Differential Patterns of HPA Activity and Reactivity in Adult Posttraumatic Stress Disorder and Major Depressive Disorder
Abstract
Despite a number of overlapping symptoms, individuals with posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) often display hypothalamic-pituitary-adrenal (HPA) profiles that appear quite different from one another. This review describes the patterns of HPA-axis activity and reactivity in healthy individuals compared to individuals with these two disorders. Measures of HPA-axis activity and reactivity include cortisol levels at rest, in response to the dexamethasone suppression test (DST), and in response to psychological stress. The research reviewed presents the possibility of diagnostic specificity with regard to HPA function. In particular, the differential response pattern to the DST suggests that, while it cannot be considered a pure diagnostic tool, it should be one measure taken into consideration during diagnosis.
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Extensive evidence documents perturbed hypothalamic-pituitary-adrenal axis function as a result of early life stress and in depression and certain anxiety disorders, particularly PTSD.
“there is extensive evidence documenting perturbed HPA function both as a result of ELS and in the context of depression and certain anxiety disorders (particularly PTSD)”
From Gene–environment interactions: early life stress and risk for depressive and anxiety disorders (2011) · cites this paper as Handwerger 2009
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References 122 · Cited by 122
- Authors
- Handwerger, K.
- Affiliations
- Tufts University (US)
- Corresponding author
- Handwerger, Kathryn
- Venue
- Harvard Review of Psychiatry
- Published
- 2009-05
- Volume
- 17
- Issue
- 3
- Pages
- 184-205
- ISSN
- 1067-3229 (ISSN-L)
- OpenAlex
- W2022477382
- Cited by
- 122
- References
- 122
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 3 · 2022: 6 · 2021: 1 · 2020: 10 · 2019: 8 · 2018: 6 · 2017: 3 · 2016: 7 · 2015: 7 · 2014: 12 · 2013: 9 · 2012: 19
- FWCI
- 0.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Harvard Review of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- post-traumatic stress disorder, major depressive disorder, hypothalamic-pituitary-adrenal axis, cortisol, dexamethasone suppression test, psychological stress response, diagnostic specificity
- MeSH terms
- Adrenal Cortex Function Tests, Adult, Major Depressive Disorder, Dexamethasone, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System, Stress Disorders, Post-Traumatic, Stress, Psychological, Biomarkers
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