CORTISOL SECRETION AND DEPRESSION

从12点到下午4点的短时间内，平均血浆皮质醇水平 已发现与平均24小时水平有很高的相关性 皮质醇 这些水平能有效区分皮质醇 高分泌型抑郁症与皮质醇正常型抑郁症 患者或正常对照，以及与其他患者之间 分泌过多的病症（例如，库欣综合征、神经性厌食症） 和正常对照。 因此，持续测量 皮质醇在这一时期有可能是一个简化的 皮质醇分泌过多的诊断试验。 拟议项目旨在 在（1）继续完善这个看似可靠，准确， 和方便的实验室诊断测试皮质醇分泌过多， 抑郁症患者;（2）本测试与现有测试的比较 皮质醇高分泌症的临床及家族史研究 皮质醇分泌过多的相关性，因为它是由这个测试测量。 的 建议的研究旨在建立（1）最佳程序， 测试的应用;（2）它的可靠性，（3）它的灵敏度， 的特异性 同时，新的测试将与其他测试进行比较。 相关生物学测试：平均24小时皮质醇水平， 地塞米松抑制试验，尿游离皮质醇的测量，和 17-羟皮质类固醇。 测试结果的相关性将是 采用RDC、SADS和FH-RDC对不同诊断组进行研究。 睡眠相关性将在一个较小的小组中进行研究。 临床变化 状态还将与测试结果随时间的变化进行比较，使用 SADS-C。 拟议的项目应导致建立一个 简单的下午皮质醇测试，作为生物电池的一部分， 测试，将有助于更好地理解和更好地诊断 以抑郁症状为特征的状况。

The mean plasma cortisol levels for the short period from 12 to 4 PM have been found to have a very high correlation with the mean 24-hour levels of cortisol. These levels powerfully discriminate between cortisol hypersecreting depressed patients and cortisol normosecreting depressed patients or normal controls, as well as between patients with other conditions with hypersecretion (e.g., Cushing's syndrome, anorexia nervosa) and normal controls. Therefore, continuous measurement of levels of cortisol during this period has a potential for being a simplified diagnostic test for cortisol hypersecretion. The proposed project is aimed at (1) continuation of the refinement of this seemingly reliable, accurate, and convenient laboratory diagnostic test for cortisol hypersecretion in depressed patients; (2) comparison of this test to existing tests of cortisol hypersecretion, and (3) the study of the clinical and familial correlates of cortisol hypersecretion as it is measured by this test. The proposed studies are designed to establish (1) the best procedure for application of the test; (2) its reliability, and (3) its sensitivity and specificity. Simultaneously, the new test will be compared to other relevant biological tests: The mean 24-hour cortisol levels, the dexamethasone suppression test, measurements of urinary free cortisol, and 17-hydroxycorticosteroids. The correlates of the test-results will be studied in different diagnostic groups using the RDC, SADS and FH-RDC. Sleep correlates will be studied in a smaller group. Changes in clinical state will also be compared to changes in the test-results over time, using the SADS-C. The proposed project should lead to the establishment of a simple Afternoon Cortisol Test that, as part of a battery of biological tests, will contribute to better understanding and better diagnosis of conditions characterized by depressive symptoms.