The 24-hour excretions of adrenaline, noradrenaline, and 17-hydroxycortico-steroids were measured in normals and in a) acute and b) chronic schizophrenics, (c) non-schizophrenic psychotics, d) psychoneurotic disorders, and e) a miscellaneous group composed primarily of personality disorders. Some patients were studied over a period of time and the changes in hormone excretion and in clinical conditions compared. On comparison between groups, no difference was found in adrenaline and noradrenaline output. Similarly, when the patients were grouped by dominant emotional reaction at the time of test, no significant differences were observed. The acute schizophrenics, however, did show a greater output of free corticoids, but not of total corticoids compared to the normals. When the same patients were studied over a period of time, there appeared to be a relationship between catecholamine excretion and emotional tension and/or stages of illness. Depressed patients showed a decreased adrenaline and noradrenaline output on admission to hospital but only that of adrenaline was significant. Both adrenaline and noradrenaline showed a marked, but not significant decrease in acute schizophrenics after recovery. In the chronic schizophrenics, there was, after four months of withdrawal of tranquillizers, a significant rise in the output of both; the total and free corticoids showed a similar increase which, however, was not significant. Although no significant differences in hormone excretion were observed among the groups studied, other than increased excretion of free corticoids in the acute schizophrenics, the longitudinal studies in several groups suggest significant correlations may occur between changes in clinical condition and/or emotional state and the excretion of some of the hormones measured.
There is increasing evidence that the autonomic nervous system and the endocrine system function abnormally in several psychiatric disorders. This abnormal function may, or may not, be of causal importance in these diseases; nevertheless, its definition will contribute to an understanding of these diseases. Abnormalities of adrenocortical function in schizophrenia have been suggested by the studies of Hoagland and his colleagues 1,2 and by those of others.3-5 Some studies 6,7 have, however, not supported this suggestion.In 1953 we also observed that in a group of schizophrenics the eosinophil responses to the standard corticotropin and epinephrine tests 8 were often less than normal. Particularly noticeable was a lower resting level of circulating eosinophils in the catatonic than in the paranoid schizophrenics. The fall in eosinophils following corticotropin was, however, greater in the former than in the latter. The eosinophil response to corticotropin is considered an approximate index of adrenocortical function,9 and it was, therefore, decided to examine the possibility of a difference in adrenocortical function between the catatonic and paranoid sub-
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