GLUCOCORTICOID RECEPTOR NUMBER AND CORTISOL EXCRETION IN MOOD, ANXIETY, AND PSYCHOTIC DISORDERS

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, pa nic disorder, and schizophrenia. Patients with major depression had th e 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 f rom each other in regard to the number of lymphocyte glucocorticoid re ceptors. 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 dia gnostic 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 signi ficance. 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 gluc ocorticoid receptor number in tandem with cortisol levels may provide a more meaningful estimate of hypothalamic-pituitary-adrenal axis acti vity than is achieved using cortisol alone.