Anxious-retarded depression: Relation with plasma vasopressin and cortisol

Abstract

Dysregulation of the hypothalamus-pituitary-adrenal(HPA) axis is related to melancholic or endogenous depression; however, the strength ofthis relationship depends on the definition ofthe specific depression subcategory. A two-dimensionally defined subcategory, anxious-retarded depression, is related to melancholic depression. Since arginine vasopressin (AVP) activates the HPA axis, and bothmajor depression and the melancholic subcategory are associated with elevated plasma AVP levels, we investigated whetherthe plasmaAVP levelis also elevated in anxious-retarded depression, melancholic depression and anxious-retarded melancholic depression, andwhether plasma AVP and cortisollevels are correlated in these subcategories. A totalof 66 patients with major depression not using oralcontraception were investigated. Patients with anxious-retarded depression had a highly significant AVP-cortisolcorrelation, while nosuch correlation was found in patients with nonanxious-retarded depression. Log-transformed mean plasma AVP values were higher inpatients with anxious-retarded depression than in patients with nonanxious-retarded depression. Patients with anxious-retardedmelancholic depression also had a significantly elevated levelof plasma AVP and a highly significant correlation between plasma AVP andcortisollevels. The correlation was low in patients with melancholic depression. Anxious-retarded depression may be a usefulrefinementof the melancholic subcategory with regard to dysregulation of the HPA axis and plasma AVP release. © 2003 American College of Neuropsychopharmacology.