We appreciate the comments of McCrank and Schaefer concerning our work.1 We read with interest their results with adrenal weight measurements in coroners' cases in Ontario. Their inability to replicate the findings of Zis and Zis,2 of in- creased adrenal weights in subjects who had committed violent suicide, is of interest. Close scrutiny, however, indicates that their findings really do not contradict ours. It is well established that not all subjects who commit suicide meet diagnostic criteria for major depression. Pathological activation of the pituitary-adrenal axis has primarily been associated with the presence of depression and not with that of suicide per se; thus, the discrepancy between our findings and those of McCrank and Schaefer could be due to the absence of melancholia and other forms of severe depression in their population.
They found the overall weight of the adrenal glands to be higher than that reported in
Nemeroff CB, Krishnan KRR, Dunnick NR. The Adrenal Gland and Depression-Reply. Arch Gen Psychiatry. 1993;50(10):832-833. doi:10.1001/archpsyc.1993.01820220088011