Persistent Elevation of Urinary Free Cortisol and Loss of Circannual Periodicity in Recovered Depressive Patients. A Trait Finding

By comparing a group of 8 normal subjects with 7 recovered depressive patients who had been dexamethasone suppression test (DST) nonsuppressors while depressed, the following differences were identified: (1) mean urinary free cortisol (UFC) levels were significantly higher for recovered depressive patients than for controls in the summer and fall as well as for the year; (2) patients who had recovered from depression lost their circannual pattern of cortisol excretion; and (3) there was a positive correlation between depressive symptoms as reflected on the Beck Depression Inventory and UFC levels in recovered patients but not controls. The elevated UFC levels in depressed patients with DST nonsuppression represents the first trait marker which persists over time. The implications of the close association between UFC levels and depressive symptoms is discussed.