Birmaher et al1 separated adolescents
into those at high and low risk for affective disorders on the basis of family
history and have demonstrated that those at high risk have a relatively attenuated
growth hormone (GH) response to GH–releasing hormone (GHRH). We propose
that rather than being a "trait marker for depression," these data reflect
hypothalamic-pituitary-adrenal axis dysfunction that has been demonstrated
in patients with high familial loading for affective disorders.2
This view is also supported by preliminary evidence that variations in steroid
function, particularly dehydroepiandrosterone levels, predict subsequent depression
in adolescents.3