Urinary-free cortisol in depressed patients and controls: relationship to urinary indices of noradrenergic function

We measured urinary outputs of urinary-free cortisol in 28 medication-free depressed patients and 32 normal controls. Depressed patients had significantly greater urinary outputs of urinary-free cortisol than controls. Also, there were significant correlations among depressed patients, but not among controls, between urinary-free cortisol and urinary outputs of norepinephrine and its metabolite vanillylmandelic acid (VMA). These urinary data extend recent findings suggesting that dysregulation of both the hypothalamic-pituitary-adrenal axis and noradrenergic system occur together in depression.