The observation that levels of adrenal corticosteroids increase in states of emotional distress has led to increasing use of this hormonal measurement as a research tool in psychiatry. The findings of this new area of psychoendocrine research have helped to clarify thinking about many problems in clinical psychiatry.
A good example is the study of corticosteroid responses in depressive illness. It would at first appear that this condition, usually associated with such disturbing symptoms as guilt, agitation, and sleep disturbance, would be a severe stress associated with marked increase in corticosteroid levels. Initial reports seemed to confirm this idea, but the subsequent literature has tended to be contradictory. As a recent review of the field points out,1 many of these studies have failed to control for such critical variables as the response to admission to the mental ward (a stressful experience which elevates corticosteroids in normal persons as well