The hypothalamic-pituitary-adrenal system in panic disorder.

The authors evaluated 24 outpatients with panic disorder by means of the afternoon continuous test for cortisol and the 1-mg dexamethasone suppression test (DST) and compared the results with those of 38 outpatients with major depressive disorder and 61 healthy control subjects. The mean basal cortisol level of the patients with panic disorder was significantly higher than that of the normal control subjects but almost identical to that of the depressed patients. Only three of the patients with panic disorder had abnormal DST results. These results indicate that patients with panic disorder have an abnormality of at least one function of the hypothalamic-pituitary-adrenal system which overlaps the abnormality in major depressive disorder.