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September 1985, Vol 42, No. 9 >
Article | September 1985

Cortisol Secretion in Endogenous Depression: Title and subTitle BreakII. Time-Related Functions

Uriel Halbreich, MD; Gregory M. Asnis, MD; Richard Shindledecker, MA; Barnett Zumoff, MD; R. Swami Nathan, MD
[+] Author Affiliations

Accepted for publication March 26, 1985.

Read in part at the 13th Annual Meeting of the American Psychiatric Association, New Orleans, May 13, 1981, at the National Institute of Mental Health-Psychoendocrinology Workshop, Hamilton, Ontario, Canada, June 18, 1981, and at the Annual Meeting of the American College of Neuropsychopharmacology, San Juan, Puerto Rico, Dec 14, 1983, and Dec 13, 1984.

Reprint requests to Department of Psychiatry, State University of New York at Buffalo, Erie County Medical Center, K-Annex, 462 Grider St, Buffalo, NY 14215 (Dr Halbreich).


Arch Gen Psychiatry. 1985;42(9):909-914. doi:10.1001/archpsyc.1985.01790320081011
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• Plasma levels of cortisol were sampled for 24 hours in 32 endogenously depressed (ED) patients and 72 controls to examine mean 24-hour plasma levels of cortisol, intervention in the feedback mechanism of the hypothalamic-pituitaryadrenal system (the dexamethasone suppression test), the circadian rhythm of cortisol secretion and its magnitude, and the ultradian rhythm of cortisol secretion. The main difference in the pattern of cortisol secretion in ED patients, as compared with controls, was in the ultradian rhythm. No acrophase or nadir advance of cortisol secretion in endogenous depression was found when age was controlled, but there was an earlier timing of first secretory episode of cortisol (during night). Only some ED patients have abnormalities in each of the functions studied, and they only partially overlap each other. The results suggest that abnormal cortisol secretion in depression should not be viewed as a monolithic malfunction characteristic of endogenous depression.

