Adrenal Cortical Function in Anxious Human Subjects

Evidence has been presented in a previous communication from this Institute that in anxious subjects the plasma level of hydrocortisone and the urinary excretion of one group of its metabolites, the hydroxycorticoids, are almost double the values found in normal persons.¹The elevation in these levels may be explained by one of two alternative hypotheses: an increased rate of production of hydrocortisone by the adrenal cortex or a diminished rate of disposal of the hormone. The rate of disappearance of hydrocortisone from plasma has been shown to be significantly faster in anxious patients than in normal subjects, and, furthermore, the anxious subject metabolized hydrocortisone in such a fashion as to produce a smaller proportion of hydroxycorticoids than the normal control subject.²It is therefore likely that the high endogenous levels of plasma hydrocortisone and urinary hydroxycorticoids found in anxious patients are due to an increased rate of production