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Adrenal gland volume in major depression. Increase during the depressive episode and decrease with successful

R T Rubin1, J J Phillips, T F Sadow

  • 1Neurosciences Research Center, Medical College of Pennsylvania.

Archives of General Psychiatry
|March 1, 1995
PubMed
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Adrenal gland enlargement in major depression is temporary, shrinking with successful treatment. This finding suggests it reflects the current depressive state, not cumulative lifetime illness.

Area of Science:

  • Neuroendocrinology
  • Psychiatry
  • Medical Imaging

Background:

  • Pituitary-adrenocortical axis hyperactivity is a key neuroendocrine abnormality in major depression.
  • Adrenal gland enlargement has been observed in major depression, hypothesized as an indicator of cumulative illness.
  • The effect of depression treatment on adrenal size was previously unstudied.

Purpose of the Study:

  • To determine adrenal gland volume in major depression patients before and after treatment compared to controls.
  • To compare adrenal size with functional indices of pituitary-adrenocortical activity.

Main Methods:

  • Magnetic resonance imaging (MRI) was used to measure adrenal gland volumes in patients with major depression and matched controls.
  • Adrenal volumes were assessed during depression and remission, with medication stopped for at least one month.

Related Experiment Videos

  • Basal and stimulated plasma levels of corticotropin (ACTH) and cortisol were measured.

    • Main Results:

    • Mean adrenal gland volume was significantly larger (approx. 70%) in depressed patients compared to their remitted state and controls.
    • After treatment, mean adrenal volume decreased to levels not significantly different from controls.
    • The decrease in adrenal volume positively correlated with the duration of the depressive episode.

    Conclusions:

    • Adrenal gland enlargement in major depression is state-dependent, reverting to normal size upon remission.
    • Adrenal enlargement does not appear to be an index of cumulative lifetime depression.
    • The relationship between adrenal volume and pituitary-adrenocortical activity requires further investigation, possibly involving non-ACTH factors.