Am J Psychiatry 1991; 148:505-508
Copyright © 1991 by American Psychiatric Association
Salivary cortisol levels and their correlation with plasma ACTH levels in depressed patients before and after the DST
R Galard, JM Gallart, R Catalan, S Schwartz, JM Arguello and JM Castellanos
Department of Biochemistry, Valle Hebron General Hospital, Barcelona, Spain.
OBJECTIVE: The aim of this work was to study the clinical utility of
salivary cortisol concentrations in a group of depressed patients
undergoing the dexamethasone suppression test (DST) and the correlation of
these concentrations with plasma ACTH levels. METHOD: Twenty outpatients
from the psychiatric department of a Barcelona hospital who were diagnosed
as having nonendogenous (N = 9) or endogenous (N = 11) depression according
to DSM-III criteria and the Newcastle scale participated in the study. The
comparison group consisted of 12 healthy volunteers. Blood and saliva
samples were taken before and after administration of 1 mg of dexamethasone
Salivary cortisol and plasma ACTH concentrations were determined by direct
iodine-125 radioimmunoassay with commercial kit reagents. RESULTS:
Predexamethasone salivary cortisol concentrations were significantly higher
in the group with endogenous depression than in the comparison group. A
significant correlation was obtained between plasma ACTH and
predexamethasone salivary cortisol levels in the group with nonendogenous
depression and in the comparison subjects. CONCLUSIONS: These preliminary
findings indicate that salivary cortisol could substitute for plasma
cortisol in clinical studies in which the DST and hypercortisolemia are
evaluated. The lack of correlation between ACTH and cortisol levels in
saliva in the group of endogenously depressed patients could indicate a
disturbance in the regulation of cortisol secretion in major depression.
