Hostname: page-component-8448b6f56d-jr42d Total loading time: 0 Render date: 2024-04-23T16:43:25.041Z Has data issue: false hasContentIssue false
  • English
  • Français

Urinary free Cortisol excretion in depression

Published online by Cambridge University Press:  09 July 2009

Bernard J. Carroll ,
George C. Curtis ,
B. M. Davies ,
J. Mendels  and
A. Arthur Sugerman
Bernard J. Carroll
Affiliation:
University of Michigan, Ann Arbor, the University of Melbourne, Parkville, Victoria, Australia, the Veterans Administration Hospital, Philadelphia, the Carrier Clinic, Belle Mead, N.J.
George C. Curtis
Affiliation:
University of Michigan, Ann Arbor, the University of Melbourne, Parkville, Victoria, Australia, the Veterans Administration Hospital, Philadelphia, the Carrier Clinic, Belle Mead, N.J.
B. M. Davies
Affiliation:
University of Michigan, Ann Arbor, the University of Melbourne, Parkville, Victoria, Australia, the Veterans Administration Hospital, Philadelphia, the Carrier Clinic, Belle Mead, N.J.
J. Mendels
Affiliation:
University of Michigan, Ann Arbor, the University of Melbourne, Parkville, Victoria, Australia, the Veterans Administration Hospital, Philadelphia, the Carrier Clinic, Belle Mead, N.J.
A. Arthur Sugerman
Affiliation:
University of Michigan, Ann Arbor, the University of Melbourne, Parkville, Victoria, Australia, the Veterans Administration Hospital, Philadelphia, the Carrier Clinic, Belle Mead, N.J.
Get access Rights & Permissions [Opens in a new window]

Synopsis

Urinary free Cortisol (UFC) excretion was determined in 60 depressed inpatients and in 35 psychiatric inpatients with other disorders. The depressed patients had high daily UFC values, while the other patients excreted normal amounts. Over 40% of the depressed patients had UFC excretions in the range seen in Cushing's disease, while only 6% of the other patients excreted such high amounts of Cortisol. Age and sex differences did not account for the results. Among the depressed patients those with depressive neuroses excreted less than unipolar or bipolar depressives. Following treatment, more normal UFC excretion was found in depressed patients. The estimation of UFC and its clinical utility are discussed in detail. UFC determination is a simple and informative indicator of adrenal cortical activation and its application to psychoendocrine studies is recommended.

Type
Research Article
Information
Psychological Medicine , Volume 6 , Issue 1 , February 1976 , pp. 43 - 50
Copyright
Copyright © Cambridge University Press 1976

