Psychiatry Research. 26,3542 Elsevier 35 Plasma Postdexamethasone Cortisol Levels in Schizoaffective Disorder James H. Meador-Woodruff, John F. Greden, Leon Grunhaus, and Roger F. Haskett Received December 21. 1987; revised version received April 6, 1988; accepted June 10, 1988. zyxwvutsrqpo Abstract. The degree of hypothalamic-pituitary-adrenal (HPA) axis dysregula- tion in depressed patients with schizoaffective disorder was compared to that seen in patients with major depressive disorder with and without delusional features. The frequency of nonsuppression to dexamethasone was similar for all three diagnostic groups. Maximum postdexamethasone plasma cortisol was greater for delusional depressives, but did not differ between patients with major depressive and schizoaffective disorders. Modest correlations were found between post- dexamethasone plasma cortisol levels, severity of illness, age, and recent weight loss, for patients with both major depressive disorder and delusional depression. For schizoaffective patients, associations between postdexamethasone plasma cortisol levels and various measures of severity of illness, but not age and recent weight loss, were found. Although HPA axis dysregulation occurs more fre- quently in all three of the studied diagnostic groups than in normal individuals, factors contributing to this dysregulation may be qualitatively different for schizoaffective patients. Key Words. Schizoaffective disorder, dexamethasone suppression test, depres- sion, hypothalamic-pituitary-adrenal axis dysregulation. Many patients with depression have dysregulation of their hypothalamic-pituitary- adrenal (HPA) axes. Early investigation suggested that this dysregulation, as reflected by nonsuppression of plasma cortisol following oral dexamethasone, might be a neuroendocrine correlate of endogenous depression (Carroll et al., 1981). Subsequently, it has become apparent that some nonendogenously depressed patients also have evidence of HPA axis dysregulation, although fewer of these patients have abnormal dexamethasone suppression test (DST) results (Mendlewicz et al., 1982; Brown et al., 1985). Thus, it seems that this dysregulation may reflect the severity of affective disturbance and is not specific for any particular subtype of depression. A role of psychosis in HPA axis dysregulation also has been proposed. Patients with delusional depression have abnormal DST results, often demonstrating higher postdexamethasone plasma cortisol levels than depressed patients without psychosis James H. Meador-Woodruff, M.D., is Research Track Resident; John F. Greden, M.D., is Professor and Chairman; Leon Grunhaus, M.D., is Assistant Professor; and Roger F. Haskett, M.D., is Associate Professor of Psychiatry, Department of Psychiatry, Clinical Studies Unit of the University of Michigan Depression Program, University of Michigan Medical Center, Ann Arbor, MI 48109. (Reprint requests to Dr. J.H. Meador-Woodruff, Department of Psychiatry, Mental Health Research Institute, University of Michigan Medical Center, 205 Washtenaw Place, Ann Arbor, MI 48109, USA.) 01651781/88/$03.50 @ 1988 Elsevier Scientific Publishers Ireland Ltd.