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January 12, 1963

Correlation of Anxiety and Hostility With Adrenocortical FunctionStudy of Two Psychologic Variables in Patients With Lung Cancer

JAMA. 1963;183(2):113-114. doi:10.1001/jama.1963.63700020012013b

DURING THE COURSE of their disease, patients with bronchogenic carcinoma manifest adrenocortical hyperfunction as measured by several parameters. One of the most notable indices of this hyperactivity appears to be the concentration of morning plasma unconjugated 17-hydroxycorticosteroids (17-OHCS) which increase as the disease progresses and the interval to death shortens. Although several metabolic aspects might be suspected of influencing the adrenocortical status of these seriously ill patients, a possible factor to be considered is their emotional state, as numerous studies of patients with cancer have indicated a wide range of emotional response. Of the many emotional factors to be considered, anxiety has been most closely associated with changes in adrenocortical function,1, 2 probably through neuroendocrine pathways affecting corticotrophin release.

The purpose of the present study has been to explore this possible relationship by correlating plasma 17-OHCS levels with anxiety in patients with and without lung cancer. The factor