Pathophysiology of hypercortisolism in depression

Carroll, B. J.; Cassidy, F.; Naftolowitz, D.; Tatham, N. E.; Wilson, W. H.; Iranmanesh, A.; Liu, P. Y.; Veldhuis, J. D.

doi:10.1111/j.1600-0447.2007.00967.x

Cited by 317Stress Responses and CortisolAdrenal Hormones and DisordersNeuropeptides and Animal Physiology

Pathophysiology of hypercortisolism in depression

Carroll, B. J., Cassidy, F., Naftolowitz, D., Tatham, N. E., Wilson, W. H., Iranmanesh, A., Liu, P. Y., Veldhuis, J. D.·2007·Acta Psychiatrica Scandinavica

DOI 10.1111/j.1600-0447.2007.00967.x

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Abstract

OBJECTIVE: The mechanisms mediating hypercortisolemia in depression remain controversial. Adopting the biomarker strategy, we studied adrenocorticotropin (ACTH) and cortisol dynamics in hypercortisolemic and non-hypercortisolemic depressed in-patients, and in normal volunteers. METHOD: Deconvolution analysis of 24-h pulsatile secretion, approximate entropy (ApEn) estimation of secretory regularity, cross-ApEn quantitation of forward and reverse ACTH-cortisol synchrony, and cosine regression of 24-h rhythmicity. RESULTS: Hypercortisolemia was strongly associated with melancholic and psychotic depressive subtypes. Hypercortisolemic patients had elevated ACTH and cortisol secretion, mediated chiefly by increased burst masses. Basal ACTH secretion was increased, ACTH half-life was reduced, and mean 24-h ACTH concentration was normal. Cortisol secretion was increased in a highly irregular pattern (high ApEn), with high ACTH --> cortisol cross-ApEn (impaired feedforward coupling). Cortisol-mediated feedback on the secretory pattern of ACTH was normal. Hypercortisolemic depressed patients had normal programming of the central hypothalamo-pituitary-adrenal (HPA) axis pulse generator: ACTH pulse frequency, cortisol pulse frequency, circadian acrophases, and ApEn of ACTH secretion were normal. Responsiveness of the adrenal cortex to endogenous ACTH was normal. Non-hypercortisolemic patients resembled hypercortisolemic patients on ACTH regulatory parameters but had low total cortisol secretion. CONCLUSION: Increased ACTH secretion occurs in depressed in-patients regardless of cortisolemic status, confirming central HPA axis overdrive in severe depression. Depressive hypercortisolemia results from an additional change in the adrenal cortex that causes ACTH-independent, disorderly basal cortisol release, a sign of physiological stress in melancholic/psychotic depression.

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Some depressives show reduced sensitivity to glucocorticoid fast feedback and/or to dexamethasone negative feedback, although these findings depend upon depressive subtype, being most common in melancholic and psychotic cases.
“some depressives show reduced sensitivity to glucocorticoid “fast feedback” (Young et al. 1993) and/or to dexamethasone negative feedback (Carroll et al. 1981), although these findings depend upon depressive subtype, being most common in melancholic and psychotic cases (Carroll et al. 2007).”
From Brain structural and functional abnormalities in mood disorders: implications for neurocircuitry models of depression (2008) · cites this paper as Carroll et al. 2007
Chronic conditions such as coronary artery disease, fibromyalgia, rheumatoid arthritis, Major Depressive Disorder, and Post Traumatic Stress Disorder are associated with abnormally high cortisol levels and metabolic disruptions.
“chronic conditions such as coronary artery disease, fibromyalgia, rheumatoid arthritis, and mood disorders such as Major Depressive Disorder (MDD) and Post Traumatic Stress Disorder (PTSD) have also been associated with abnormally high CORT levels and metabolic disruptions ( 5-13 ).”
From Dynamic modulation of glucose utilisation by glucocorticoid rhythms in health and disease (2020) · cites this paper as [8]
In hypercortisolism, cortisol levels are higher than normal and in some cases display abnormal rhythmicity, varying by underlying condition.
“in hypercortisolism, it is not only that CORT levels are higher than normal, but in some cases, they also display abnormal rhythmicity. This varies depending on whether the underlying condition is associated with Cushing's syndrome, depression, PTSD, acute inflammation following major surgery, or chronic inflammatory diseases (e.g., rheumatoid arthritis) ( 2, 5-13, 57-60 ).”
From Dynamic modulation of glucose utilisation by glucocorticoid rhythms in health and disease (2020) · cites this paper as [8]
Many conditions associated with hypercortisolism are accompanied by disruption of normal glucose metabolism while preserving some degree of cortisol rhythmicity.
“many of these conditions are accompanied by a disruption of normal glucose metabolism while preserving some degree of CORT rhythmicity.”
From Dynamic modulation of glucose utilisation by glucocorticoid rhythms in health and disease (2020) · cites this paper as [8]
The validation dataset included plasma ACTH and cortisol concentrations of 17 healthy subjects measured every 10 minutes for a 24-hour period.
“To validate the models, we used a dataset by Carroll and colleagues which included plasma ACTH and cortisol concentrations of 17 healthy subjects (8). The datasets reported the concentrations every 10 minutes for a 24 hour period”
From Modeling the hypothalamus-pituitary-adrenal axis: A review and extension (2015) · cites this paper as [8]

