Hypothalamic-pituitary-adrenocortical function in mixed and pure mania

A. C. Swann, P. E. Stokes, R. Casper, S. K. Secunda, C. L. Bowden, N. Berman, M. M. Katz, E. Robins

Research output: Contribution to journalArticle

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Abstract

There is little information about hypothalamic-pituitary-adrenocortical (HPA) axis function in mania, particularly in mixed states. We therefore investigated HPA function and its relationship to clinical state in 19 hospitalized manic patients meeting Schedule for Affective Disorders and Schizophrenia - Research Diagnostic Criteria for acute manic episodes, compared patients with and without a mixed presentation, and examined correlations between HPA activity and hehavior. Data were available from 13- 16 patients. Behavioral and biochemical analyses were conducted during a 15-d placebo period. Patients with mania had elevated cerebrospinal fluid (CSF) and urinary free cortisol excretion compared with healthy subjects, and did not differ from depressed patients in any cortisol measures. Mixed manics had significantly higher morning plasma cortisol, postdexamethasone plasma cortisol and CSF cortisol than pure manics. Five of 7 mixed manics and 3 of 9 pure manics were dexamethasone suppression test (DST) nonsuppressors. Afternoon plasma cortisol and CSF cortisol correlated significantly with depressed mood; urinary free cortisol correlated with anxiety. None of the cortisol measures correlated with mania or agitation scores. These data suggest that increased cortisol secretion is a characteristic of the depressed state in mixed manics, although pure manics may also have increased DST nonsuppression.

Original languageEnglish (US)
Pages (from-to)270-274
Number of pages5
JournalActa Psychiatrica Scandinavica
Volume85
Issue number4
StatePublished - 1992

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Bipolar Disorder
Hydrocortisone
Cerebrospinal Fluid
Dexamethasone
Mood Disorders
Schizophrenia
Appointments and Schedules
Healthy Volunteers
Anxiety
Placebos

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Neuroscience(all)

Cite this

Swann, A. C., Stokes, P. E., Casper, R., Secunda, S. K., Bowden, C. L., Berman, N., ... Robins, E. (1992). Hypothalamic-pituitary-adrenocortical function in mixed and pure mania. Acta Psychiatrica Scandinavica, 85(4), 270-274.

Hypothalamic-pituitary-adrenocortical function in mixed and pure mania. / Swann, A. C.; Stokes, P. E.; Casper, R.; Secunda, S. K.; Bowden, C. L.; Berman, N.; Katz, M. M.; Robins, E.

In: Acta Psychiatrica Scandinavica, Vol. 85, No. 4, 1992, p. 270-274.

Research output: Contribution to journalArticle

Swann, AC, Stokes, PE, Casper, R, Secunda, SK, Bowden, CL, Berman, N, Katz, MM & Robins, E 1992, 'Hypothalamic-pituitary-adrenocortical function in mixed and pure mania', Acta Psychiatrica Scandinavica, vol. 85, no. 4, pp. 270-274.
Swann AC, Stokes PE, Casper R, Secunda SK, Bowden CL, Berman N et al. Hypothalamic-pituitary-adrenocortical function in mixed and pure mania. Acta Psychiatrica Scandinavica. 1992;85(4):270-274.
Swann, A. C. ; Stokes, P. E. ; Casper, R. ; Secunda, S. K. ; Bowden, C. L. ; Berman, N. ; Katz, M. M. ; Robins, E. / Hypothalamic-pituitary-adrenocortical function in mixed and pure mania. In: Acta Psychiatrica Scandinavica. 1992 ; Vol. 85, No. 4. pp. 270-274.
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