Psychological Stress and Endocrine Functions

Abstract

Summary Evidence indicating the importance of the adrenal cortex and thyroid in adaptation to stressful conditions was reviewed. Serum protein-bound iodine (PBI) and plasma 17-hydroxycorticosterone (17-OH) were determined in 30 patients within 24 hours after their admission to the psychiatric section of a general hospital. These patients showed a significantly elevated 17-OH mean level in comparison with control subjects. Their diurnal fall was less than that of controls. The patients' PBI mean level was distinctly higher than that of controls, but the difference was proportionately less than that observed for 17-OH. There was a small but significant decline in PBI level during the morning. Subgroups were established on the basis of psychiatric criteria according to (a) quality and intensity of emotional distress and (b) diagnostic category. Analysis of hormone levels of patients in these subgroups suggested that exceptionally high hormone levels are associated with (a) very intense distress (especially of a depressive affect in the presence of retarded behavior) and (b) the development of extensive personality disintegration (especially the psychotic depressive reactions). Fourteen patients were retested 17 days later (average), and found to have lower mean 17-OH levels than on the day of admission, yet somewhat above those of controls. The PBI levels were very similar to those of the initial day. When this follow-up group was divided into two subgroups, consisting of those who did and did not receive electroconvulsive therapy, they differed notably in mean levels of 17-OH and PBI. The more disturbed patients who had received EST had relatively high levels, while the less disturbed patients who had not received EST manifested normal levels. The following areas were discussed: interpretation of the initial elevated hormone levels; duration of elevated levels; and methodological problems, especially in the handling of psychiatric data in psychosomatic studies.