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Beardweil, G. C., Burke, C. W. & Cope, C. L. (1968). Urinary free Cortisol measured by competitive protein binding. Journal of Endocrinology 42, 79–89.CrossRefGoogle Scholar
Beisel, W. R., Cos, J. J., Horton, R., Chao, P. Y. & Forsham, P. H. (1964). Physiology of urinary Cortisol excretion. Journal of Clinical Endocrinology 24, 887–893.CrossRefGoogle ScholarPubMed
Burke, C. W. & Roulet, F. (1970). Increased exposure of tissues to cortisol in late pregnancy. British Medical Journal 1, 657–659.CrossRefGoogle ScholarPubMed
Butler, P. W. P. & Besser, G. M. (1968). Pituitary—adrenal function in severe depressive illness. Lancet 2, 1234–1236.CrossRefGoogle Scholar
Carpenter, W. T. & Bunney, W. E. (1971). Adrenal cortical activity in depressive illness. American Journal of Psychiatry 128, 31–40.CrossRefGoogle ScholarPubMed
Carroll, B. J. (1972). The hypothalamic–pituitary–adrenal axis in depression. In Davies, B. et al. (eds.), Depressive Illness: Some Research Studies. Thomas: Springfield, Ill.Google Scholar
Cope, C. L. & Black, E. G. (1959). The reliability of some adrenal function tests. British Medical Journal 2, 1117–1122.CrossRefGoogle ScholarPubMed
Cope, C. L. & Pearson, J. (1965). Clinical value of the Cortisol secretion rate. Journal of Clinical Pathology 18, 82–87.CrossRefGoogle ScholarPubMed
Curtis, G., Fogel, M., McEvoy, D. & Zarate, C. (1970). Urine and plasma corticosteroids, psychological tests, and effectiveness of psychological defences. Journal of Psychiatric Research 7, 237–247.CrossRefGoogle Scholar
Daughaday, W. H. (1958). Binding of corticosteroids by plasma proteins. IV. The electrophoretic demonstration of corticosteroid binding globulin. Journal of Clinical Investigation 37, 519–523.CrossRefGoogle ScholarPubMed
Doig, R. J., Mummery, R. V. & Wills, N. R. (1966). Plasma cortisol levels in depression. British Journal of Psychiatry 112, 1263–1267.CrossRefGoogle ScholarPubMed
Eddy, R. L., Jones, A. L., Gilliland, P. F., Ibarra, J. D., Thompson, J. Q. & McMurry, F. J. (1973). Cushing's syndrome: a prospective study of diagnostic methods. American Journal of Medicine 55, 621–630.CrossRefGoogle ScholarPubMed
Espiner, E. A. (1966). Urinary Cortisol excretion in stress situations and in patients with Cushing's syndrome. Journal of Endocrinology 35, 29–44.CrossRefGoogle ScholarPubMed
Ferguson, H. C., Bartram, A. C. G., Fowlie, H. C., Cathro, D. M., Birchall, K. & Mitchell, F. L. (1964). A preliminary investigation of steroid excretion in depressed patients before and after electroconvulsive therapy. Acta Endocrinologica 47, 58–68.Google Scholar
Fullerton, D. T., Wenzel, F. J., Lohrenz, F. N. & Fahs, H. (1968). Circadian rhythm of adrenal cortical activity in depression. Archives of General Psychiatry 19, 674–681.CrossRefGoogle ScholarPubMed
Gaddum, J. H. (1945). Log-normal distributions. Nature 156, 463–466.CrossRefGoogle Scholar
Gibbons, J. L. (1964). Cortisol secretion rate in depressive illness. Archives of General Psychiatry 10, 572–575.CrossRefGoogle ScholarPubMed
Gibbons, J. L. (1966). The secretion rate of corticosterone in depressive illness. Journal of Psychosomatic Research 10, 263–266.CrossRefGoogle Scholar
Gibbons, J. L. (1974). Editorial: Endocrinology and psychiatry. Psychological Medicine 4, 240–243.CrossRefGoogle ScholarPubMed
Greaves, M. S. & West, H. F. (1960). Relation of free corticosteroids in urine to steroid dosage. Lancet i, 368.CrossRefGoogle Scholar
Hamanaka, Y., Manabe, H., Tanaka, H., Monden, Y., Uozumi, T. & Matsumoto, K. (1960). Effects of surgery on plasma levels of cortisol, corticosterone and non-protein-bound cortisol. Acta Endocrinologica 64, 439–451.Google Scholar
Hankin, M. E., Theile, H. M. & Steinbeck, A. W. (1972). Cortisol and aldosterone excretion and plasma cortisol concentrations in normal and obese female subjects. Clinical Science 43, 289–298.CrossRefGoogle ScholarPubMed
Harris, J. J. & Crane, M. G. (1964). Urinary cortisol excretion as a test of adrenal cortical function. Metabolism 13, 45–59.CrossRefGoogle ScholarPubMed
Heath, D. F. (1967). Normal or log-normal: appropriate distributions. Nature 213, 1159–1160.CrossRefGoogle Scholar
Hellman, L., Nakada, F., Curti, J., Weitzman, E. D., Kream, J., Roffwarg, H., Ellman, S., Fukushima, D. K. & Gallagher, T. F. (1970). Cortisol is secreted episodically by normal man. Journal of Clinical Endocrinology 30, 411–422.CrossRefGoogle ScholarPubMed
Hsu, T. H. & Blesdoe, T. (1970). Measurement of urinary free corticoids by competitive protein-binding radioassay in hypoadrenal states. Journal of Clinical Endocrinology 30, 443–448.CrossRefGoogle ScholarPubMed
James, V. H. T. & Landon, J. (1968). Control of corticosteroid secretion-current views and methods of assessment. In James, V. H. T. (ed.), Recent Advances in Endocrinology, 8th edn.Churchill: London.Google Scholar
Juselius, R. E. & Kenny, F. M. (1974). Urinary free cortisol excretion during growth and aging: correlation with cortisol production rate and 17-hydroxy-corticosteroid excretion. Metabolism 23, 847–852.CrossRefGoogle Scholar
King, D. J. (1973). Plasma cortisol binding capacity in mental illness. Psychological Medicine 3, 153–165.CrossRefGoogle ScholarPubMed
