This study attempts to further delineate the relationship between the hypercortisolemic state that characteirzes psychotic depression and sopaminergic activity. It is hypothesized that HPA axis overactivity may lead to dopaminergic overactivity resulting in psychotic symptoms. In this study, the HPA axis is evaluated using CRH and hydrocortisone as probes for discerning the difference between healthy controls and patients with major depression, with and without psychotic symptoms. Measures of dopamine activity are evaluated in response to these challenge probes. This study began in early 1995 and continues. We have collected data on 28 controls, 42 depressed patients, and 12 psychotically depressed patients. Of these 82 patients, 53 have been studied at Stanford and 29 at the East Coast site (previously the Brigham and Women's Hospital, Boston, now the Metropolitan St. Louis Psychiatric Center, St. Louis).
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