Preoperative emotional states and adrenal cortical activity; studies on cardiac and pulmonary surgery patients.

Although it is widely accepted that the central nervous system is involved in the regulation of secretion of pituitary adrenocorticotropic hormone (ACTH), little is known of the relationships between specific emotional responses and the release of ACTH. Since the pituitary-adrenal system is generally stimulated under conditions in which the integrity of the organism is threatened, it might be expected that fear or anxiety most likely would be associated with increased ACTH release and subsequent increased secretion of adrenocortical hormones. Some studies have been made of both psychological and endocrine factors in human subjects during grossly threatening life situations. 1,2,4,8,13 As in other, previous studies, the initial hypothesis in this study of patients about to undergo cardiac or pulmonary surgery was that there would be a close relationship between the degree to which a patient was anxious and the plasma levels of his adrenocortical hormone. Attempts were made to predict this