Dysregulation of hypothalamic-pituitary-adrenal axis function in depressed alcoholic patients

Hypothalamic-pituitary-adrenal (HPA) axis function was examined in 28 hospitalized, withdrawing alcoholic patients. Fourteen patients met DSM-III criteria for Major Depressive Disorder. Elevated 8 a.m. basal cortisols were noted in 7 depressed alcoholic patients (50%) and no non-depressed alcoholics (P less than 0.01). Escape from dexamethasone suppression was noted in 9 depressed alcoholics (64%) and no non-depressed alcoholics (P less than 0.005). The measurement of HPA axis function may be a useful marker for endogenous depression in an alcoholic population.