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Cerebrospinal fluid and plasma free cortisol concentrations in depression

Published online by Cambridge University Press:  09 July 2009

Bernard J. Carroll ,
George C. Curtis  and
J. Mendels
Bernard J. Carroll
Affiliation:
Department of Psychiatry and Mental Health Research Institute, University of Michigan, Ann Arbor, and the Department of Psychiatry, University of Pennsylvania, and Veterans Administration Hospital, Philadelphia
George C. Curtis
Affiliation:
Department of Psychiatry and Mental Health Research Institute, University of Michigan, Ann Arbor, and the Department of Psychiatry, University of Pennsylvania, and Veterans Administration Hospital, Philadelphia
J. Mendels
Affiliation:
Department of Psychiatry and Mental Health Research Institute, University of Michigan, Ann Arbor, and the Department of Psychiatry, University of Pennsylvania, and Veterans Administration Hospital, Philadelphia
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Synopsis

Cerebrospinal fluid (CSF) cortisol levels were examined in a total group of 65 patients. Those who were not depressed (ND), and those suffering from depressive neuroses (DN) had marginally elevated values. Patients with unipolar depression (UD) and bipolar depression (BD) had levels twice as high as the ND and DN patients. Psychotic UD and BD patients had the highest values, three to four times as high as the ND and DN subjects. A significant reduction of CSF cortisol levels was observed following treatment and recovery. Manic patients had moderately elevated CSF cortisol values. The CSF results were in good agreement with plasma total cortisol levels and with urinary free cortisol excretion. Age and sex effects were not responsible for the observed differences; similar results were found in patient subgroups studied in Australia and in the United States. Preliminary equilibrium dialysis data are presented for plasma and CSF cortisol binding. CSF cortisol was 20% bound and 80% free. Plasma free cortisol levels were in good agreement with CSF free cortisol values. Depressed patients have increased tissue and central nervous system (CNS) exposure to free, physiologically active glucocorticoids. The appearance of severe depressive symptoms which manifest a diurnal rhythm may be determined in part by excessive CNS exposure to glucocorticoids.

Type
Research Article
Information
Psychological Medicine , Volume 6 , Issue 2 , May 1976 , pp. 235 - 244
Copyright
Copyright © Cambridge University Press 1976

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