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May 1992

Adrenal Gland Enlargement in Major DepressionA Computed Tomographic Study

Author Affiliations

From the Departments of Psychiatry (Drs Nemeroff and Krishnan and Ms Reed), Pharmacology (Dr Nemeroff), and Radiology (Drs Leder, Beam, and Dunnick), Duke University Medical Center, Durham, NC.

Arch Gen Psychiatry. 1992;49(5):384-387. doi:10.1001/archpsyc.1992.01820050048008

• To determine whether the well-documented hyperactivity of the hypothalamic-pituitary-adrenal axis in depressed patients includes adrenal gland hypertrophy, adrenal gland size was evaluated by computed tomography. Assessments consisted of (1) global ratings by two radiologists ignorant of the diagnostic identity of the subjects and (2) calculation of adrenal volume. Of the 38 patients with major depression, 12 were rated as exhibiting adrenal hypertrophy. Adrenal volumes in the depressed patients were significantly increased when compared with those of normal controls. Adrenal gland size was not correlated with dexamethasone suppression test results, patient age, duration of the depressive episode, or depression severity. These results are concordant with the hypothesis that chronic corticotropin hypersecretion in depression results in adrenocortical hypertrophy. Adrenal gland enlargement may be a measure of cumulative lifetime depression.