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Pupil Dilation Could Be a Depression-Risk Biomarker for Adolescents Taking Therapeutic Steroids: Presented at AACAP

By Maria Bishop

BOSTON, MA -- October 26, 2007 -- A new biomarker may have been found for the increased depression risk associated with steroid treatment in adolescents, according to research presented here at the 54th Annual Meeting of the American Academy of Child & Adolescent Psychiatry (AACAP).

Recent studies have found that brain regions implicated in the aetiology of depression also control pupil dilation. The pupil dilates in conditions of cognitive and emotional processing, noted lead author Eva M. Szigethy, MD, PhD, Assistant Professor of Psychiatry and Pediatrics, Children's Hospital Pittsburgh, Pittsburgh, Pennsylvania, United States.

Dr. Szigethy and her colleagues from the University of Pittsburgh undertook a small study of 16 children aged 10 to 17 years old (mean 14.6 years) with ulcerative colitis or Crohn's disease who were attending the Children's Hospital Pittsburgh IBD Center. The children were on a therapeutic dose of 20 mg/day or more of prednisone for at least 7 days.

At the outset of the study, 44% of patients with ulcerative colitis were assessed as having major depression 2; 56% of patients with Crohn's disease were assessed as having minor depression 3.

The team investigated the effects of steroids on pupil response in this population during an emotional processing task, using a computerised pupillometer to measure pupil dilation and constriction.

Results show that there was a diminished late pupil dilation response (9 to 12 seconds) to emotional stimuli (negative words), which was more marked among children with the greatest severity of depression.

Could pupil dilation, then, be a biomarker for depression risk in physically ill youth on steroids?

"This research has already been instrumental in getting schools to implement special-education plans to help kids succeed academically when they are sick with IBD and/or on steroids," Dr. Szigethy noted.

The team has further theorised that similar brain mechanisms may mediate both steroid-induced and endogenous depression.

Dr. Szigethy has just received a prestigious Director Innovator Award from the National Institutes of Health to combine pupil measurements with brain functional magnetic resonance imaging in depressed youth with IBD before and after receiving cognitive behavioural therapy.

This research was supported by grants from the National Institutes of Mental Health and the University of Pittsburgh.


[Presentation title: Neurobiological Effects of Steroids on Youth With Inflammatory Bowel Disease. Abstract A51]

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