The degradation rate w3 is 0.009 [1/min], found using the half-life of cortisol concentration reported in the literature.
“The degradation rate, w3, is 0.009 [1/min] and it is found by using the half-life of the cortisol concentration reported in the literature (8).”
From Modeling the hypothalamus-pituitary-adrenal axis: A review and extension (2015) · cites this paper as [8]
k2 and w3 are biological parameters which should not be very different across individuals.
“Yet these two are biological parameters which should not be very different across individuals (For instance, the half-life of ACTH for healthy individuals reported in (8) is 19.9 minutes with a relatively tight standard deviation of 4 minutes).”
From Modeling the hypothalamus-pituitary-adrenal axis: A review and extension (2015) · cites this paper as [8]
In typical circadian oscillations, the hormone is at minimum between 8 p.m. and 4 a.m., increases to maximum between 4 a.m. and 12 p.m., then declines to minimum from 12 p.m. to 8 p.m.
“In typical circadian oscillations, the hormone is at the minimum level between 8 p.m. and 4 a.m. It increases to a maximum level between 4 a.m. and 12 p.m. then it declines to a minimum level from 12 p.m. to 8 p.m. (8).”
From Modeling the hypothalamus-pituitary-adrenal axis: A review and extension (2015) · cites this paper as [8]
These fixed point values are in the correct range when compared to averages of healthy individual data from (8, 47) as reported in (27) which found 3.06 ng/ml for cortisol, 21 pg/ml for ACTH, and 7.66 pg/ml for CRH.
“These values are in the correct range when compared to averages of healthy individual data from (8, 47) as reported in (27) which found 3.06 ng/ml for cortisol, 21 pg/ml for ACTH, and 7.66 pg/ml for CRH providing further confidence in the overall plausibility of the results.”
From Modeling the hypothalamus-pituitary-adrenal axis: A review and extension (2015) · cites this paper as [8]
Early attempts to establish objective markers for diagnosing depression based on HPA hormone levels and patterns have not been successful.
“Early attempts of establishing objective markers for diagnosing depression based on hormone levels and patterns produced by the HPA axis have not been successful [9, 12, 43].”
From Patient specific modeling of the HPA axis related to clinical diagnosis of depression (2017) · cites this paper as [9]
The data come from a study by Carroll et al. that included healthy controls and depressive humans.
“The data come from a study described by Carroll et al. [9], where healthy controls and depressive humans were included.”
From Patient specific modeling of the HPA axis related to clinical diagnosis of depression (2017) · cites this paper as [9]
The secretion of cortisol exhibits both circadian and ultradian oscillations.
“The secretion of cortisol has been studied in many cases revealing both circadian and ultradian oscillations in the concentration [8, 9, 10, 16, 41].”
From Patient specific modeling of the HPA axis related to clinical diagnosis of depression (2017) · cites this paper as [9]
Depression is commonly believed to be caused by malfunctions in the HPA axis.
“However, it is commonly believed that depression is caused by malfunctions in the Hypothalamic-Pituitary-Adrenal (HPA) axis - a coupled endocrine system [9, 12, 20, 40].”
From Patient specific modeling of the HPA axis related to clinical diagnosis of depression (2017) · cites this paper as [9]

