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Relationship between serum cortisol, liver function, and depression in detoxified alcoholics
Alcoholism, Clinical and Experimental Research
|June 1, 1986
Summary
The dexamethasone suppression test remains valuable for diagnosing depression in detoxified alcoholics, even with mild liver dysfunction. This study confirms its diagnostic utility alongside cortisol levels in this population.
Area of Science:
- Endocrinology
- Psychiatry
- Hepatology
Background:
- High serum cortisol and abnormal dexamethasone suppression tests aid in diagnosing major depressive disorder.
- A controversy exists regarding the impact of alcohol-related liver dysfunction on the dexamethasone suppression test's diagnostic value in alcoholics.
Purpose of the Study:
- To investigate the diagnostic utility of the dexamethasone suppression test in alcohol-dependent individuals undergoing detoxification.
- To analyze the relationship between liver function, cortisol levels, and psychiatric status in this cohort.
Main Methods:
- Subjects meeting DSM III criteria for alcohol dependence without chronic medication or other substance abuse were recruited.
- Evaluations included routine blood screening for liver function, afternoon cortisol tests, dexamethasone suppression tests, and structured psychiatric assessments.
Main Results:
- No significant liver synthetic dysfunction was observed, though 43% had elevated liver enzymes.
- No differences in liver function were found between patients with normal and abnormal cortisol levels.
- Subjects with endogenous depression showed elevated afternoon cortisol levels and tended to have more normal liver tests.
Conclusions:
- Modest liver dysfunction does not invalidate plasma cortisol tests or the dexamethasone suppression test for diagnosing depression in detoxified alcoholics.
- An association between depression and plasma cortisol levels was demonstrated.
- A correlation between depression and better liver function was suggested in alcoholics seeking detoxification.