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September 1985

Cortisol Secretion in Endogenous DepressionII. Time-Related Functions

Author Affiliations

From the Department of Psychiatry, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY (Drs Halbreich and Asnis and Mr Shindledecker); Division of Endocrinology, Department of Medicine, Beth Israel Medical Center and Mount Sinai School of Medicine, New York City (Dr Zumoff); and Department of Psychiatry, Western Psychiatric Institute, Pittsburgh (Dr Nathan). Dr Halbreich is now with the State University of New York at Buffalo.

Arch Gen Psychiatry. 1985;42(9):909-914. doi:10.1001/archpsyc.1985.01790320081011

• 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.