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May 1967

Pituitary Adrenal Function and Depression: An Outline for Research

Author Affiliations

Chicago; Bethesda, Md
From the Illinois State Psychiatric Institute and the Department of Psychiatry, University of Illinois School of Medicine, Chicago (Dr. Fawcett); and the Depression Project, Adult Psychiatry Branch, National Institute of Mental Health, Bethesda, Md (Dr. Bunney).

Arch Gen Psychiatry. 1967;16(5):517-535. doi:10.1001/archpsyc.1967.01730230001001

OVER the past two decades, since Selye1 introduced the concept of the "general adaptation syndrome," an impressive body of psychoendocrine studies has described increased 17-hydroxycorticosteroid (17-OHCS) excretion and elevated plasma 17-OHCS levels in association with psychological responses to both naturally occurring and experimentally contrived stress situations. Relatively greater and more sustained increases in indices of pituitary adrenal function have been well documented in some severely depressed patients.

The potential now exists to pursue a new level of investigation of the role of pituitary adrenal function in depression, and perhaps in a broader sense, in human behavior. This paper reviews current data relating depression and pituitary adrenal function and proposes an outline for future research in this field. A consideration of the relationship of steroid metabolism to depression suggests three overall questions. (1) Is there evidence that a consistent significant alteration

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