Nocturnal ACTH, cortisol, growth hormone, and prolactin secretion in prepubertal depression

Michael D. De Bellis, Ronald E. Dahl, James M. Perel, Boris Birmaher, Mayadah Al-Shabbout, Douglas E. Williamson, Beverly Nelson, Neal D. Ryan

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Objective: To examine nocturnal secretion of adrenocorticotropin, cortisol, growth hormone, and prolactin in 38 medically healthy children with prepubertal major depression compared with 28 medically and psychiatrically healthy control children. Method: Prior to sampling, subjects underwent an 'adaptation night' with the intravenous catheter in place and electroencephalographic (EEG) electrodes for standard all-night polysomnogram. On the following night, plasma samples were obtained every 20 minutes through an indwelling catheter. Hormonal concentrations were measured by specific radioimmunoassay and aligned by EEG-confirmed sleep onset. Areas under the curve were calculated for total secretion and compared using analysis of variance. Results: Prepubertal depressed children had lower cortisol secretion during the first 4 hours after sleep onset compared with controls. Adrenocorticotropin, prolactin and growth hormone secretion did not differ between groups. Examination of clinical characteristics in depressed children revealed lower nocturnal adrenocorticotropin concentrations in depressed inpatients versus depressed outpatients and in depressed sexually abused versus depressed nonabused children. A significant sex by diagnosis effect revealed lower growth hormone secretion in depressed females compared with depressed males. Conclusions: In contrast to neuroendocrine challenge studies in these same subjects, nocturnal neuroendocrine measures did not reveal any of the expected group differences. These results emphasize the contrasts between unstimulated and challenge studies of neuroendocrine secretion and of the importance of considering clinical characteristics and maturation influences in biological studies of prepubertal depression.

Original languageEnglish (US)
Pages (from-to)1130-1138
Number of pages9
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number9
StatePublished - Sep 1996


  • adrenocorticotropin (ACTH)
  • cortisol
  • growth hormone
  • prepubertal major depression
  • prolactin

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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