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Molecular Mechanisms of Depression: Perspectives on New Treatment Strategies
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Brain structural and functional abnormalities in mood disorders: implications for neurocircuitry models of depression
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“…some depressives show reduced sensitivity to glucocorticoid ‘‘fast feedback’’ (Young et al. 1993) and/ or to dexamethasone negative feedback (Carroll et al. 1981), although these findings depend upon depressive subtype, being most common in melancholic and psychotic cases (Carroll et al. 2007).”
Background
Major depressive disorder
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Neurocircuitry of Mood Disorders
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Neurobiology of resilience
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Handbook of Religion and Health
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · doi:10.1093/oso/9780190088859.001.0001 · Cited by 1,150 · see citing works
Major depressive disorder and hypothalamic-pituitary-adrenal axis activity
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Epilepsy and brain inflammation
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Altered Expression of Genes Involved in Inflammation and Apoptosis in Frontal Cortex in Major Depression
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Depression and anxiety among US adults: associations with body mass index
Zhao, G., Ford, E. S., Dhingra, S., Li, C., Strine, T. W., & Mokdad, A. H. (2009) · International Journal of Obesity · doi:10.1038/ijo.2008.268 · Cited by 423 · see citing works
Mood and gut feelings
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Dissociation of ACTH and glucocorticoids
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Psychobiological mechanisms of resilience: Relevance to prevention and treatment of stress-related psychopathology
Haglund, M., Nestadt, P. S., Cooper, N. S., Southwick, S. M., & Charney, D. S. (2007) · Development and Psychopathology · doi:10.1017/s0954579407000430 · Cited by 315 · see citing works
Reductions in anti-inflammatory gut bacteria are associated with depression in a sample of young adults
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Motivations and Methods for Analyzing Pulsatile Hormone Secretion
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Interactions between antidepressants and P‐glycoprotein at the blood–brain barrier: clinical significance of in vitro and in vivo findings
O'Brien, F. E., Dinan, T. G., Griffin, B. T., & Cryan, J. F. (2011) · British Journal of Pharmacology · doi:10.1111/j.1476-5381.2011.01557.x · Cited by 218 · see citing works
Smoking, nicotine and neuropsychiatric disorders
Döme, P., Lazáry, J., Kalapos, M. P., & Rihmer, Z. (2009) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2009.07.013 · Cited by 215 · see citing works
Stress, Hypothalamic-Pituitary-Adrenal Axis and Eating Disorders
Lo Sauro, C., Ravaldi, C., Cabras, P. L., Faravelli, C., & Ricca, V. (2008) · Neuropsychobiology · doi:10.1159/000138912 · Cited by 215 · see citing works
The Neurobiology of Depression: an Integrated Overview from Biological Theories to Clinical Evidence
Ferrari, F., & Villa, R. F. (2016) · Molecular Neurobiology · doi:10.1007/s12035-016-0032-y · Cited by 186 · see citing works
Cholinergic regulation of mood: from basic and clinical studies to emerging therapeutics
Dulawa, S. C., & Janowsky, D. S. (2019) · Molecular Psychiatry · doi:10.1038/s41380-018-0219-x · Cited by 187 · see citing works
Assessing Daily Stress Processes in Social Surveys by Combining Stressor Exposure and Salivary Cortisol
Almeida, D. M., McGonagle, K. A., & King, H. A. (2009) · Biodemography and Social Biology · doi:10.1080/19485560903382338 · Cited by 185 · see citing works
Appetite changes reveal depression subgroups with distinct endocrine, metabolic, and immune states
Simmons, W. K., Burrows, K., Avery, J. A., Kerr, K. L., Taylor, A. A., Bodurka, J., Potter, W. T., Teague, T. K., & Drevets, W. C. (2018) · Molecular Psychiatry · doi:10.1038/s41380-018-0093-6 · Cited by 183 · see citing works
