PSYCHONEUROENDOCRINOLOGY OF DEPRESSION
Abstract
Among the more consistent observations in patients with major depression is dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis presenting as elevation of basal cortisol, dexamethasone-mediated negative feedback resistance, increased cerebrospinal fluid levels of corticotropin-releasing factor (CRF), and a blunted adrenocorticotropic hormone (ACTH) response to challenge with exogenous CRF. These features appear to be state, rather than trait markers, and are normalized upon successful treatment. These pathophysiologic adaptations may arise from defects in central drive to the neuroendocrine hypothalamus, disruption of normal adrenocortical hormone receptor function or a modification of HPA axis function at any level. Functional assessment of the HPA axis is thought to provide a window into central nervous system operation that may be of diagnostic value in this and other affective disorders regardless of whether CRF and glucocorticoids are directly involved in the origin of major depression or merely exacerbate the consequences of other primary defects.
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HPA axis dysfunction is strongly implicated in the etiopathology of affective disorders.
“HPA axis dysfunction is strongly implicated in the etiopathology of affective disorders (93–95)”
From Higher Circulating Cortisol in the Follicular vs. Luteal Phase of the Menstrual Cycle: A Meta-Analysis (2020) · cites this paper as [94]
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- Authors
- Plotsky, P. M., Owens, M. J., & Nemeroff, C. B.
- Affiliations
- Emory University (US)
- ORCID
- Nemeroff, Charles B.
- Venue
- Psychiatric Clinics of North America
- Publisher
- Elsevier BV
- Published
- 1998-06
- Volume
- 21
- Issue
- 2
- Pages
- 293-307
- ISSN
- 0193-953X (ISSN-L)
- OpenAlex
- W3240440
- Cited by
- 672
- References
- 144
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 14 · 2023: 9 · 2022: 7 · 2021: 9 · 2020: 16 · 2019: 22 · 2018: 18 · 2017: 11 · 2016: 16 · 2015: 19 · 2014: 26 · 2013: 28 · 2012: 35
- FWCI
- 10.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Clinics of North America (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- major depressive disorder, psychoneuroendocrinology, diathesis-stress model, genetic susceptibility, epigenetic factors, life events, neuroplasticity, developmental neuroscience, psychoanalytic theory, anxiety disorders, perinatal period, peripubertal period
- MeSH terms
- Depression, Female, Glucocorticoids, Humans, Hypothalamo-Hypophyseal System, Male, Pituitary-Adrenal System, Receptors, Glucocorticoid
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