Published Paper Details:

ABSTRACT Background: There is a growing interest in investigating the pathological and anatomical basis of psychiatric illness. The introduction of brain imaging technology revolutionized the study of psychiatric illnesses. The growing belief that endocrine abnormalities may underlie many mental conditions have led to increased use of imaging and hormonal assays in patients attending to psychiatric OPDs. To investigate whether Hypothalamic-Pituitary-Adrenal (HPA) axis activation in psychosis is also associated with pituitary volume changes, measurement of the pituitary glands by Magnetic Resonance Imaging (MRI) in patients experiencing their first episode of psychopathology is most suitable, when they are most likely to show HPA axis abnormalities. Objectives: ? To study the Pituitary volume in first episode of psychopathology using MRI and comparing the age and gender matched controls. ? Follow up MRI scan of psychiatric patients, to review Pituitary volume after 3 months or more and correlate with the final psychiatric diagnosis. Materials and methods: The study included 50 patients, with symptoms of psychiatric illness for the first time and presenting within one month of onset of illness 50 age and gender matched healthy controls. Both patients and controls were made to undergo MRI of the Brain. The patients underwent MRI of the brain twice, at initial presentation and again after 3 months. Results: ? There was significantly larger pituitary gland volume in the cases than the controls, irrespective of psychiatric diagnosis at first presentation. ? No significant differences were seen between Pituitary gland volumes at initial MRI and review MRI of the cases. Conclusion: There is a strong likelihood of HPA axis overactivity during initial phase of all mental disorders along with increased pituitary gland volumes. Further studies including hormonal assays and correlation with imaging are likely to provide further insight into neuroanatomical and pathological basis of psychiatric disorders.