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Neuroendocrine aspects of hypercortisolism in major depression
Abstract
A consistent finding in biological psychiatry is that hypothalamic-pituitary-adrenal (HPA) axis physiology is altered in humans with major depression. These findings include hypersecretion of cortisol at baseline and on the dexamethasone suppression test. In this review, we present a process-oriented model for HPA axis regulation in major depression. Specifically, we suggest that acute depressions are characterized by hypersecretion of hypothalamic corticotropin-releasing factor, pituitary adrenocorticotropic hormone (ACTH), and adrenal cortisol. In chronic depressions, however, enhanced adrenal responsiveness to ACTH and glucocorticoid negative feedback work in complementary fashion so that cortisol levels remain elevated while ACTH levels are reduced. In considering the evidence for hypercortisolism in humans, studies of nonhuman primates are presented and their utility and limitations as comparative models of human depression are discussed.
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“The induction of anhedonia has been the primary focus in this model”
From Chronic unpredictable stress induces depression-related behaviors by suppressing AgRP neuron activity (2021) · cites this paper as [40]
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“has been the most consistent biological abnormality in this disorder [38, 40].”
From Chronic unpredictable stress induces depression-related behaviors by suppressing AgRP neuron activity (2021) · cites this paper as [40]
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“along with its important feature reproducing hypercortisolism, which is found in 40–60% of patients with major depression”
From Chronic unpredictable stress induces depression-related behaviors by suppressing AgRP neuron activity (2021) · cites this paper as [40]
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Metadata
- Authors
- Parker, K. J., Schatzberg, A. F., & Lyons, D. M.
- Affiliations
- Stanford Medicine (US)
- Corresponding author
- Parker, Karen J
- Venue
- Hormones and Behavior
- Publisher
- Elsevier BV
- Published
- 2003-01
- Volume
- 43
- Issue
- 1
- Pages
- 60-66
- ISSN
- 0018-506X (ISSN-L)
- OpenAlex
- W2093358121
- Cited by
- 455
- References
- 89
- Citations by year
- 2026: 8 · 2025: 4 · 2024: 13 · 2023: 12 · 2022: 23 · 2021: 18 · 2020: 18 · 2019: 18 · 2018: 25 · 2017: 18 · 2016: 19 · 2015: 17 · 2014: 27 · 2013: 27 · 2012: 22
- FWCI
- 7.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hormones and Behavior (publishedVersion)
- PubMed (publishedVersion)
- Funders
- School of Medicine, Stanford University
- National Institute of Mental Health (MH-47573, R01MH050604, MH50604, R01MH047573)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroendocrine regulation and behavior
- Keywords
- hypercortisolism, major depressive disorder, hypothalamic-pituitary-adrenal axis, cortisol, corticotropin-releasing factor, ACTH, glucocorticoid negative feedback, dexamethasone suppression test, chronic depression, acute depression, neuroendocrinology
- MeSH terms
- Adrenocorticotropic Hormone, Animals, Corticotropin-Releasing Hormone, Major Depressive Disorder, Humans, Hydrocortisone, Neurosecretory Systems
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