Pituitary Adrenal Function and Depression

Fawcett, Jan

doi:10.1001/archpsyc.1967.01730230001001

Cited by 76 publications

(11 citation statements)

References 93 publications

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“…This has suggested to some investigators (22) that small changes in plasma cortisol levels might significantly change the steroid concentration in the human brain. A considerable amount of knowledge now indicates that depressive illness per se does not cause the adrenocortical overactivity that was concluded from earlier studies and that overactivity, if it does occur, is most probably due to the presence of anxiety brought on by emotional stresses.…”

mentioning

confidence: 99%

Suppression Studies in Affective Disorders

McClure

Cleghorn

1968

Canadian Psychiatric Association Journal

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confidence: 99%

Suppression Studies in Affective Disorders

McClure

Cleghorn

1968

Canadian Psychiatric Association Journal

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“…Raised midnight levels have been reported in stressed patients, and in particular in patients suffering from depression (Fawcett and Bunney, 1967;Butler and Besser, 1968;Carroll, Martin, and Davies, 1968). It is possible that the occasional raised midnight levels found in the obese and hirsute patients was the result of the mental stress of admission to hospital.…”

Section: Discussionmentioning

confidence: 99%

Plasma and Urinary 11-Hydroxycorticosteroids in Differential Diagnosis of Cushing's Syndrome

Mattingly¹,

Tyler²

1972

BMJ

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SummaryMorning plasma 1l-hydroxycorticoids, urinary 11-hydroxycorticoids, and urinary 17-oxogenic steroids were measured before and during a dexamethasone suppression test. This consisted in the administration by mouth of 2 mg of dexamethasone daily for 48 hours, followed by 8 mg daily for 48 hours. In addition midnight plasma li-hydroxycorticoids were measured before the start of the test. The subjects investigated were 21 patients with Cushing's syndrome, 27 obese female patients, 10 female patients with the Stein-Leventhal syndrome, and 8 female patients with idiopathic hirsutism.The results showed that the clearest distinction between the groups was made by measurement of the basal urinary l1-hydroxycorticoid excretion, where, in the group of patients with Cushing's syndrome, all the levels were well above the upper limit of normal. In addition raised midnight plasma 11-hydroxycorticoid levels were of great diagnostic value. By using these results together with those of the dexamethasone suppression tests it was possible to make a firm preoperative diagnosis of pituitary-dependent Cushing's syndrome in 90% of patients in this series. IntroductionWe have already shown the value of estimations of free urinary 11-hydroxycorticosteroids (11-OHCS) as a simple screening test for Cushing's syndrome (Mattingly and Tyler, 1967). The present paper describes an extension of this work in which plasma and urinary li-OHCS estimations were used both at rest and during a dexamethasone suppression test.Although suppression tests are widely used in investigating patients with suspected Cushing's syndrome, the dose and nature of the steroid used varies from test to test, and the methods of measuring the adrenal response are also different (Cope, 1956;Liddle, 1960;Slater et al., 1962;Nugent, Nichols, and Tyler, 1965;McHardy-Young et al., 1967;Hartog et al., 1968). In this investigation we followed the procedure first described by Liddle (1960) and measured the adrenal response after dexamethasone given by mouth for a period of 48 hours at each of two dose levels. In addition to plasma and urinary ll-OHCS levels we also measured urinary 17-oxogenic steroid (17-OGS) excretion as an index of adrenal suppression, in contrast to Liddle who measured only the urinary 17-hydroxycorticosteroids. Twenty-one patients with Cushing's syndrome were investigated in this way and the results are compared with those found in obese and hirsute patients.

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“…1966), the significance of these findings has been questioned (Brooksbank and Coppen 1967;Sachar 1967). Earlier studies of the relationship between pituitary adrenal function and depression have been reviewed in some detail by Fawcett and Bunney (1967). A particularly well-planned investi- (9) 7S±6l (9) Recovered 13S±126 (9) lS9±l08 (9)2 100±49 (9) Mean l43± 9S (9)3 lSS± SO (9) 4 82±2l (9) Not with Endogenous Depression III 29± 14 (9)1 6S± 40 (9) 86±Sl (9) Recovered 40± 26 (7) 62± 31 (7)2 97±Sl (7) Mean 3S± 17 (7)3 6S± 29 (7) 4 92±46 (7) All determinations are in ~moles.…”

Section: Discussionmentioning

confidence: 99%

“…One can only speculate about the analogy these changes may bear to depression or to such other affective states as anxiety. Adrenocortical steroid hormones, electrolytes, and catecholamines have all been implicated as being associated with alterations in mood and behavior, particularly mania and depression, and each of these areas has been the focus of a great deal of investigative effort Fawcett and Bunney 1967;Williams, Katz, and Shield 1969;Gibbons 1963). In general, however, each group of investigators have pursued their "own thing," and there have been only a limited number of attempts at establishing interrelationships (Baer e.t at.…”

Section: Treatmentmentioning

confidence: 99%

Brain Chemistry and Mental Disease

Ho¹,

McIsaac²

1971

Advances in Behavioral Biology

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PREFACEThis volume contains the proceedings of the fourth international symposium held in November 1970 at the Texas Research Institute of Mental Sciences in Houston. Leading psychiatrists, biochemists, and pharmacologists from the United States and Great Britain presented new material and reviewed current concepts concerning schizophrenia and the affective disorders, with particular reference to the neurochemical basis of the etiology and chemotherapy of these diseases.Although the multiple mechanisms of mental disease are still not fully understood, substantial progress has definitely been made. The greatest contribution has come through the development of new therapeutic agents that not only provide invaluable help to the mentally ill but serve as chemical tools for studying the biological mechanisms associated with the disease state. Studies concerning the proposed catecholamine and indolealkylamine hypotheses for affective disorders and the possible formation of endogenous. toxins in schizophrenia have stimulated significant new research.This book presents new studies of schizophrenia and the affective disorders in one volume. It is our hope that it represents an effective integration of basic biochemical and pharmacological research with current clinical findings and that it will increase understanding of the etiology of mental disease and provide an impetus for the development of more effective therapeutic agents.We thank Drs.

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Pituitary Adrenal Function and Depression

Cited by 76 publications

References 93 publications

Suppression Studies in Affective Disorders

Suppression Studies in Affective Disorders

Plasma and Urinary 11-Hydroxycorticosteroids in Differential Diagnosis of Cushing's Syndrome

Brain Chemistry and Mental Disease

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