Enlarged pituitary glands have been found in some adolescents with
early-onset major depression, raising the question of what role, if any, the
gland plays in their disorder.
The finding about the enlarged pituitary glands comes from Vivek Kusumakar,
M.D., an associate professor of psychiatry at Dalhousie University in Halifax,
Nova Scotia, and Frank MacMaster, a doctoral candidate in anatomy and
neurobiology at the National Research Council in Halifax. Results appeared in
the May-June Journal of Psychiatric Research.
Some abnormalities in hormones under the control of the pituitary gland
have been noted in individuals with a major depression. For example, a failure
to suppress blood levels of the hormone cortisol have been noted in major
depression subjects after they were given dexamethasone. And in 1991, Ranga
Krishnan, M.D., chair of psychiatry at Duke University, and colleagues found
enlarged pituitary glands in acutely depressed adult subjects compared with
healthy control subjects. So Kusumakar and MacMaster suspected that they might
find enlarged pituitary glands in adolescents with major depressive
They used high-resolution magnetic resonance imaging (MRI) to measure the
volume of the pituitary gland in 17 teens with a major depressive disorder and
in 17 gender-matched healthy-control teens. The 34 subjects were, on average,
16.5 years old. A trained rater blind to the diagnosis of each subject
conducted the MRI measurements.
The subjects with a major depressive disorder were found to have pituitary
glands that were significantly greater in volume— by 25
percent—than were the pituitary glands of the control subjects. And even
when the researchers eliminated the three depressed subjects who were on
psychotropic medications from their evaluations, they still found that
subjects with a major depression had significantly larger pituitary glands
than did controls.
"To our knowledge," Kusumakar and MacMaster said, "this
study is the first direct comparison of in vivo pituitary volumes between
early-onset, adolescent major depressive disorder patients and age- and
sex-matched healthy controls, indicating anatomical abnormalities in the
pituitaries of these patients."
Since this study was published, MacMaster told Psychiatric News,
he has conducted another study with David Rosenberg, M.D., of Wayne State
University, in 25 teens with a major depressive disorder and 25 healthy
control subjects, and this time none of the depressed teens were on
medication. Again, MacMaster said, larger pituitary volumes were found in the
The question that still needs to be answered is what the enlarged pituitary
glands in depressed youth mean. Do they contribute to the depression? Do they
stem from it? And do they lead to abnormal hormone production in the body? For
instance, one might expect abnormally high levels of cortisol in the blood to
occur if a pituitary gland were abnormally large in volume. Yet while
abnormally high levels of cortisol have been noted in adults with major
depressive disorder, such high levels appear to be rare in teens with the
In any event, "the findings are interesting and confirm our earlier
reports in adults," Krishnan told Psychiatric News.
To date, only a few studies have examined the size of the pituitary gland
in psychiatric illnesses. Abnormally small pituitary glands have been noted in
bulimic patients and in children with obsessive-compulsive disorder, and
abnormally large pituitary glands have been reported in subjects with alcohol
The study was funded by the Nova Scotia Health Research Foundation and the
Theodore and Vada Stanley Foundation.
An abstract of the study report, "MRI Study of the Pituitary
Gland in Adolescent Depression," can be accessed online at<www.sciencedirect.com/science/journals>
by clicking onJournal of Psychiatric Research. ▪