Klein, D. F. (1974). Endogenomorphic depression. Archives of General Psychiatry 31, 447–454.CrossRefGoogle ScholarPubMed
Knapp, M. S., Keane, P. M. & Wright, J. G. (1967). Circadian rhythm of plasma 11-hydroxycorticosteroids in depressive illness, congestive heart failure and Cushing's syndrome. British Medical Journal 2, 27–30.CrossRefGoogle ScholarPubMed
Kobberling, J. & von zur Muhlen, A. (1974). The circadian rhythm of free cortisol determined by urine sampling of two-hour intervals in normal subjects and patients with severe obesity or Cushing's syndrome. Journal of Clinical Endocrinology 38, 313–319.CrossRefGoogle ScholarPubMed
Krieger, D. T., Allen, W., Rizzo, F. & Krieger, H. (1971). Characteristics of the normal temporal pattern of plasma corticosteroid levels. Journal of Clinical Endocrinology and Metabolism 32, 266–284.CrossRefGoogle Scholar
Kurland, H. D. (1964). Steroid excretion in depressive disorders. Archives of General Psychiatry 10, 554–560.CrossRefGoogle ScholarPubMed
Mattingly, D. & Tyler, C. (1967). Simple screening test for Cushing's syndrome. British Medical Journal 4, 394–397.CrossRefGoogle ScholarPubMed
Meikle, A. W., Takiguchi, H., Mizutani, S., Tyler, F. H. & West, C. D. (1969). Urinary cortisol excretion determined by competitive protein-binding radioassay: a test of adrenal cortical function. Journal of Laboratory and Clinical Medicine 74, 803–812.Google ScholarPubMed
Miller, R. G., Rubin, R. T., Clark, B. R., Crawford, W. R. & Arthur, R. J. (1970). The stress of aircraft carrier landings. I. Corticosteroid responses in naval aviators. Psychosomatic Medicine 32, 581–588.CrossRefGoogle ScholarPubMed
Mills, I. H., Schedl, H. P., Chen, P. S. & Bartter, F. C. (1960). The effect of estrogen administration on the metabolism and protein binding of hydrocortisone. Journal of Clinical Endocrinology and Metabolism 20, 515–528.CrossRefGoogle Scholar
Murphy, B. E. P. (1967). Some studies of the protein-binding of steroids and their application to the routine micro and ultramicro measurement of various steroids in body fluids by competitive protein-binding radioassay. Journal of Clinical Endocrinology and Metabolism 27, 973–990.CrossRefGoogle Scholar
Murphy, B. E. P. (1968). Clinical evaluation of urinary cortisol determinations by competitive protein-binding radioassay. Journal of Clinical Endocrinology and Metabolism 28, 343–348.CrossRefGoogle Scholar
Murray, D. (1967). Cortisol binding to plasma proteins in man in health, stress, and at death. Journal of Endocrinology 39, 571–591.CrossRefGoogle ScholarPubMed
Poe, R. O., Rose, R. M. & Mason, J. W. (1970). Multiple determinants of 17-hydroxycorticosteroid excretion in recruits during basic training. Psychosomatic Medicine 32, 369–378.CrossRefGoogle ScholarPubMed
Rosner, J. M., Cos, J. J., Biglieri, E. G., Hane, S. & Forsham, P. H. (1963). Determination of urinary unconjugated cortisol by glass fibre chromatography in the diagnosis of Cushing's syndrome. Journal of Clinical Endocrinology and Metabolism 23, 820–827.CrossRefGoogle Scholar
Rubin, R. T. & Mandell, A. J. (1966). Adrenal cortical activity in pathological emotional states: a review. American Journal of Psychiatry 123, 387–400.CrossRefGoogle ScholarPubMed
Ruder, H. J., Guy, R. L. & Lipsett, N. B. (1972). A radioimmunoassay for cortisol in plasma and urine. Journal of Clinical Endocrinology and Metabolism 35, 219–224.CrossRefGoogle ScholarPubMed
Sachar, E. J. (1967 a). Corticosteroids in depressive illness. I. A re-evaluation of control issues and the literature. Archives of General Psychiatry 17, 544–553.CrossRefGoogle Scholar
Sachar, E. J. (1967 b). Corticosteroids in depressive illness. II. A longitudinal psychoendocrine study. Archives of General Psychiatry 17, 554–567.CrossRefGoogle Scholar
Sachar, E. J., Hellman, L., Fukushima, D. K. & Gallagher, T. F. (1970). Cortisol production in depressive illness. Archives of General Psychiatry 23, 289–298.CrossRefGoogle ScholarPubMed
Sachar, E. J., Hellman, L., Roffwarg, H. P., Halpern, F. X., Fukushima, D. K. & Gallagher, T. F. (1973). Disrupted 24-hour patterns of cortisol secretion in psychotic depression. Archives of General Psychiatry 28, 19–24.CrossRefGoogle ScholarPubMed
Sclare, A. B. & Grant, J. K. (1971). Urinary steroids in depressive illness. Scottish Medical Journal 16, 224–227.CrossRefGoogle ScholarPubMed
Schteingart, D. E., Gregerman, R. I. & Conn, J. W. (1963). A comparison of the characteristics of increased adrenocortical function in obesity and in Cushing's syndrome. Metabolism 12, 484–497.Google ScholarPubMed
Slaunwhite, W. R. & Sandberg, A. A. (1959). Transcortin: a corticosteroid-binding protein of plasma. Journal of Clinical Investigation 38, 384–391.CrossRefGoogle ScholarPubMed
Slaunwhite, W. R., Lockie, G. N., Back, N. & Sandberg, A. A. (1962). Inactivity in vivo of transcortin-bound cortisol. Science 135, 1062–1063.CrossRefGoogle ScholarPubMed
Streeten, D. H. P., Stevenson, C. T., Dalakos, T. G., Nicholas, J. J., Dennick, J. G. & Fellerman, H. (1969). The diagnosis of hypercortisolism. Biochemical criteria differentiating patients from lean and obese normal subjects and from females on oral contraceptives. Journal of Clinical Endocrinology 29, 1191–1211.CrossRefGoogle ScholarPubMed