Joyce P R, Donald R A, Elder P A
J Affect Disord. 1987 Jan-Feb;12(1):1-5. doi: 10.1016/0165-0327(87)90054-1.
Daytime plasma cortisol levels in four rapid cycling bipolar affective disorder patients were measured longitudinally over multiple affective episodes, and changes in levels with mood state assessed for each individual patient. While three of the four patients had, as expected, increased cortisol levels during depression, higher cortisol levels were also found in the days immediately preceding depressive episodes. Daytime cortisol levels in mania were more variable but were lower in mania for two of the patients. It is hypothesized that in the early stages of mania decreased cortisol levels reflect early neurochemical changes, but that, as manic episodes become dysphoric and/or severe, elevated cortisol levels occur.
对4例快速循环型双相情感障碍患者在多个情感发作期进行了日间血浆皮质醇水平的纵向测量，并评估了每位患者皮质醇水平随情绪状态的变化。正如预期的那样，4例患者中有3例在抑郁发作时皮质醇水平升高，但在抑郁发作前几天也发现皮质醇水平较高。躁狂发作时的日间皮质醇水平变化更大，但有2例患者在躁狂发作时皮质醇水平较低。据推测，在躁狂发作的早期，皮质醇水平下降反映了早期神经化学变化，但随着躁狂发作变得烦躁不安和/或严重，皮质醇水平会升高。