Is salivary alpha-amylase an indicator of autonomic nervous system dysregulations in mental disorders?—A review of preliminary findings and the interactions with cortisol
Schumacher, S., Kirschbaum, C., Fydrich, T., & Ströhle, A. (2013) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2013.02.003 · Cited by 181 · see citing works
Stress, seizures, and hypothalamic–pituitary–adrenal axis targets for the treatment of epilepsy
Maguire, J. L., & Salpekar, J. A. (2012) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2012.09.040 · Cited by 169 · see citing works
Insulin Resistance as a Shared Pathogenic Mechanism Between Depression and Type 2 Diabetes
Silva, N. M. L. E., Lam, M. P., Soares, C. N., Munoz, D. P., Milev, R. V., & Felice, F. G. D. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00057 · Cited by 169 · see citing works
Major Depression: One Brain, One Disease, One Set of Intertwined Processes
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Glucocorticoid Dysregulations and Their Clinical Correlates: From Receptors to Therapeutics
Marques, A. H., Silverman, M. N., & Sternberg, E. M. (2009) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2009.04987.x · Cited by 158 · see citing works
BMAL1 knockout macaque monkeys display reduced sleep and psychiatric disorders
Qiu, P., Jiang, J., Liu, Z., Cai, Y., Huang, T., Wang, Y., Liu, Q., Nie, Y., Liu, F., Cheng, J., et al. (2019) · National Science Review · doi:10.1093/nsr/nwz002 · Cited by 157 · see citing works
Orexins Mediate Sex Differences in the Stress Response and in Cognitive Flexibility
Grafe, L. A., Cornfeld, A., Luz, S., Valentino, R., & Bhatnagar, S. (2017) · Biological Psychiatry · doi:10.1016/j.biopsych.2016.10.013 · Cited by 135 · see citing works
Circadian phase and sex effects on depressive/anxiety-like behaviors and HPA axis responses to acute stress
Verma, P., Hellemans, K. G. C., Choi, F., Yu, W. K., & Weinberg, J. (2009) · Physiology & Behavior · doi:10.1016/j.physbeh.2009.11.002 · Cited by 137 · see citing works
HPA axis and sleep: Identifying subtypes of major depression
Antonijevic, I. A., & Antonijevic, I. A. (2008) · Stress · doi:10.1080/10253890701378967 · Cited by 134 · see citing works
Molecular biomarkers of depression
Gururajan, A., Clarke, G. A., Dinan, T. G., & Cryan, J. F. (2016) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.02.011 · Cited by 134 · see citing works
Cortisol secretion in depressed, and at-risk adults
Dienes, K. A., Hazel, N. A., & Hammen, C. L. (2013) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2012.09.019 · Cited by 128 · see citing works
Molecular aspects of depression: A review from neurobiology to treatment
Boas, G. R. V., de Lacerda, R. B., Paes, M. M., Gubert, P., Almeida, W. L. D. C., Rescia, V. C., Galdino, P. M., de Carvalho, A. A. V., & Oesterreich, S. A. (2019) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2019.02.024 · Cited by 128 · see citing works
Modulation of glucocorticoid receptor nuclear translocation in neurons by immunophilins FKBP51 and FKBP52: Implications for major depressive disorder
Tatro, E. T., Everall, I. P., Kaul, M., & Achim, C. L. (2009) · Brain Research · doi:10.1016/j.brainres.2009.06.036 · Cited by 125 · see citing works
Assessment of a prevention program for work-related stress among urban police officers
Arnetz, B. B., Arble, E. P., Backman, L., Lynch, A., & Lublin, A. (2012) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-012-0748-6 · Cited by 127 · see citing works
Effects of maternal prenatal stress on offspring development: a commentary
Lazinski, M. J., Shea, A. K., & Steiner, M. S. (2008) · Archives of Women s Mental Health · doi:10.1007/s00737-008-0035-4 · Cited by 120 · see citing works
Hypothalamic-Pituitary-Adrenal Hypofunction in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) as a Consequence of Activated Immune-Inflammatory and Oxidative and Nitrosative Pathways
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The Interface of Pain and Mood Disturbances in the Rheumatic Diseases
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Which clinical and experimental data link temporal lobe epilepsy with depression?
