Steroid Excretion in Depressive Disorders

Abstract
The occurrence of symptoms of psychiatric depression in states of adrenocortical hypofunction (Addison's disease) is well documented in standard medical texts.1,2 Euphoria, mental elation, despondency, irritability, and insomnia frequently have been found in patients with adrenocortical hyperfunction (Cushing's disease)1-3 and in those undergoing cortisone and corticotropin therapy.4-8 Glaser3 reported that 40% of patients with spontaneous Cushing's syndrome and 36% of those treated with corticotropin or cortisone for an average of 14.6 months developed psychiatric disturbances. Emotional stress produced by anxiety-provoking real-life and experimental situations has been shown to increase plasma and urinary levels of 17-hydroxycorticosteroids (17-OHCS).9-14 Persky15 demonstrated that the rates of production and removal of plasma 17-OHCS were almost twice as great for anxious patients as for normal subjects. Adrenocortical functioning in schizophrenic patients has been studied extensively. Hoagland,16 in a recent comprehensive