Original article| Volume 34, ISSUE 1-2, P18-25, July 01, 1993

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Glucocorticoid receptor number and cortisol excretion in mood, anxiety, and psychotic disorders

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      In the present study, we measured cytosolic lymphocyte glucocorticoid receptor and 24-hour urinary cortisol excretion in patients with major depressive disorder, bipolar mania, posttraumatic stress disorder, panic disorder, and schizophrenia. Patients with major depression had the smallest, and posttraumatic stress disordered patients the largest, mean number of glucocorticoid receptors per cell compared to patients in the other groups. Bipolar manic and panic patients did not differ from each other in regard to the number of lymphocyte glucocorticoid receptors. Bipolar manic and panic patients did have significantly more glucocorticoid receptors/cell than schizophrenic patients. The mean 24-hour urinary cortisol excretion was significantly higher in patients with major depression and bipolar mania than in those in the other diagnostic groups. Lymphocyte glucocorticoid receptor number and cortisol excretion tended to be inversely related, when the entire sample was considered as a whole, but this effect did not reach statistical significance. It is concluded that lymphocyte glucocorticoid receptors may be modulated by multiple influences, not just ambient cortisol levels. These preliminary data suggest that the assessment of lymphocyte glucocorticoid receptor number in tandem with cortisol levels may provide a more meaningful estimate of hypothalamic-pituitary-adrenal axis activity than is achieved using cortisol alone.


