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I. Basal Plasma Levels

Uriel Halbreich, MD; Gregory M. Asnis, MD; Richard Shindledecker, MA; Barnett Zumoff, MD; R. Swami Nathan, MD

Arch Gen Psychiatry. 1985;42(9):904-908.

Abstract
• Plasma levels of cortisol were sampled for 24 hours in 32 endogenously depressed (ED) patients and 72 normal controls who also underwent the dexamethasone suppression test. The ED patients had significantly higher mean 24-hour plasma levels of cortisol ( 24h PC). However, 24h PC values of subjects in both groups were normally distributed, with a marked overlap between the two. Only seven ED patients had 24h PC values higher than 2 SDs from the normal mean (>10 µg/dL). An abnormal dexamethasone suppression test result was only partially related to basal cortisol levels. The mean plasma level of cortisol between 1 and 4 PM was found to be highly correlated with the 24h PC value in ED patients, as has been previously reported in normal subjects and patients with various other diseases (in which it also powerfully discriminated between hypersecretors and normosecretors). This finding supports the use of mean cortisol levels between 1 and 4 PM as a reliable and convenient indication of cortisol secretion.

Author Affiliations
From the Department of Psychiatry, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY (Drs Halbreich and Asnis and Mr Shindledecker); Division of Endocrinology and Metabolism, Department of Medicine, Beth Israel Medical Center and Mount Sinai School of Medicine, New York City (Dr Zumoff); and Department of Psychiatry, Western Psychiatric Institute, Pittsburgh (Dr Nathan). Dr Halbreich is now with the State University of New York at Buffalo.

Footnotes
Accepted for publication March 26, 1985.

Read in part at the 13th Annual Meeting of the American Psychiatric Association, New Orleans, May 13, 1981, at the National Institute of Mental Health—Psychoendocrinology Workshop, Hamilton, Ontario, Canada, June 18, 1981, and at the Annual Meeting of the American College of Neuropsychopharmacology, San Juan, Puerto Rico, Dec 14, 1983.

Reprint requests to Department of Psychiatry, State University of New York at Buffalo, Erie County Medical Center, K-Annex, 462 Grider St, Buffalo, NY 14215 (Dr Halbreich).

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