Clin Psychopharmacol Neurosci.  2017 May;15(2):163-169. 10.9758/cpn.2017.15.2.163.

Dehydroepiandrosterone Sulfate Level Varies Nonlinearly with Symptom Severity in Major Depressive Disorder

  • 1Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Korea.
  • 2Research Institute of Mental Health, Korea University, Korea.
  • 3Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital, Korea.
  • 4Department of Biomedical Sciences, Korea University Graduate School, Seoul, Korea.


OBJECTIVE: The pathophysiology of major depressive disorder (MDD) is still not well understood. Conflicting results for surrogate biomarkers in MDD have been reported, which might be a consequence of the heterogeneity of MDD patients. Therefore, we aim to investigate how the severity of depression and various symptom domains are related to the levels of dehydroepiandrosterone sulfate (DHEA-s) in MDD patients.
We recruited 117 subjects from a general practice. Depressive symptoms were assessed using the Beck Depression Inventory (BDI). Depressive symptoms were divided into three subdomains according to BDI items; somatic symptoms, guilt and failure, and mood and inhibition.
In subjects with very-mild-to-moderate depression, the DHEA-s level increased as BDI score did. However, the DHEA-s levels in the subjects with severe depression were significantly lower than in subjects with moderate depression (p=0.003). DHEA-s level was correlated with the BDI subscore for guilt and failure in very-mild-to-moderate depression (r=0.365, p=0.006).
The DHEA-s level appears to be indicative of MDD severity with respect to depressive symptoms, especially regarding guilt and failure. Our findings suggest that the upregulation of DHEA-s may be a part of a compensatory process in very-mild-to-moderate depression, and the failure of this compensation mechanism may underlie the development of severe depression.


Dehydroepiandrosterone sulfate; Depression; Differential diagnosis; Neuroendocrinology
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