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Letters to the Editor |

The Role of Hypothalamic-Pituitary-Adrenal Axis Dysfunction in the Attenuated Growth Hormone Response in Adolescents With Familial Loading for Affective Disorder

Boris Birmaher, MD; Ronald E. Dahl, MD; Neal D. Ryan, MD; Douglas E. Williamson, PhD
Arch Gen Psychiatry. 2002;59(2):187. doi:.
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We agree with the authors that the blunted GH response to GHRH (as reported in a sample of never-depressed children at high risk to develop major depressive disorder1) may potentially be due to alterations in other systems. However, their suggestion that hypercortisolemia, particularly during the evening, inhibits the release of GH and at least partially accounts for our findings does not fit with our data. We examined measurements of cortisol levels, collected every 20 minutes from 9 PM until the child awoke the next morning, from the high-risk and low-risk healthy children and found no significant correlations between the night cortisol levels and the GH levels (Table 1). Additionally, we examined cortisol obtained at 5 PM before a corticotropin-releasing hormone (CRH) challenge and cortisol response to CRH and found no significant correlations to the GH measures (Table 1). Given the results noted above and the fact that, in general, our group and others have found few hypothalamic-pituitary-adrenal abnormalities associated with depression in children and adolescents,27 it is probable that the blunted GH response to GHRH that we reported is not due to alterations of the hypothalamic-pituitary-adrenal system.

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