Adrenal gland volume in major depression: Relationship to basal and stimulated pituitary-adrenal cortical axis function

• Published in: Biological psychiatry (1969) Vol. 40; no. 2; pp. 89 - 97
• Main Authors: Rubin, Robert T., Phillips, Jeffrey J., McCracken, James T., Sadow, Todd F.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15.07.1996; Elsevier Science
• Subjects: ACTH; Adolescent; adrenal cortex; Adrenal Cortex - pathology; Adrenal Cortex - physiopathology; Adrenal Glands - pathology; Adrenal volume; Adrenocorticotropic Hormone - blood; Adult; Adult and adolescent clinical studies; Biological and medical sciences; Corticotropin-Releasing Hormone; cortisol magnetic resonance imaging; Cosyntropin - blood; CRH; Depression; Depressive Disorder - diagnosis; Depressive Disorder - physiopathology; Depressive Disorder - psychology; Female; Humans; Hydrocortisone - blood; Hypothalamo-Hypophyseal System - physiopathology; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Mood disorders; Organ Size - physiology; Personality Inventory; pituitary gland; Pituitary-Adrenal System - physiopathology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Radioimmunoassay; CRH; ACTH; cortisol magnetic resonance imaging; pituitary gland; adrenal cortex; Adrenal volume; Human; Mood disorder; Volumetric analysis; Adrenal glands; Hypothalamohypophysoadrenal axis; ACTH-RH; Depression; Exploration; Cortisol; Glucocorticoid; Nuclear magnetic resonance imaging; Hypothalamic hormone; Adenohypophyseal hormone; Adrenal hormone; Adult; Hormone releasing factor
• ISSN: 0006-3223; 1873-2402
• DOI: 10.1016/0006-3223(95)00358-4

We measured adrenal gland volume and both baseline and stimulated pituitary and adrenal cortical hormones in 35 unmedicated, major depressives and 35 individually matched normal control subjects. Mean adrenal volume in the depressives was significantly larger, by about 38%, than the adrenal volume of their matched controls. Basal plasma adrenocorticotropic hormone (ACTH) 1–39 was significantly lower, and basal plasma cortisol was significantly higher, in the patients. In contrast, basal plasma ACTH determined by radioimmunoassay (RIA) was not significantly different between the two groups. The ACTH response to ovine corticotropin-releasing hormone (oCRH), whether measured specifically as ACTH 1–39 or by the less-specific RIA, was highly significantly lower in the depressives than in the controls. However, neither the cortisol response to oCRH nor its response to low-dose ACTH 1–24 differed significantly between groups. In both groups of subjects, correlations between adrenal gland volume and all the hormone measures were low, and none represented more than 4% shared variance. In the patients, adrenal volume did not correlate significantly with duration of the present episode, lifetime number of episodes, melancholic subtype, Hamilton Depression Scale total score, or the Hamilton suicidality item. However, adrenal volume was significantly positively related to the somatization factor of the Hamilton scale, which was almost totally accounted for by the specific items of somatic symptoms and somatic anxiety.