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        • Bridges M.
        • Yeragani V.K.
        • Rainey J.M.
        • et al.
        Dexamethasone suppression test in patients with panic attacks.
        Biol Psychiatry. 1986; 21: 853-855
        • Butler P.D.
        • Nemeroff C.B.
        Corticotropin-releasing-factor as a possible cause of comorbidity in anxiety and depressive disorders.
        in: Maser J.D. Cloninger C.R. Comorbidity of Mood and Anxiety Disorders. American Psychiatric Association, Washington, DC1991: 413-438
        • Curtis G.C.
        • Cameron O.G.
        • Nesse R.M.
        The dexamethasone suppression test in panic disorder and agoraphobia.
        Am J Psychiatry. 1982; 139: 1043-1046
        • DeKloet R.
        • Joels M.
        • Oitzl M.
        • Sutanto W.
        Implication of brain corticosteroid receptor diversity for the adaptation syndrome concept.
        in: Neuroendocrinology of Stress. Vol 14. Karger, Basel1991: 104-132
        • Faludi G.
        • Kasko M.
        • Perenyi A.
        • et al.
        The dexamethasone suppression test in panic disorder and major depressive episodes.
        Biol Psychiatry. 1986; 21: 1008-1011
        • Goldstein S.
        • Halbreich U.
        • Asnis G.
        • et al.
        The hypothalamic-pituitary-adrenal system in panic disorder.
        Am J Psychiatry. 1987; 144: 1320-1325
        • Gormley G.J.
        • Lowy M.T.
        • Reder A.T.
        • et al.
        Glucocorticoid receptors in depression: Relationship to the dexamethasone suppression test.
        Am J Psychiatry. 1985; 142: 1278-1284
        • Hamilton M.
        A rating scale for depression.
        J Neurol Neurosurg Psychiatry. 1960; 23: 56-62
        • Hunter R.
        • Dick H.
        • Christie J.E.
        • Goodwin G.M.
        • Fink G.
        Lymphocyte glucocorticoid receptor binding in depression: Normal values following recovery.
        J Affective Disord. 1988; 14: 155-159
        • Junker K.
        Glucocorticoid receptors of human mononuclear leukocytes in vitro.
        J Clin Endocrinol Metab. 1983; 57: 506-512
        • Kontula K.
        • Pelkonen R.
        • Andersson L.
        • et al.
        Glucocorticoid receptors in adrenocorticoid disorders.
        J Clin Endocrinol Metab. 1980; 51: 654-655
        • Kontula K.
        • Andersson L.C.
        • Huttunen M.
        • Pelkonen R.
        Reduced level of cellular glucocorticoid receptors in patients with anorexia nervosa.
        Horm Metab Res. 1982; 14: 619-620
        • LaCroix A.
        • Bonnard G.D.
        • Lippman M.E.
        Modulation of glucocorticoid receptors by mitogenic stimuli, glucocorticoids and retinoids in normal human cultured T cells.
        J Steroid Biochem. 1984; 21: 73-80
        • Lieberman J.A.
        • Brenner R.
        • Lesser M.
        • et al.
        Dexamethasone suppression test in patients with panic disorder.
        Am J Psychiatry. 1983; 140: 917-919
        • Lowy M.T.
        Quantification of type I and II adrenal steroid receptors in neuronal, lymphoid, and pituitary tissues.
        Brain Res. 1989; 503: 191-197
        • Lowy M.T.
        Reserpine induced decrease in type I and II corticosteroid receptors in neuronal and lymphoid tissue of adrenalectomized rats.
        Neuroendocrinology. 1990; 51: 190-196
        • Lowy M.T.
        • Gormley G.J.
        • Reder A.T.
        • et al.
        Immune function, glucocorticoid receptor regulation and depression.
        in: Miller A.H. Depressive Disorders and Immunity. American Psychiatric Association, Washington DC1989: 105-113
        • Mason J.W.
        • Giller E.L.
        • Kosten T.R.
        • Ostroff R.B.
        • Podd L.
        Urinary free-cortisol levels in post-traumatic stress disorder patients.
        J Nerv Ment Dis. 1986; 174: 145-159
        • McEwen Bs.
        • deKloet E.R.
        • Rostene W.H.
        Adrenal steroid receptors and actions in the nervous system.
        Physiol Rev. 1986; 66: 1121-1188
        • Roy-Byrne P.P.
        • Bierer L.M.
        • Uhde T.W.
        The dexamethasone suppression test in panic disorder: Comparison with normal controls.
        Biol Psychiatry. 1985; 20: 1237-1240
        • Roy-Byrne P.
        • Uhde T.W.
        • Post R.M.
        The corticotropin-releasing hormone stimulation test in patients with panic disorder.
        Am J Psychiatry. 1986; 143: 896-899
        • Rupprecht R.
        • Frolich L.
        • Mergenthaler T.
        • et al.
        Glucocorticoid receptors on mononuclear leukocytes in Alzheimer's disease.
        Psychiatry Res. 1990; 34: 241-347
        • Sapolsky R.M.
        • Krey L.C.
        • McEwen B.S.
        Stress down regulates corticosterone receptors in a site specific manner in the brain.
        Endocrinology. 1984; 114: 287-292
        • Schlechte J.A.
        • Sherman B.M.
        Decreased glucocorticoid receptor binding in adrenal insufficiency.
        J Clin Endocrinol Metab. 1982; 54: 145-149
        • Schlechte J.A.
        • Sherman B.
        Lymphocyte glucocorticoid receptor binding in depressed patients with hypercortisolemia.
        Psychoneuroendocrinology. 1985; 10: 469-474
        • Schlechte J.A.
        • Ginsburg B.H.
        • Sherman B.M.L.
        Regulation of the glucocorticoid receptor in human lymphocytes.
        J Steroid Biochem. 1982; 16: 69-74
        • Spitzer R.L.
        • Williams J.B.W.
        Structured Clinical Interview for DSM-III-R.
        Biometrics Research Department, NY State Psychiatric Institute, New York1985
        • Svec F.
        Minireview: Glucocorticoid receptor regulation.
        Life Sci. 1985; 36: 2359-2366
        • Wassef W.
        • Smith E.M.
        • Rose R.M.
        • et al.
        Mononuclear leukocyte glucocorticoid receptor binding characteristics and down-regulation in major depression.
        Psychoneuroendocrinology. 1990; 15: 59-68
        • Whalley L.J.
        • Borthwick N.
        • Copolov D.
        • et al.
        Glucocorticoid receptors and depression.
        BMJ. 1986; 292: 859-861
      1. Yehuda R, Nemeroff CF (in press): Neuropeptide alterations in affective and anxiety disorders. In Handbook of Anxiety and Depression. Marcel Dekker, Inc

        • Yehuda R.
        • Southwick S.M.
        • Nussbaum G.
        • et al.
        Low urinary cortisol excretion in PTSD.
        in: J Nerv Ment Dis. 178. 1990: 366-369
        • Yehuda R.
        • Giller E.L.
        • Southwick S.M.
        • Lowy M.T.
        • Mason J.W.
        Hypothalamic-pituitary-adrenal dysfunction in posttraumatic stress disorder.
        Biol Psychiatry. 1991; 30: 1031-1048
        • Yehuda R.
        • Giller E.L.
        • Boisoneau D.
        • et al.
        The low dose DST in PTSD.
        in: New Research Abstracts. American Psychiatric Association, Washington, DC1991: 144
        • Yehuda R.
        • Lowy M.T.
        • Southwick S.M.
        • Shaffer S.
        • Giller E.L.
        Increased number of glucocorticoid receptor number in post-traumatic stress disorder.
        Am J Psychiatry. 1991; 149: 499-504
        • Yehuda R.
        • Southwick S.M.
        • Krystal J.H.
        • Charney D.S.
        • Mason J.W.
        Enhanced suppression of cortisol following dexamethasone in posttraumatic stress disorder.
        Am J Psychiatry. 1993; 150: 83-86