Hostname: page-component-76fb5796d-dfsvx Total loading time: 0 Render date: 2024-04-29T08:41:43.870Z Has data issue: false hasContentIssue false
  • English
  • Français

Raised Plasma Cortisol Concentrations a Feature of Drug-Free Psychotics and not Specific for Depression

Published online by Cambridge University Press:  29 January 2018

Janice E. Christie ,
Lawrence J. Whalley ,
Heinz Dick ,
Douglas M. R. Blackwood ,
Ivy M. Blackburn  and
George Fink
Janice E. Christie*
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF
Lawrence J. Whalley
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF
Heinz Dick
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF
Douglas M. R. Blackwood
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF
Ivy M. Blackburn
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF
George Fink
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF
*
Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

To determine whether high plasma cortisol concentrations are a distinctive feature of depression or whether plasma cortisol is also elevated in other forms of psychosis, cortisol concentrations were measured in 59 patients with acute functional psychoses, six non-psychotic depressed patients and 37 control subjects, all free of antidepressant and neuroleptic drugs for at least three months. Patients with schizoaffective disorder, manic type, had the highest concentrations throughout the day and those with major depressive disorder, psychotic sub-type had higher concentrations than controls in the afternoon and evening. Manic and schizophrenic patients had cortisol concentrations above controls in the afternoon only. Elevated concentrations were not related to the presence of depressed mood or to duration of stay in hospital, and a return to normal occurred irrespective of the type of treatment used. Thus raised plasma cortisol concentrations are a feature of psychotic illness, but in drug-free patients are not specific for severe depression.