REFERENCES

1 +
Gibbons JL, McHugh PR:  Plasma cortisol in depressive illness . J Psychiatr Res 1962;;1:162-171.
2 +
Sachar EJ, Hellman L, Roffwarg HP, Halpern FS, Fukushima DK, Gallagher TF:  Disrupted 24-hour patterns of cortisol secretion in psychotic depression . Arch Gen Psychiatry 1973;;28:19-24.
3 +
Carroll BJ, Curtis GC, Mendels J:  Neuroendocrine regulation in depression: I. Limbic system-adrenocortical dysfunction . Arch Gen Psychiatry 1976;;33:1039-1044.
4 +
Carroll BJ, Curtis GC, Mendels J:  Neuroendocrine regulation in depression: II. Discrimination of depressed from nondepressed patients . Arch Gen Psychiatry 1976;;33:1051-1058.
5 +
Schlesser MA, Winokur G, Sherman BM:  Hypothalamic-pituitaryadrenal axis activity in depressive illness: Its relationship to classification . Arch Gen Psychiatry 1980;;37:737-743.
6 +
Carroll BJ, Feinberg M, Greden JF, Tarika J, Albala AA, Haskett RF, James NM, Kronfol Z, Lohr N, Steiner M, de Vigne JP, Young E:  A specific laboratory test for the diagnosis of melancholia: Standardization, validation, and clinical utility . Arch Gen Psychiatry 1981;;38:15-22.
7 +
Stokes PE, Stoll PM, Koslow SH, Maas JW, Davis JM, Swann AC, Robins SE:  Pretreatment DST and hypothalamic-pituitary-adrenocortical function in depressed patients and comparison groups: A multicenter study . Arch Gen Psychiatry 1984;;41:257-266.
8 +
Halbreich U, Asnis GM, Shindledecker R, Zumoff B, Nathan RS:  Cortisol secretion in endogenous depression: I. Basal plasma levels . Arch Gen Psychiatry 1985;;42:904-908.
9 +
Halberg F, Vestergaard P, Sakai M:  Rhythmometry on urinary 17-ketosteroid excretion by healthy men and women and patients with chronic schizophrenia: Possible chronopathology in depressive illness . Arch Anat Histol Embryol 1968;;51:301-311.
10 +
Lohrenz FN, Fullerton DT, Wenzel FJ, Chosy JJ, Dickson KB, Reincke L:  Circadian rhythm of adrenal cortical activity in depression . Behav Neuropsychiatry 1969;;1:10-13.
11 +
Green R:  Morning and afternoon plasma 17-hydroxycorticosteroid levels during affective psychosis . Int J Neurol Psychiatry 1967;;2:133-137.
12 +
McClure DJ:  The diurnal variation of plasma cortisol levels in depression . J Psychosom Res 1966;;10:189-195.
13 +
Yamashita I, Morojoi T, Yamazaki K, Koto H, Sakashita A, Onodera I, Ho K, Okada F, Saito Y, Tamakus Li M, Suma N:  Neuroendocrinological studies in mental disorders and psychotropic drugs: I. On the circadian rhythm of plasma adrenocortical hormone in mental patients and metamphetamine and chloropromazine-treated animals . Folia Psychiatr Neurol Jpn 1969;;23:143-158.
14 +
Fullerton DT, Wenzel FJ, Lohrenz FN:  Circadian rhythm of adrenal cortisol activity in depression: I. A comparison of depressed patients with normal subjects . Arch Gen Psychiatry 1968;;19:674-681.
