Amsterdam J D, Marinelli D L, Arger P, Winokur A
Psychiatry Res. 1987 Jul;21(3):189-97. doi: 10.1016/0165-1781(87)90022-9.
Excessive adrenocortical activation in depression has been postulated to be the result of overactivity of limbic system-hypothalamic function. In contrast, several studies have suggested the possibility that excessive secretion of cortisol might also result, in part, from a heightened adrenocortical responsiveness to adrenocorticotropic hormone (ACTH), or even a mild adrenal hyperplasia. Because computed tomography (CT) may provide a method for assessing an increase in adrenal size, we performed CT scans of the adrenal glands in depressed patients and healthy volunteers, who also received the dexamethasone suppression test. Eight out of 16 patients (50%) had adrenal volumes in excess of the 95th percentile value of the control distribution for adrenal volume. These observations suggest that there may be demonstrable adrenal hypertrophy during depressive illness.
抑郁症中肾上腺皮质过度激活被假定为边缘系统 - 下丘脑功能过度活跃的结果。相比之下，多项研究表明，皮质醇分泌过多也可能部分是由于肾上腺皮质对促肾上腺皮质激素（ACTH）的反应性增强，甚至是轻度肾上腺增生所致。由于计算机断层扫描（CT）可能提供一种评估肾上腺大小增加的方法，我们对抑郁症患者和健康志愿者进行了肾上腺CT扫描，这些志愿者也接受了地塞米松抑制试验。16名患者中有8名（50%）的肾上腺体积超过了肾上腺体积对照分布的第95百分位数。这些观察结果表明，在抑郁症期间可能存在可证实的肾上腺肥大。
