The answer of GH to GRF (1-29) in the anguish crises.

Porras, S.; Ortiz, F.; Vidal, C.; Gavilán C.; Ortuño, E.
General hospital of Elda (Alicante, ESPAÑA-UE).

Presented/displayed in the National Congress of Seville 1995.

INTRODUCTION:

In the last years it is being studied the hipofisaria answer to different stimuli and in special the one from hormone of growth (GH) in different psychiatric upheavals: anxiety, depression, TOC, alcoholism, upheavals of the nourishing conduct and suicidal conduct among others. One comes using like estimuladores: GRF, clorimipramina, mCPP, lexinosan, etc. Usually one concludes lately with the existence of a disregulación of dopaminérgicos, adrenérgicos, colinérgicos receivers and of some serotoninérgicos subtypes.

We studied the answer of GH to GRF in 27 patients diagnosed of crisis of anguish in agreement with DSM and CIE, 15 women and 12 men, before the 9 in the morning. The values of GH were determined by R.I.A to the 0, 15, 30 60 and 120 150 minutes of to have administered mcgr. of GRF i.v. The group control was of 20, 11 women and 9 men. The statistical analysis was made with the test of Wilcoxon and Mann-Whitney.

A revision became of histories with the list of groups of ítems of the SCAN to investigate the comorbidity.

Table 1. GH after stimulation with GRF in population with anguish crisis.

There were differences of no age in both groups (table 2).

Both groups showed to significant increases of GH after GRF during the first hour of the test and a significant minor answer in this time in the patients with anguish crisis (table 1 and 2), figure 1 and 2). The basal GH was of much smaller significant form in the studied sample that in the group control (table 2, figure 1) and in the women with crisis of anguish in relation to the group control of women (table 2, figure 2).

Table 2. Comparative study between population with anguish and group control

RESULTS:

Of the 24 patients with the SCAN, 87'50 % (21) had the diagnosis of upheaval of panic (CIE) or upheaval of anguish (DSM).

The upheavals of panic severe and moderate degree in CIE and the upheavals of anguish without agoraphobia in DSM suppose 62'5 % (15).

In 25 % (6) another diagnosis is associated that in general is the main one.

The diagnosis of greater depression appears in 20'83 % (5) in DSM, whereas it only appears in 8'33 % (2) in the CIE, with slight and moderate degree. Both classifications in 3 cases do not diagnose anguish or panic upheaval.

1. Women with clinic of anguish upheaval and 0'5 ng/ml or less of basal GH could constitute a clinical marker, although he would be recommendable to test of stimulation with GRF and the patients of both sexes with clinic of anguish upheaval and answer of 5 inferior GH to ng/ml in the first hour of the test after GRF could be an excellent clinical marker.

2. The depressions, the phobias and the TOC are the diagnoses that are associated more to the anguish upheavals, that nevertheless it appears like only diagnosis in a 60% of the patients (clinical impression versus SCAN retrospectively).

Table 4: Authors, Country, dose IV of GHRH, Nº of panics, Nº of controls and answer of GH.

DISCUSSION:

In table 4 it is observed that the findings of an hypoanswer of GH to GRF are the general tonic with the logics discrepancies. In our sample we have used standardized dose of 150 intravenous ms g of GRF(1-29)NH2, which supposes the greater stimulus (between 1 and 2 ms g/Kg) of the reviewed ones.

Between the results of a basal GH in women with significantly inferior crises of anguish to the controls, when not being confirmed by other authors, we must put it in group of forty and force to us to test of stimulation with GRF.

Possibly a good clinical history next to a meticulous exploration of symptoms like which it makes the SCAN with criteria DSM and CIE is not sufficient to have the certainty to find us before an anguish upheaval and is necessary, the inclusion like greater criterion, for the diagnosis of anguish upheaval, a test like which we described. Although the clinical evidence makes us put the hand in the fire and say that "ésto is an anguish crisis", and if in addition reasonably there is no a depressive upheaval, nor fóbico (excluding the agoraphobia), we suggested a normal answer of GH after GRF it orients to the diagnosis of an upheaval of generalized anxiety severe and excludes the one from anguish upheaval. In this line we continued investigating increasing the sample present and whose results are on the verge of being communicated next.

1. Rapaport, M.H.; Risch, S.C.; Gillin, J.C.; Golshan, S.; Janowsky, D.S. Blunted growth hormone response to peripheral infusion of human growth hormone-releasing factor in patients with panic to disorder. A.m.. J. Psychiat., 146 (1), 92-95, 1989.
2. Clubs, S.; Vidal, C. Respuesta of the hormone of growth to the stimulation with GRF, as marking clinical in the anguish upheavals. Rev. Psiquiat. BNA. Vol XIX, N 6, nov-dic. 1992.
3. Manuel And Tancer, M.D., Murray B. Stein, M.D. Bruce Black, M.D., and Thomas W. Uhde, M.D. Blunted growth hormone responses to growth hormone releasing factor and to clonidine in panic to disorder. A.m. J Psychiatry 1993;150:336-337.
4. Brambilla-F; Perna-G; Garberi-A; Nobile-P; Bellodi-L. Receiving Alpha 2-adrenergic sensitivit y in panic disorder: GH response to GHRH and clonidine stimulation in panic disorder. Psychoneuroendocrinology. 1995; 20 (1): 1-9.

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