15 +
Wehr TA, Goodwin FK (eds): Circadian Rhythms in Psychiatry . Pacific Grove, Calif, Boxwood Press, 1983;.
16 +
Weitzman ED, Fukushima D, Nogeire C, Roffwarg H, Gallagher TF, Hellman L:  Twenty-four hour pattern of the episodic secretion of cortisol in normal subjects . J Clin Endocrinol Metabol 1971;;33:14-22.
17 +
Hellman L, Nakada F, Curti J, Weitzman ED, Kream J, Roffwarg H, Ellman S, Fukushima DK, Gallagher TF:  Cortisol is secreted episodically by normal man . J Clin Endocrinol Metabol 1970;;30:411-422.
18 +
Nelson W, Liang Ton Y, Jung-Kuen L, Halberg F:  Methods for cosinor-rhythmometry . Chronobiologia 1979;;6:305-323.
19 +
Gottman JM: Time-Series Analysis . New York, Cambridge University Press, 1981;.
20 +
Halberg F:  Physiologic considerations underlying rhythmometry with special reference to emotional illness , in de Ajuriaguerra F (ed): Cycles Biologique et Psychiatric . Paris, Mason et Cie, 1968;, pp 73-126.
21 +
Yamaguchi N, Maeda K, Kuromaru S:  The effects of sleep deprivation on the circadian rhythm of plasma cortisol levels in depressive patients . Folia Psychiatr Neurol Jpn 1978;;32:479-487.
22 +
Gelenberg AJ, Klerman GL, Hartman EL, Salt P:  Recurrent unipolar depressions with a 48 hour cycle: Report of a case . Br J Psychiatry 1978;; 133:123-129.
23 +
Doerr P, von Zerssen D, Fischler M, Schulz H:  Relationship between mood changes and adrenal cortisol activity in a patient with 48 hour unipolar depressive cycles . J Affective Disord 1979;;1:93-104.
24 +
Weitzman ED, Czeisler CA, Moor-Ele MC: Sleep-wake, endocrine, and temperature rhythms in man during temporal isolation, in Johnson LC, Tepas DI, Colguhoun WP, Culligan MJ (eds):  Advances in Sleep Research . New York, SP Medical and Scientific Books, 1979;, vol 7: Biological Rhythms, Sleep, and Shift Work , pp 75-93.
25 +
Kripke DF, Mullaney DJ, Atkinson ML, Huey LY, Hubard B:  Circadian rhythm phases in affective illness . Chronobiologia 1979;;6:365-374.
26 +
Jarrett DB, Coble PA, Kupfer DJ:  Reduced cortisol latency in depressive illness . Arch Gen Psychiatry 1983;;40:506-511.
27 +
Keller-Wood ME, Dallman MF:  Corticosteroid inhibition of ACTH secretion . Endocr Rev 1984;;5:1-24.
28 +
Asnis GM, Sachar EJ, Halbreich U, Nathan RS, Halpern FS:  Cortisol secretion and dexamethasone response in depression . Am J Psychiatry 1981;;138:1218-1221.
29 +
Brown WA, Keitner G, Qualls B, Haier R:  The dexamethasone suppression test and pituitary-adrenocortical function . Arch Gen Psychiatry 1985;;42:121-123.
30 +
Holsboer F, Gerken A, Steiger A, Fass V:  Mean 14.00-17.00 h plasma cortisol concentration and its relationship to the 1-mg dexamethasone suppression response in depressives and controls . Acta Psychiatr Scand 1984;;69:383-390.

