Noradrenergic function and hypothalamic-pituitary-adrenal axis activity in adolescents with major depressive disorder.

Levels of plasma norepinephrine (NE), free 3-methoxy-4-hydroxyphenylglycol (MHPG), and cortisol in adolescents with major depressive disorder (10 girls, 1 boy; mean +/- SD age = 16.4 +/- 1.6 years, range = 14-19 years) did not differ significantly from those in a group of healthy adolescents (17 girls, 12 boys; mean +/- SD age = 15.9 +/- 1.5 years, range = 12-18 years). No correlations were observed between these variables and age within the adolescent groups. However, when the adolescent data were viewed in combination with data previously obtained for an adult population (De Villiers et al., 1987), significant positive correlations between the variables were observed within the patient group. A moderate positive correlation with age was also observed for patients' NE and free MHPG levels. No such correlations were observed for the combined control group. When groups were partitioned into three age categories, it became apparent that differences in the three variables between the patient and the control groups were restricted to elderly subjects (greater than 50 years). In adults (21-50 years old), only the patients' NE levels were significantly elevated. These findings suggest that duration of illness may be important in determining the full expression of the biochemical abnormality in major depression.