Not fade away: the HPA axis and depression
Open accessAbstract
Salivary cortisol sampling has confirmed the presence of increased cortisol secretion in depression and has also revealed that some aspects of hypothalamo-pituitary-adrenal (HPA) axis disturbance have trait-like characteristics that may predict the risk of future illness. Persistent hypersecretion of cortisol in individuals vulnerable to depression also has implications for the medical co-morbidities associated with mood disorder. Pharmacological treatments targeted at the HPA axis represent a novel approach to the management of depression and its complications; however, a better understanding of the molecular basis of HPA axis dysfunction in depressed patients will be needed before this promise can be fulfilled.
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An elevated CAR should not be construed solely as a 'scar' of depression, i.e. a marker that is only present following an MDE.
“Because the CAR prospectively predicts first onsets, these data suggest that an elevated CAR should not be construed solely as a ‘scar’ of depression (Cowen, 2010), i.e. a marker that is only present following an MDE, which may be indicative of damage caused by the episode.”
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 Cowen, 2010
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- Authors
- Cowen, P. J.
- Affiliations
- Warneford Hospital (GB)
- Corresponding author
- Cowen, P. J.
- ORCID
- Cowen, P. J.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2009-04-01
- Volume
- 40
- Issue
- 1
- Pages
- 1-4
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2124814518
- Cited by
- 191
- References
- 22
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 5 · 2023: 5 · 2022: 10 · 2021: 28 · 2020: 5 · 2019: 13 · 2018: 15 · 2017: 7 · 2016: 5 · 2015: 9 · 2014: 16 · 2013: 19 · 2012: 20
- FWCI
- 6.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Medical Research Council
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- hypothalamic-pituitary-adrenal axis, depression, salivary cortisol, cortisol hypersecretion, depression risk prediction, comorbidities, mood disorders, HPA axis dysregulation
- MeSH terms
- Affect, Antidepressive Agents, Circadian Rhythm, Depressive Disorder, Major, Major Depressive Disorder, Dexamethasone, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System, Prognosis, Saliva, Comorbidity
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