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Cited by 511Stress Responses and CortisolAdrenal Hormones and DisordersPosttraumatic Stress Disorder Research

Psychoneuroendocrinological contributions to the etiology of depression, posttraumatic stress disorder, and stress-related bodily disorders: the role of the hypothalamus-pituitary-adrenal axis

Ehlert, Ulrike, Gaab, Jens, Heinrichs, Markus·2001·Biological Psychology
DOI 10.1016/s0301-0511(01)00092-8
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Abstract

Following the assumption that stressors play an important part in the etiology and maintenance of psychiatric disorders, it is necessary to evaluate parameters reflecting stress-related physiological reactions. Results from these examinations may help to deepen the insight into the etiology of psychiatric disorders and to elucidate diagnostic uncertainties. One of the best-known stress-related endocrine reactions is the hormonal release of the hypothalamic-pituitary-adrenal (HPA) axis. Dysregulations of this axis are associated with several psychiatric disorders. Profound hyperactivity of the HPA-axis has been found in melancholic depression, alcoholism, and eating disorders. In contrast, posttraumatic stress disorder, stress-related bodily disorders like idiopathic pain syndromes, and chronic fatigue syndrome seem to be associated with diminished HPA activity (lowered activity of the adrenal gland). Hypotheses referring to (a) the psychophysiological meaning and (b) the development of these alterations are discussed.

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  • Altered stress reactivity appears to play an important role in the development of psychiatric disorders as well as cardiovascular disease.

    “Altered stress reactivity appears to play an important role in the development of psychiatric disorders (Ehlert et al., 2001) as well as cardiovascular disease (Phillips et al., 2013; Lovallo, 2011; Treiber et al., 2003).”

    From More than a feeling: A unified view of stress measurement for population science (2018) · cites this paper as Ehlert et al., 2001

  • Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, and particularly the hormone cortisol, has been implicated in the etiology of major depressive disorder by animal and cross-sectional human research.

    “Dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, and particularly the hormone cortisol, has been implicated in the etiology of major depressive disorder by a large body of animal research and cross-sectional research in humans (Chrousos & Gold, 1992; Ehlert et al. 2001).”

    From The cortisol awakening response predicts major depression: predictive stability over a 4-year follow-up and effect of depression history (2013) · cites this paper as Ehlert et al. 2001

  • Many psychiatric disorders, including ED, PTSD, and anxiety disorders, are characterised by dysregulation of the HPA axis.

    “Since many psychiatric disorders, including ED, PTSD, and anxiety disorders, are characterised by dysregulation of the HPA axis (Connan et al., 2007;Ehlert et al., 2001;Lo Sauro et al., 2008), there has been increasing interest in further exploration of the potential anti-stress and anxiolytic effects of intranasal oxytocin in psychiatric disorders characterised by elevated threat sensitivity.”

    From Meta-analytic review of the effects of a single dose of intranasal oxytocin on threat processing in humans (2018) · cites this paper as Ehlert et al., 2001

  • Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is frequently implicated in the etiology of Major Depressive Disorder (MDD).

    “Dysregulation of the hypothalamic-pituitary-adrenal axis (HPA), one of the body's major stress-sensitive physiological systems, is frequently implicated in the etiology of Major Depressive Disorder (MDD) (Ehlert et al., 2001; Gold and Chrousos, 2002; Holsboer, 2000).”

    From Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence (2010) · cites this paper as Ehlert et al., 2001

  • Robust cross-sectional associations exist between MDD and HPA-axis alterations including elevated cortisol, elevated corticotropin releasing hormone (CRH), and impaired negative feedback control of the HPA.

    “Robust cross-sectional associations have been found between the presence of MDD and a variety of alterations of the HPA-axis, including elevated cortisol levels, elevated corticotropin releasing hormone (CRH), and impaired negative feedback control of the HPA (Chrousos and Gold, 1992; Ehlert et al., 2001; Thase et al., 2002).”

    From Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence (2010) · cites this paper as Ehlert et al., 2001

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Authors
Ehlert, U., Gaab, J., & Heinrichs, M.
Affiliations
University of Zurich (CH)
Corresponding author
Ehlert, Ulrike
ORCID
Venue
Biological Psychology
Publisher
Elsevier BV
Published
2001-08
Volume
57
Issue
1-3
Pages
141-152
ISSN
0301-0511 (ISSN-L)
DOI
10.1016/s0301-0511(01)00092-8
OpenAlex
W2001420067
Cited by
510
References
94
Citations by year
2026: 8 · 2025: 9 · 2024: 14 · 2023: 14 · 2022: 16 · 2021: 21 · 2020: 22 · 2019: 24 · 2018: 29 · 2017: 23 · 2016: 20 · 2015: 28 · 2014: 26 · 2013: 31 · 2012: 22
FWCI
5.99
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Biological Psychology (publishedVersion)
  • PubMed (publishedVersion)
  • Research Bank (Australian Catholic University) (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
Topics
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords
hypothalamic-pituitary-adrenal axis, depression, post-traumatic stress disorder, chronic fatigue syndrome, alcoholism, eating disorders, endogenous depression, HPA axis hyperactivity, stress hormones, psychoneuroendocrinology, etiology of mental disorders
MeSH terms
Arousal, Depressive Disorder, Humans, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System, Somatoform Disorders, Stress Disorders, Post-Traumatic, Fatigue Syndrome, Chronic

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