Adrenal Function Predicts Demoralization After Losses

Abstract

Stressful experiences can cause disturbances in the hypothalamic-pituitary-adrenocortical axis and the sympathetic-adrenomedullary system. The authors hypothesized that assessments of adrenal function made in the circumstances of stressful losses would predict outcome 1 or 2 years later. The authors collected 24-hour urinary free cortisol, serum cortisol, and 24-hour urinary catecholamines 2 months after intake and used these measures as predictors of depression, anxiety, hopelessness/helplessness, unresolved grief, self-rated health, and help-seeking behavior on follow-up at 13 and 25 months. Adrenal function in the circumstances of a loss predicted only demoralization scores (hopelessness/helplessness) on follow-up.