF CORTISOL SECRETION
74 Citations1982H. M. Schulte, George P. Chrousos +5 more
The recent identification of ovine corticotropin releasing factor (CRF), a 41-amino acid peptide, provides a potential new approach to evaluate disorders of the hypothalamic-pituitary-adrenal axis.