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Psychoneuroendocrinological contributions to the etiology of depression, posttraumatic stress disorder, and stress-related bodily disorders: the role of the hypothalamus-pituitary-adrenal axis
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 (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
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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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Metadata
- Authors
- Ehlert, U., Gaab, J., & Heinrichs, M.
- Affiliations
- University of Zurich (CH)
- Corresponding author
- Ehlert, Ulrike
- Venue
- Biological Psychology
- Publisher
- Elsevier BV
- Published
- 2001-08
- Volume
- 57
- Issue
- 1-3
- Pages
- 141-152
- ISSN
- 0301-0511 (ISSN-L)
- 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
- 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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