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July 1957

Adrenal Cortical Function in Anxious Human Subjects: Effect of Corticotropin (ACTH) on Plasma Hydrocortisone Level and Urinary Hydroxycorticoid Excretion

Author Affiliations

Chicago

From the Institute for Psychosomatic and Psychiatric Research and Training, Michael Reese Hospital.

AMA Arch NeurPsych. 1957;78(1):95-100. doi:10.1001/archneurpsyc.1957.02330370109016
Abstract

Evidence has been presented in a previous communication from this Institute that in anxious subjects the plasma level of hydrocortisone and the urinary excretion of one group of its metabolites, the hydroxycorticoids, are almost double the values found in normal persons.1 The elevation in these levels may be explained by one of two alternative hypotheses: an increased rate of production of hydrocortisone by the adrenal cortex or a diminished rate of disposal of the hormone. The rate of disappearance of hydrocortisone from plasma has been shown to be significantly faster in anxious patients than in normal subjects, and, furthermore, the anxious subject metabolized hydrocortisone in such a fashion as to produce a smaller proportion of hydroxycorticoids than the normal control subject.2 It is therefore likely that the high endogenous levels of plasma hydrocortisone and urinary hydroxycorticoids found in anxious patients are due to an increased rate of production

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