Adrenal Gland Enlargement in Major Depression: A Computed Tomographic Study

doi:10.1001/archpsyc.1992.01820050048008

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Vol. 49 No. 5, May 1992

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Adrenal Gland Enlargement in Major Depression

A Computed Tomographic Study

Charles B. Nemeroff, MD, PhD; K. Ranga R. Krishnan, MD; Deborah Reed, RN, MSN; Richard Leder, MD; Craig Beam, PhD; N. Reed Dunnick, MD

Arch Gen Psychiatry. 1992;49(5):384-387.

Abstract

• To determine whether the well-documented hyperactivityof the hypothalamic-pituitary-adrenal axis in depressed patientsincludes adrenal gland hypertrophy, adrenal gland size was evaluatedby computed tomography. Assessments consisted of (1) globalratings by two radiologists ignorant of the diagnostic identityof the subjects and (2) calculation of adrenal volume. Of the38 patients with major depression, 12 were rated as exhibitingadrenal hypertrophy. Adrenal volumes in the depressed patientswere significantly increased when compared with those of normalcontrols. Adrenal gland size was not correlated with dexamethasonesuppression test results, patient age, duration of the depressiveepisode, or depression severity. These results are concordantwith the hypothesis that chronic corticotropin hypersecretionin depression results in adrenocortical hypertrophy. Adrenalgland enlargement may be a measure of cumulative lifetime depression.

Author Affiliations

From the Departments of Psychiatry (Drs Nemeroff and Krishnan and Ms Reed), Pharmacology (Dr Nemeroff), and Radiology (Drs Leder, Beam, and Dunnick), Duke University Medical Center, Durham, NC.

Footnotes

Accepted for publication June 17, 1991.

Reprint requests to Department of Psychiatry, Emory UniversitySchool of Medicine, 1701 Uppergate Dr, Atlanta, Ga 30322 (DrNemeroff).

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