Pituitary and adrenal hormone responsiveness to synachten in melancholic subjects versus subjects with minor depression

Michael Maes*, Herbert Meltzer, Paul Cosyns, Joseph Calabrese, Peter D'Hondt, Pierre Blockx, Carine Vandervorst, Jef Raus

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Increased adrenal cortex responsiveness to adrenocorticotropic hormone (ACTH) has been suggested to contribute to increased cortisol secretion in dexamethasone nonsuppression and melancholia. To further examine this hypothesis, the following variables were examined in 68 patients with unipolar depression (minor, n = 24; simple major, n = 25; melancholic, n = 19): basal or post-Synachten [ACTH(1-24), 250 μg IV] intact ACTH(1-39), β-endorphin/β-lipotropin, cortisol, and androstenedione concentrations, as well as the postdexamethasone (DST) (DST) plasma ACTH(1-39) and cortisol values. Melancholic subjects showed significantly higher baseline ACTH(1-39), β-endorphin/β-lipotropin, and androstenedione values compared with subjects with minor depression. No significant differences in post-Synacthen cortisol or androstenedione secretion between any of the groups or between [ACTH(1-39) or cortisol] DST nonsuppressors and suppressors were found. No significant relationships between DST and ACTH test results were observed. Abnormally increased post-DST cortisol values in melancholic subjects were highly preicted (68% of the variance) by post-DST intact ACTH levels. ACTH(1-39) values were significantly lower after Synacthen administration in melancholic subjects than in subjects with minor depression. These results are not consistent with the hypothesis that melancholia is characterized by an increased adrenocortical responsivity to exogenous ACTH compared with minor depression or that DST nonsuppression is due to adrenal hyperresponsiveness.

Original languageEnglish (US)
Pages (from-to)624-629
Number of pages6
JournalBiological psychiatry
Issue number8-9
StatePublished - 1993


  • ACTH test
  • adrenocorticotropic hormone
  • androstenedione
  • cortisol
  • depression
  • dexamethasone suppression test
  • short Synachten test
  • β-endorphin

ASJC Scopus subject areas

  • Biological Psychiatry


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