IJCRR - 6(1), January, 2014
A POSTMORTEM STUDY ON THE WEIGHT AND MORPHOLOGY OF ADRENAL GLANDS IN VICTIMS OF SUICIDE
Author: Arpita Sarkar, Manjari Chatterjee, Suddhodhan Batabyal
Objective: Stress plays an important role in affecting adrenal gland anatomy and structure which may have connection with suicidal behaviour in depressed patients. The increase in adrenal cortical function is paralleled by increased adrenal weight and zone specific cortical width. Method: Adrenal glands from persons aged 20-85 years who died unexpectedly either from road traffic accident or committed suicide and died immediately, were obtained from mortuary of Medical college and Hospital, Kolkata, within 48 hours of death and without any gross sign of putrefaction. After overnight fixation, the adrenals were carefully cleaned of adherent fat, blotted dry, weighed on electronic weighing machine having the accuracy of ± 0.1gram. After proper fixation, paraffin blocks were prepared, sectioned and stained with haematoxylin and eosin. Widths of cortical zones were measured by means of a calibrated eyepiece micrometer under light microscope. Result: The weight of right and left, both adrenal glands are significantly higher for suicide group than the control group. The width of zona fasciculata of right and left, both adrenal glands are significantly higher for suicide group than the accident group. The total cortical width of right and left, both adrenal glands are significantly higher for suicide group than the accident group. Conclusion: Increased weight of adrenal glands in suicide victims is mainly due cortical hypertrophy with increased width of zona fasciculata.
Keywords: Adrenal gland, suicide, weight, width of zona fasciculata, cortical width
Arpita Sarkar, Manjari Chatterjee, Suddhodhan Batabyal. A POSTMORTEM STUDY ON THE WEIGHT AND MORPHOLOGY OF ADRENAL GLANDS IN VICTIMS OF SUICIDE International Journal of Current Research and Review. 6(1), January, 21-27
1. Amsterdam, J.D. et al. (1987). Assessment of adrenal gland volume by computed tomography in depressed patients and healthy volunteers: A pilot study. Psychiatry Res., 21: 189-197
2. Beattie, M. K. and Heasman, M. A. (1958): The pituitary and adrenal glands of elderly mental hospital patients with and without hypertension. J. Path. Bact., 75, 83-94.
3. Bransome, Jr, E.D. (1968). Regulation of adrenal growth. Differences in the effects of ACTH in normal and dexamethasonesuppressed guinea pigs. Endocrinology, 83: 956-964.
4. Carroll BJ, Curtis GC, and Mendels J. (1976). Neuroendocrine regulation in depression. II. Discrimination of depressed from nondepressed patients. Arch Gen Psychiatry 33: 1051–1058.
5. Chrousos, G.P. (1998). Stressors, stress, and neuroendocrine integration of the adaptive response. The 1997 Hans Selye Memorial Lecture. Ann. N.Y. Acad. Sci., 851: 311-335.
6. De Kloet, E.R. et al. (1998). Brain corticosteroid receptor balance in health and disease. Endocrine Rev., 19: 269-301.
7. De Kloet, E.R., Joëls, M., and Holsboer, F. (2005). Stress and the brain: From adaptation to disease. Nat. Rev. Neurosci., 6: 463-475.
8. De Rijk, R.H. et al. (2008). Corticosteroid receptor-gene variants: Modulators of the stress-response and implications for mental health. European Journal of Pharmacology, 585: 492-501.
9. Dorovini-Zis K, Zis AP. (1987) Increased adrenal weight in victims of violent suicide. Am J Psychiatry;144:1214-1215.
10. Dorovini-Zis K, Barocka A, Schubert E.(1998). Weight of adrenal glands may be increased in persons who commit suicide. Am J Forensic Med Pathol;19:72-76.
11. Dumser, Thomas; Barocka, Arndt; Schubert, Evelyn (March 1998) - Weight of Adrenal Glands May Be Increased in Persons Who Commit Suicide - American Journal of Forensic Medicine and Pathology: - Volume 19 - Issue 1 - pp 72-76
12. Gibbons JL. (1964) Cortisol secretion rate in depressive illness. Arch Gen Psychiatry 10: 572–575.
13. Jaeckle RS, et al. (1987). Enhanced adrenal sensitivity to exogenous cosyntropin (ACTH alpha 1–24) stimulation in major depression. Relationship to dexamethasone suppression test results. Arch Gen Psychiatry 44: 233– 240.
14. Kalin NH, et al. (1987). Function of the adrenal cortex in patients with major depression. Psychiatry Res 22: 117–125.
15. M. Pompili et al. "The hypothalamicpituitary-adrenal axis and serotonin abnormalities: a selective overview for the implications of suicide prevention."European archives of psychiatry and clinical neuroscience 260.8 (2010): 583-600.
16. Mackinnon, P. C. B., and I. L. Mackinnon. "Morphologic features of the human suprarenal cortex in men aged 20-86 years." Journal of Anatomy 94, no. Pt 2 (1960): 183.
17. Nelson A. Gelfman.(1964). Morphological change of adrenal cortex in disease; Yale journal of biology and medicine, Volume 37, August, 1964
18. Nemeroff CB, et al. (1992). Adrenal gland enlargement in major depression; a computed tomographic study. Arch Gen Psychiatry. 1992;49:384-387.
19. Rubin RT, et al. (1987). Neuroendocrine aspects of primary endogenous depression. I. Cortisol secretory dynamics in patients and matched controls. Arch Gen Psychiatry 44: 328–336.
20. Rubin RT, et al. (1995). Adrenal gland volume in major depression. Increase during the depressive episode and decrease with successful treatment. - Arch Gen Psychiatry. 1995 Mar;52(3):213-8.
21. Rubin RT, et al. (1996). Adrenal gland volume in major depression: relationship to basal and stimulated pituitary-adrenal cortical axis function. - Biol Psychiatry. 1996 Jul 15;40(2):89-97.
22. Sachar EJ, (1973). Disrupted 24-hour patterns of cortisol secretion in psychotic depression. Arch Gen Psychiatry 28: 19–24.
23. Sarason, E. L.(1943): Adrenal cortex in systemic disease. Arch. intern. Med., 1943, 71, 702-712.
24. Siddiqua, Dilruba, Shamim Ara, Abu Sadat Mohammad Nurunnabi, Rukshana Ahmed, and Ara Parven Hosne. "A postmortem study on the weight of the human adrenal glands." Bangladesh Journal of Medical Science 9, no. 4 (2010): 204-207.
25. Stein E,(1993). Adrenal gland weight and suicide. - Can J Psychiatry. 1993 Oct;38(8):563-6.
26. Solberg, L.C., et al. (2006). Genetic analysis of the stress-responsive adrenocortical axis. Physiol. Genomics, 27: 362-369.
27. Szigethy E, et al. (1994). Adrenal weight and morphology in victims of completed suicide. Biol Psychiatry.36:374-380.
28. Ulrich-Lai YM, et al. (2006). Chronic stress induces adrenal hyperplasia and hypertrophy in a subregion-specific manner. American Journal of Physiology - Endocrinology and Metabolis,Published 1 November 2006Vol. 291no. E965-E973
29. Willenberg HS, et al.(1998). Morphological changes in adrenals from victims of suicide in relation to altered apoptosis. Endocr Res 24: 963–967.