Assessment of Adrenal Gland Volume by Computed Tomography in Depressed Patients and Healthy Volunteers: a Pilot Study

Excessive adrenocortical activation in depression has been postulated to be the result of overactivity of limbic system-hypothalamic function. In contrast, several studies have suggested the possibility that excessive secretion of cortisol might also result, in part, from a heightened adrenocortical responsiveness to adrenocorticotropic hormone (ACTH), or even a mild adrenal hyperplasia. Because computed tomography (CT) may provide a method for assessing an increase in adrenal size, we performed CT scans of the adrenal glands in depressed patients and healthy volunteers, who also received the dexamethasone suppression test. Eight out of 16 patients (50%) had adrenal volumes in excess of the 95th percentile value of the control distribution for adrenal volume. These observations suggest that there may be demonstrable adrenal hypertrophy during depressive illness.