Type
Papers
Information
The British Journal of Psychiatry , Volume 148 , Issue 1 , January 1986 , pp. 58 - 65
Copyright
Copyright © 1986 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barnes, R. F., Veith, R. C., Borson, S., Verhey, J., Raskind, M. A. & Halter, J. B. (1983) High levels of plasma catecholamines in dexamethasone-resisant depressed. American Journal of Psychiatry, 140, 1623–1623.Google ScholarPubMed
Blackburn, I. M. Loudon, J. B. & Ashworth, C. M. (1977) A new scale for measuring mania. Psychological Medicine, 7, 453–458.CrossRefGoogle ScholarPubMed
Buckingham, J. C. (1980) Corticotrophin releasing factor, Pharmacological Reviews, 31, 253–275.Google Scholar
Carpenter, W. T. Jr. & Bunney, W. E. (1971) Adrenal cortical activity in depressive illness. American Journal of Psychiatry, 128, 31–40.Google Scholar
Carroll, B. J., Curtis, G. C. & Mendels, J. (1976) Neuroendocrine regulation in depression I. limbic system-adrenocortical dysfunction. Archives of General Psychiatry. 33, 1039–1044.Google Scholar
Feinberg, M., Greden, J. F., Tarika, J., Albala, A. A., Haskett, R. F., el al (1981) A specific laboratory test for the diagnosis of melancholia. Archives of General Psychiatry, 38, 15–22.Google Scholar
Checkley, S. A. & Crammer, J. L. (1977) Hormone responses to methyl-amphetamine in depression: A new approach to the noradrenaline depletion hypothesis. British Journal of Psychiatry. 131, 582–586.Google Scholar
Christie, J. E., Whalley, L. J., Brown, N. S. & Dick, H. (1982) Effect of ECT on the neuroendocrine response to apomorphine in severely depressed patients. British Journal of Psychiatry, 140, 268–273.Google Scholar
Coppen, A., Abou-Saleh, M., Milln, P., Metcalfe, M., Harwood, J. & Bailey, J. (1983) Dexamethasone suppression test in depression and other psychiatric illness. British Journal of Psychiatry, 142, 498–504.Google Scholar
Duncan, D. B. (1961) Bayes rules for a common multiple comparisons problem and related student-t problems. Annals of Mathematical Statistics, 32, 1013.Google Scholar
Elias, A. N., Lubomir, J. V., Szekeres, A. V. & Grossman, M. K. (1982) Regulatory role of gamma-aminobutyric acid in pituitary hormone secretion. Psychoneuroendocrinology, 7, 15–30.Google Scholar
Feighner, J. P., Robins, E. Guze, S. B., Woodruff, R. A., Winokur, G., & Munoz, M. D. (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 57–63.Google Scholar
Feinberc, M., Greden, J. F. & Carroll, B. J. (1981) the effect of amphetamine on plasma Cortisol in patients with endogenous and non-endogenous depression. Psychoneuroendocrinology, 6, 355–357.CrossRefGoogle Scholar
Gibbons, J. (1964) Cortisol secretion rate in depressive illness. Archives of General Psychiatry, 10, 572–575.Google Scholar
Graham, P. M., Booth, J., Boranga, G., Galhenage, S., Myers, C. M., Tech, C. L. & Cox, L. S. (1982) The dexamethasone suppression test m mania. Journal of Affective Disorders, 4, 201–211.Google Scholar
Hamilton, M. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–62.Google Scholar
Jimerson, D. C. Insel, T. R., Reus, V. I. & Kopin, D. J. (1983) Increased plasma MHPG related to dexamethasone-resistant depressed patients. Archives of General Psychiatry, 40, 173–176.CrossRefGoogle ScholarPubMed
Kendell, R. (1982) The choice of diagnostic criteria for biological research. Archives of General Psychiatry, 39, 1334–1339.Google Scholar
Koslov, S. H., Maas, J. W., Bowden, C., Davis, J. M., Hanin, I. & Javaid, J. (1983) CSF and urinary biogenic amines and metabolites in depression and mania. Archives of General Psychiatry, 40, 999–1010.Google Scholar
Mezey, E., Reisine, T. D., Palkovits, M., Brownstein, M. J. & Axelrod, J. (1983) Direct stimulation of-adrenergic receptors in rat anterior pituitary induces the release of adrenocorticotropin in vivo. Proceedings of the National Academy of Sciences, USA, 80, 6728–6731.Google Scholar
Overall, J. E. & Gorham, D. R. (1962) The brief psychiatric rating scale. Psychological Reports. 10, 799–812.Google Scholar
Rasklnd, M., Peskind, E., Rivard, M. F., Veitch, R. & Barnes, R. (1982) Dexamethasone Suppression Test and Cortisol circadian rhythm in primary degenerative dementia. American Journal of Psychiatry. 139, 1468–1471.Google Scholar
Rivier, C. & Vale, W. (1983) Modulation of stress-induced ACTH release by corticotropin-rdeasing factor, catecholamines and vasopressin. Nature. 305, 325–327.Google Scholar
Rubin, R. T., Poland, R. E., Bodgett, A. L. N., Winston, R. A., Forster, B. & Carroll, B. J. (1980) Cortisol dynamics and dexamethasone pharmacokinetics in primary endogenous depression; preliminary findings. In Cortisol Progress in Psychoneuroendocrinology (eds. Brambilla, F., Racagni, G. & de Wied, D.). Amsterdam: Elsevier/North Holland.Google Scholar
Sachar, E. J. (1967) Corticosteroids in depressive illness. Archives of General Psychiatry. 17, 544–567.Google Scholar
Sachar, E. J., Asnis, G., Nathan, R. S., Halbreich, U., Tabrizi, M. A. & Halpern, S. S. (1980) Dextroamphetamine and Cortisol in depression: Morning plasma Cortisol levels suppressed. Archives of General Psychiatry. 37, 755–757.Google Scholar
Hellman, L., Roffwarg, H. P., Halpern, F., Fukushima, S. & Gallagher, T. (1973) Disrupted 24-hour patterns of Cortisol secretion in psychotic depression. Archives of General Psychiatry, 28, 29–44.Google Scholar
Seth, J. & Brown, L. M. (1978) A simple radioimmunoassay for plasma Cortisol. Clinica Chemica Acta, 86, 109–120.Google Scholar
Schildkraut, J. J., Orsulak, P. J., Schatzberg, A. F., Gudeman, J. E., Cole, J. O., Rohde, W. A. & La Brie, R. A. (1978) Towards a biochemical classification of depressive disorders, 1. Differences in urinary excretion of MHPG and othere catecholamine metabolites in clinically defined subtypes of depressions. Archives of General Psychiatry, 35, 1427–1433.Google Scholar
Siever, L. J., Uhde, T. W., Jimerson, D. C., Post, R. M., Lake, C. R., & Murphy, D. L. (1984) Plasma Cortisol responses to Clonidine in depressed patients and controls. Archives of General Psychiatry, 41, 63–68.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria (RDC) for a selected group of functional disorders, 3rd edition. Biometrics Research New York State, New York.Google Scholar
Stokes, P. E., Stoll, P. M., Koslov, S. H., Maas, J. W., Davis, J. M., Swann, A. C. & Robins, E. (1984a) Pretreatment DST and hypothalamic-pituitary-adrenoconical function in depressed patients and comparison groups: A multicenter study. Archives of General Psychiatry, 41, 257–267.Google Scholar
Swann, A. C., Koslov, S., Swann, A., Stoll, P., Maas, J., Kocsis, J. & Jawaid, J. (1984b) Neurochemical/neuroendocrine interactions in depression and mania. Clinical Neuropharmacology, 7, Suppl. 1. 836–837.Google Scholar
Swigar, M. E., Kolakowska, T. & Quinlan, D. M. (1979) Plasma Cortisol levels in depression and other psychiatric disorders: a study of newly admitted psychiatric patients. Psychological Medicine, 9, 449–455.Google Scholar
Weiner, R. I. & Ganong, W. F. (1978) Role of brain monoamines and histamine in regulation of anterior pituitary secretion. Physiological Reviews, 58, 905–975.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. London: Cambridge University Press.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.