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The Effects of Social Support, Depression, and Stress on Drinking Behaviors in a College Student Sample
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Neurobiology of resilience
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The Neuroendocrinology of Mood Disorders
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Psychosomatic aspects of Cushing’s syndrome
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Late-night salivary cortisol measurement in the diagnosis of Cushing’s syndrome
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The diagnosis of Cushing’s syndrome
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Parental history of depression or anxiety and the cortisol awakening response
Vreeburg, S. A., Hartman, C. A., Hoogendijk, W. J. G., van Dyck, R., Zitman, F. G., Ormel, J., & Penninx, B. W. J. H. (2010) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.109.076869 · Cited by 94 · see citing works
Chronic maternal stress affects growth, behaviour and hypothalamo–pituitary–adrenal function in juvenile offspring
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A final common pathway for depression? Progress toward a general conceptual framework
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Reduced hypothalamic-pituitary-adrenal axis activity in chronic multi-site musculoskeletal pain: partly masked by depressive and anxiety disorders
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Assessment of the hypothalamic–pituitary–adrenal axis activity: glucocorticoid receptor and mineralocorticoid receptor function in depression with early life stress – a systematic review
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Dex/CRH test cortisol response in outpatients with major depression and matched healthy controls
Carpenter, L. L., Ross, N. S., Tyrka, A. R., Anderson, G. M., Kelly, M., & Price, L. H. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2009.03.009 · Cited by 70 · see citing works
Microglia and HPA axis in depression: An overview of participation and relationship
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Early life stress in depressive patients: role of glucocorticoid and mineralocorticoid receptors and of hypothalamic-pituitary-adrenal axis activity.
Juruena, M. F., Baes, C. V. W., Menezes, I. C., & Graeff, F. (2015) · Current pharmaceutical design · doi:10.2174/1381612821666150105125500 · Cited by 60 · see citing works
Behavioral adjustment in a community sample of boys: Links with basal and stress-induced salivary cortisol concentrations
Tyrka, A. R., Kelly, M. M., Graber, J. A., DeRose, L. M., Lee, J. K., Warren, M. P., & Jeanne Brooks-gunn, B. (2010) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2010.02.002 · Cited by 66 · see citing works
The Wistar-Kyoto rat model of endogenous depression: a tool for exploring treatment resistance with an urgent need to focus on sex differences
Millard, S. J., Weston-Green, K., & Newell, K. A. (2020) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2020.109908 · Cited by 62 · see citing works
Alterations in glucocorticoid negative feedback following maternal Pb, prenatal stress and the combination: A potential biological unifying mechanism for their corresponding disease profiles
Rossi‐George, A., Virgolini, M. B., Weston, D. D., & Cory‐Slechta, D. A. (2008) · Toxicology and Applied Pharmacology · doi:10.1016/j.taap.2008.10.003 · Cited by 65 · see citing works
Volume of the adrenal and pituitary glands in depression
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The roles of the sympathetic nervous system in osteoporotic diseases: A review of experimental and clinical studies
Ji-ye, H., Jiang, L., & Dai, L. (2011) · Ageing Research Reviews · doi:10.1016/j.arr.2011.01.002 · Cited by 65 · see citing works
Dynamics of the HPA axis and inflammatory cytokines: Insights from mathematical modeling
Malek, H., Ebadzadeh, M. M., Safabakhsh, R., Razavi, A., & Zaringhalam, J. (2015) · Computers in Biology and Medicine · doi:10.1016/j.compbiomed.2015.09.018 · Cited by 63 · see citing works
Depression and Bone Metabolism
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Is there a relation between major depression and hair cortisol? A systematic review and meta-analysis
