Association between gonadal dysregulation and refractory psychiatric disorder

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K19755
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Psychiatric science
• Research Institution: Niigata University
• Principal Investigator: Tsuneyama Nobuto 新潟大学, 医歯学総合病院, 助教 (90750349)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: うつ病 / 性ホルモン / 治療抵抗性

Outline of Final Research Achievements

Insulin-like growth factor 1 (IGF-I) is a neurotrophic factor produced by the hypothalamic-pituitary-somatotropic (HPS) axis and is considered a potential contributor to the pathology of major depressive disorder (MDD). Although it is known that the hypothalamic-pituitary-adrenal (HPA) axis and cortisol are involved in the pathology of MDD, the association with dehydroepiandrosterone sulfate (DHEAS) remains unclear. Subjects were 91 Japanese patients with MDD. Serum IGF-I, cortisol, and DHEAS were measured. Depressive symptoms were assessed using the Hamilton Depression Rating Scale(HAM-D). Serum IGF-I levels were not correlated with cortisol. Higher IGF-I, cortisol, and cortisol/DHEAS ratios were associated with higher HAM-D scores, and higher IGF-I and cortisol were associated with higher melancholic or suicide sub-scores. Our findings suggest that hormonal dysregulation of the HPA and HPS axes may be related to the symptom severity of MDD, melancholia, and suicide-related factors.

Free Research Field

精神医学

Academic Significance and Societal Importance of the Research Achievements

本研究は、性ホルモンに着目し、精神症状・重症度との関連を明らかにすることで精神疾患の難治化のメカニズムを解明しようとした点に特色がある。性ホルモンが精神疾患の治療抵抗性を予測する生物学的マーカーであることが判明すれば、予後予測や治療法の開発に極めて有用である。
今回の成果は、神経分泌物質と難治性うつ病の重症度との関連を示しうるものであり、難治化した精神疾患の診断、そして治療における新たな一手につながる可能性がある、精神医学において大きな意義があるものである。