Morphological changes in adrenals from victims of suicide in relation to altered apoptosis

Endocrine dysfunction may cause psychiatric symptoms and, vice versa, psych iatric diseases may lead to endocrine alterations. The adrenal as the end o rgan of both the hypothalamic-pituitary-adrenocortical and sympatho-adrenal axes is subject to the functional changes of the stress system. Thus, incr eased adrenal gland weight was observed previously in victims of violent su icide. This study was designed to analyze the morphological and morphodynam ic changes of adrenals from suicide victims. We investigated 30 adrenals ob tained from 15 suicide victims using immunohistochemistry and a computerize d video system. In addition, apoptosis and cell proliferation were analyzed . We found a significant enlargement of the adrenal cortex to 158.8 % (SD = 29.8 %, p < 0.01) that was restricted to the two inner zones only (zona re ticularis, 161.6 +/- 35.3 %; zona fasciculata, 186.4 +/- 34.4 %). This incr ease in adrenocortical size correlated with a decrease in the number of apo ptotic cells within the zona fasciculata. In conclusion, these results clea rly demonstrate chronic structural adrenal changes in suicide victims. The adrenal gland mirrors the functional changes of the stress system which lea ves an imprint on the morphology of the gland.