Psarraki, E. E., Kokka, I., Bacopoulou, F., Chrousos, G. P., Artemiadis, A., & Darviri, C. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2020.105098 · Cited by 67 · see citing works
Major depression model induced by repeated and intermittent lipopolysaccharide administration: Long-lasting behavioral, neuroimmune and neuroprogressive alterations
Rodrigues, F. T. S., de Souza, M. R. M., Lima, C. N. D. C., da Silva, F. E. R., Costa, D. V. D. S., dos Santos, C. C., Miyajima, F., de Sousa, F. C. F., Vasconcelos, S. M. M., Barichello, T., et al. (2018) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2018.10.003 · Cited by 59 · see citing works
Chronic corticosterone aggravates behavioral and neuronal symptomatology in a mouse model of alpha-synuclein pathology
Burtscher, J., Copin, J., Rodrigues, J., Kumar, S. T., Chiki, A., de Suduiraut, I. G., Sandi, C., & Lashuel, H. A. (2019) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2019.08.007 · Cited by 60 · see citing works
Early Life Stress in Depressive Patients: HPA Axis Response to GR and MR Agonist
Baes, C. W., Martins, C., Tofoli, S. M. D. C., & Juruena, M. F. (2014) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2014.00002 · Cited by 53 · see citing works
Mathematical modeling of the hypothalamic–pituitary–adrenal gland (HPA) axis, including hippocampal mechanisms
Andersen, M., Vinther, F., & Ottesen, J. T. (2013) · Mathematical Biosciences · doi:10.1016/j.mbs.2013.08.010 · Cited by 56 · see citing works
Corticotropin-Releasing Hormone and Arginine Vasopressin in Depression
Bao, A., & Swaab, D. F. (2010) · Vitamins and hormones · doi:10.1016/s0083-6729(10)82018-7 · Cited by 60 · see citing works
Level of Thyroid-Stimulating Hormone (TSH) in Patients with Acute Schizophrenia, Unipolar Depression or Bipolar Disorder
Wysokiński, A., & Kłoszewska, I. (2014) · Neurochemical Research · doi:10.1007/s11064-014-1305-3 · Cited by 58 · see citing works
Regulatory Pathways of Monoamine Oxidase A during Social Stress
Higuchi, Y., Soga, T., & Parhar, I. S. (2017) · Frontiers in Neuroscience · doi:10.3389/fnins.2017.00604 · Cited by 57 · see citing works
Differential Effects of Physiological Arousal Following Acute Stress on Police Officer Performance in a Simulated Critical Incident
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Authors: Carroll, B. J., Cassidy, F., Naftolowitz, D., Tatham, N. E., Wilson, W. H., Iranmanesh, A., Liu, P. Y., & Veldhuis, J. D.
Affiliations: Duke Medical Center (US)
Salem VA Medical Center (US)
Mayo Clinic (US)
Corresponding author: Carroll, B. J.
ORCID: Carroll, B. J.
Iranmanesh, A.
Veldhuis, J. D.
Venue: Acta Psychiatrica Scandinavica
Publisher: Wiley
Published: 2007-01-15
Volume: 115
Issue: s433
Pages: 90-103
ISSN: 0001-690X (ISSN-L)
1600-0447
DOI: 10.1111/j.1600-0447.2007.00967.x
OpenAlex: W2129968987
Cited by: 317
References: 75
Citations by year: 2026: 4 · 2025: 7 · 2024: 12 · 2023: 50 · 2022: 8 · 2021: 15 · 2020: 16 · 2019: 17 · 2018: 14 · 2017: 14 · 2016: 12 · 2015: 18 · 2014: 11 · 2013: 13 · 2012: 18
FWCI: 8.79
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Acta Psychiatrica Scandinavica (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r01mh039593-10)
U.S. Public Health Service (M0100585)
National Institute of Mental Health (P30MH040159, P30 MH 40159)
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK060717)
National Center for Research Resources (M01RR000030, M01 RR 30, M01RR000585)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD 2R01 MH-39593)
Topics: Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuropeptides and Animal Physiology
Keywords: hypercortisolism, depression, ACTH secretion, cortisol secretion, hypothalamic-pituitary-adrenal axis, pulsatile secretion, approximate entropy, endogenous depression, psychotic depression, circadian rhythm, stress response
MeSH terms: Adolescent, Adrenocorticotropic Hormone, Adult, Aged, Circadian Rhythm, Cushing Syndrome, Major Depressive Disorder, Electroencephalography, Female, Humans, Hypothalamo-Hypophyseal System, Male, Middle Aged, Pituitary-Adrenal System, Diagnostic and Statistical Manual of Mental Disorders

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