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Cerebrospinal fluid and plasma free cortisol concentrations in depression
Psychological Medicine
|May 1, 1976
Summary
Cerebrospinal fluid (CSF) cortisol levels are elevated in depression, particularly in severe and psychotic forms. Treatment and recovery significantly reduce these cortisol levels, suggesting a link between CNS glucocorticoid exposure and depressive symptoms.
Area of Science:
- Neuroendocrinology
- Psychiatry
- Clinical Chemistry
Background:
- Elevated cortisol is implicated in depression.
- Cerebrospinal fluid (CSF) offers direct insight into central nervous system (CNS) hormonal milieu.
Purpose of the Study:
- To investigate CSF cortisol levels across different psychiatric conditions.
- To correlate CSF cortisol with depression severity and treatment outcomes.
Main Methods:
- Measured CSF cortisol in 65 patients with depression and controls.
- Compared CSF cortisol with plasma and urinary cortisol.
- Analyzed age, sex, and geographical effects.
- Assessed cortisol binding via equilibrium dialysis.
Main Results:
- CSF cortisol was elevated in depressive neuroses, unipolar depression, and bipolar depression, with highest levels in psychotic subtypes.
- CSF cortisol normalized post-treatment.
- Manic patients showed moderately elevated CSF cortisol.
- CSF free cortisol correlated with plasma free cortisol.
Conclusions:
- Depressed patients exhibit increased CNS exposure to free glucocorticoids.
- Elevated CNS cortisol may contribute to the pathophysiology and diurnal variations of severe depressive symptoms.