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Risk markers for depression in adolescents: sleep and HPA measures.

Rao U, Hammen CL, Poland RE - Neuropsychopharmacology (2009)

Bottom Line: Previous work has demonstrated reliable electroencephalographic (EEG) sleep and hypothalamic-pituitary-adrenal (HPA) changes associated with adult major depressive disorder.These changes might be evident before clinical manifestation of the illness in at-risk persons.Clinical follow-up evaluations were conducted at regular intervals over a 5-year period.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX 75390-9101, USA. uma.rao@utsouthwestern.edu

ABSTRACT
Previous work has demonstrated reliable electroencephalographic (EEG) sleep and hypothalamic-pituitary-adrenal (HPA) changes associated with adult major depressive disorder. These changes might be evident before clinical manifestation of the illness in at-risk persons. The aim of the study was to identify depression-related EEG sleep and HPA changes in healthy adolescents at high risk for depression, and to examine the relationship between EEG sleep (or HPA) changes and the onset of depression. Forty-eight adolescent volunteers with no personal history of a psychiatric illness, including depression, but who were at high risk for developing depression by virtue of parental depression (high-risk group), and 48 adolescent volunteers with no personal or family history of a psychiatric disorder (normal controls) were recruited. EEG sleep and HPA measures were collected on three consecutive evenings and nights at baseline. Clinical follow-up evaluations were conducted at regular intervals over a 5-year period. Compared with normal controls, adolescents at high risk for depression had shorter latency to rapid eye movement (REM) sleep, increased phasic REM sleep, more REM sleep and elevated nocturnal urinary-free cortisol (NUFC) excretion at baseline. Shorter REM latency, higher REM density and elevated NUFC (measured at baseline) were associated with the development of depression during follow-up. The findings that REM sleep abnormalities and elevated HPA activity occur before the onset of depression in at-risk adolescents suggest that these variables serve as vulnerability markers for the illness.

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REM latency values (mean of Night 2 and Night 3) in individual subjects within normal control (n = 48) and high-risk (n = 48) groups. The horizontal lines (within each column of circles) represent mean values for the two groups. A cut point of 70 minutes was considered as abnormal value.
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Figure 1: REM latency values (mean of Night 2 and Night 3) in individual subjects within normal control (n = 48) and high-risk (n = 48) groups. The horizontal lines (within each column of circles) represent mean values for the two groups. A cut point of 70 minutes was considered as abnormal value.

Mentions: An alternative approach was taken for graphical representation of the frequency of “abnormal” sleep markers. Using a receiver operator characteristic (ROC) analysis, Giles and colleagues reported age-adjusted threshold values for short REM latency in normal and depressed populations (Giles et al, 1990b). A mean REM latency value of ≤70 minutes was considered abnormal for the younger patients (Giles et al, 1990b). Based on this criterion, 2/48 (4.1%) normal controls, and 15/48 (31.3%) high-risk adolescents manifested short REM latency (χ2 = 12.08, p = .001, OR = 0.10, CI = 0.20–0.45; see Figure 1).


Risk markers for depression in adolescents: sleep and HPA measures.

Rao U, Hammen CL, Poland RE - Neuropsychopharmacology (2009)

REM latency values (mean of Night 2 and Night 3) in individual subjects within normal control (n = 48) and high-risk (n = 48) groups. The horizontal lines (within each column of circles) represent mean values for the two groups. A cut point of 70 minutes was considered as abnormal value.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2697268&req=5

Figure 1: REM latency values (mean of Night 2 and Night 3) in individual subjects within normal control (n = 48) and high-risk (n = 48) groups. The horizontal lines (within each column of circles) represent mean values for the two groups. A cut point of 70 minutes was considered as abnormal value.
Mentions: An alternative approach was taken for graphical representation of the frequency of “abnormal” sleep markers. Using a receiver operator characteristic (ROC) analysis, Giles and colleagues reported age-adjusted threshold values for short REM latency in normal and depressed populations (Giles et al, 1990b). A mean REM latency value of ≤70 minutes was considered abnormal for the younger patients (Giles et al, 1990b). Based on this criterion, 2/48 (4.1%) normal controls, and 15/48 (31.3%) high-risk adolescents manifested short REM latency (χ2 = 12.08, p = .001, OR = 0.10, CI = 0.20–0.45; see Figure 1).

Bottom Line: Previous work has demonstrated reliable electroencephalographic (EEG) sleep and hypothalamic-pituitary-adrenal (HPA) changes associated with adult major depressive disorder.These changes might be evident before clinical manifestation of the illness in at-risk persons.Clinical follow-up evaluations were conducted at regular intervals over a 5-year period.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX 75390-9101, USA. uma.rao@utsouthwestern.edu

ABSTRACT
Previous work has demonstrated reliable electroencephalographic (EEG) sleep and hypothalamic-pituitary-adrenal (HPA) changes associated with adult major depressive disorder. These changes might be evident before clinical manifestation of the illness in at-risk persons. The aim of the study was to identify depression-related EEG sleep and HPA changes in healthy adolescents at high risk for depression, and to examine the relationship between EEG sleep (or HPA) changes and the onset of depression. Forty-eight adolescent volunteers with no personal history of a psychiatric illness, including depression, but who were at high risk for developing depression by virtue of parental depression (high-risk group), and 48 adolescent volunteers with no personal or family history of a psychiatric disorder (normal controls) were recruited. EEG sleep and HPA measures were collected on three consecutive evenings and nights at baseline. Clinical follow-up evaluations were conducted at regular intervals over a 5-year period. Compared with normal controls, adolescents at high risk for depression had shorter latency to rapid eye movement (REM) sleep, increased phasic REM sleep, more REM sleep and elevated nocturnal urinary-free cortisol (NUFC) excretion at baseline. Shorter REM latency, higher REM density and elevated NUFC (measured at baseline) were associated with the development of depression during follow-up. The findings that REM sleep abnormalities and elevated HPA activity occur before the onset of depression in at-risk adolescents suggest that these variables serve as vulnerability markers for the illness.

Show MeSH
Related in: MedlinePlus