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1 +
Gibbons JL, McHugh PR:  Plasma cortisol in depressive illness . J Psychiatr Res 1962;;1:162-171.
2 +
Sachar EJ, Hellman L, Roffwarg HP, Halpern FS, Fukushima DK, Gallagher TF:  Disrupted 24-hour patterns of cortisol secretion in psychotic depression . Arch Gen Psychiatry 1973;;28:19-24.
3 +
Carroll BJ, Curtis GC, Mendels J:  Neuroendocrine regulation in depression: I. Limbic system-adrenocortical dysfunction . Arch Gen Psychiatry 1976;;33:1039-1044.
4 +
Carroll BJ, Curtis GC, Mendels J:  Neuroendocrine regulation in depression: II. Discrimination of depressed from nondepressed patients . Arch Gen Psychiatry 1976;;33:1051-1058.
5 +
Schlesser MA, Winokur G, Sherman BM:  Hypothalamic-pituitaryadrenal axis activity in depressive illness: Its relationship to classification . Arch Gen Psychiatry 1980;;37:737-743.
6 +
Carroll BJ, Feinberg M, Greden JF, Tarika J, Albala AA, Haskett RF, James NM, Kronfol Z, Lohr N, Steiner M, de Vigne JP, Young E:  A specific laboratory test for the diagnosis of melancholia: Standardization, validation, and clinical utility . Arch Gen Psychiatry 1981;;38:15-22.
7 +
Stokes PE, Stoll PM, Koslow SH, Maas JW, Davis JM, Swann AC, Robins SE:  Pretreatment DST and hypothalamic-pituitary-adrenocortical function in depressed patients and comparison groups: A multicenter study . Arch Gen Psychiatry 1984;;41:257-266.
8 +
Halbreich U, Asnis GM, Shindledecker R, Zumoff B, Nathan RS:  Cortisol secretion in endogenous depression: I. Basal plasma levels . Arch Gen Psychiatry 1985;;42:904-908.
9 +
Halberg F, Vestergaard P, Sakai M:  Rhythmometry on urinary 17-ketosteroid excretion by healthy men and women and patients with chronic schizophrenia: Possible chronopathology in depressive illness . Arch Anat Histol Embryol 1968;;51:301-311.
10 +
Lohrenz FN, Fullerton DT, Wenzel FJ, Chosy JJ, Dickson KB, Reincke L:  Circadian rhythm of adrenal cortical activity in depression . Behav Neuropsychiatry 1969;;1:10-13.
11 +
Green R:  Morning and afternoon plasma 17-hydroxycorticosteroid levels during affective psychosis . Int J Neurol Psychiatry 1967;;2:133-137.
12 +
McClure DJ:  The diurnal variation of plasma cortisol levels in depression . J Psychosom Res 1966;;10:189-195.
13 +
Yamashita I, Morojoi T, Yamazaki K, Koto H, Sakashita A, Onodera I, Ho K, Okada F, Saito Y, Tamakus Li M, Suma N:  Neuroendocrinological studies in mental disorders and psychotropic drugs: I. On the circadian rhythm of plasma adrenocortical hormone in mental patients and metamphetamine and chloropromazine-treated animals . Folia Psychiatr Neurol Jpn 1969;;23:143-158.
14 +
Fullerton DT, Wenzel FJ, Lohrenz FN:  Circadian rhythm of adrenal cortisol activity in depression: I. A comparison of depressed patients with normal subjects . Arch Gen Psychiatry 1968;;19:674-681.
15 +
Wehr TA, Goodwin FK (eds): Circadian Rhythms in Psychiatry . Pacific Grove, Calif, Boxwood Press, 1983;.
16 +
Weitzman ED, Fukushima D, Nogeire C, Roffwarg H, Gallagher TF, Hellman L:  Twenty-four hour pattern of the episodic secretion of cortisol in normal subjects . J Clin Endocrinol Metabol 1971;;33:14-22.
17 +
Hellman L, Nakada F, Curti J, Weitzman ED, Kream J, Roffwarg H, Ellman S, Fukushima DK, Gallagher TF:  Cortisol is secreted episodically by normal man . J Clin Endocrinol Metabol 1970;;30:411-422.
18 +
Nelson W, Liang Ton Y, Jung-Kuen L, Halberg F:  Methods for cosinor-rhythmometry . Chronobiologia 1979;;6:305-323.
19 +
Gottman JM: Time-Series Analysis . New York, Cambridge University Press, 1981;.
20 +
Halberg F:  Physiologic considerations underlying rhythmometry with special reference to emotional illness , in de Ajuriaguerra F (ed): Cycles Biologique et Psychiatric . Paris, Mason et Cie, 1968;, pp 73-126.
21 +
Yamaguchi N, Maeda K, Kuromaru S:  The effects of sleep deprivation on the circadian rhythm of plasma cortisol levels in depressive patients . Folia Psychiatr Neurol Jpn 1978;;32:479-487.
22 +
Gelenberg AJ, Klerman GL, Hartman EL, Salt P:  Recurrent unipolar depressions with a 48 hour cycle: Report of a case . Br J Psychiatry 1978;; 133:123-129.
23 +
Doerr P, von Zerssen D, Fischler M, Schulz H:  Relationship between mood changes and adrenal cortisol activity in a patient with 48 hour unipolar depressive cycles . J Affective Disord 1979;;1:93-104.
24 +
Weitzman ED, Czeisler CA, Moor-Ele MC: Sleep-wake, endocrine, and temperature rhythms in man during temporal isolation, in Johnson LC, Tepas DI, Colguhoun WP, Culligan MJ (eds):  Advances in Sleep Research . New York, SP Medical and Scientific Books, 1979;, vol 7: Biological Rhythms, Sleep, and Shift Work , pp 75-93.
25 +
Kripke DF, Mullaney DJ, Atkinson ML, Huey LY, Hubard B:  Circadian rhythm phases in affective illness . Chronobiologia 1979;;6:365-374.
26 +
Jarrett DB, Coble PA, Kupfer DJ:  Reduced cortisol latency in depressive illness . Arch Gen Psychiatry 1983;;40:506-511.
27 +
Keller-Wood ME, Dallman MF:  Corticosteroid inhibition of ACTH secretion . Endocr Rev 1984;;5:1-24.
28 +
Asnis GM, Sachar EJ, Halbreich U, Nathan RS, Halpern FS:  Cortisol secretion and dexamethasone response in depression . Am J Psychiatry 1981;;138:1218-1221.
29 +
Brown WA, Keitner G, Qualls B, Haier R:  The dexamethasone suppression test and pituitary-adrenocortical function . Arch Gen Psychiatry 1985;;42:121-123.
30 +
Holsboer F, Gerken A, Steiger A, Fass V:  Mean 14.00-17.00 h plasma cortisol concentration and its relationship to the 1-mg dexamethasone suppression response in depressives and controls . Acta Psychiatr Scand 1984;;69:383-390.

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