Psychoneuroendocrinology of depression: Hypothalamic-pituitary-adrenal axis

P. M. Plotsky, M. J. Owens, Charles Nemeroff

Research output: Contribution to journalArticle

528 Citations (Scopus)

Abstract

Among the more consistent observations in patients with major depression is dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis presenting as elevation of basal cortisol, dexamethasone-mediated negative feedback resistance, increased cerebrospihal fluid levels of corticotropin-releasing factor (CRF), and a blunted adrenocorticotropic hormone (ACTH) response to challenge with exogenous CRF. These features appear to be state, rather than trait markers, and are normalized upon successful treatment. These pathophysiologic adaptations may arise from defects in central drive to the neuroendocrine hypothalamus, disruption of normal adrenocortical hormone receptor function or a modification of HPA axis function at any level. Functional assessment of the HPA axis is thought to provide a window into central nervous system operation that may be of diagnostic value in this and other affective disorders regardless of whether CRF and glucocorticoids are directly involved in the origin of major depression or merely exacerbate the consequences of other primary defects.

Original languageEnglish
Pages (from-to)293-307
Number of pages15
JournalPsychiatric Clinics of North America
Volume21
Issue number2
DOIs
StatePublished - Jul 16 1998
Externally publishedYes

Fingerprint

Corticotropin-Releasing Hormone
Depression
Mood Disorders
Adrenocorticotropic Hormone
Dexamethasone
Glucocorticoids
Hypothalamus
Hydrocortisone
Central Nervous System
Hormones
Therapeutics

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Psychoneuroendocrinology of depression : Hypothalamic-pituitary-adrenal axis. / Plotsky, P. M.; Owens, M. J.; Nemeroff, Charles.

In: Psychiatric Clinics of North America, Vol. 21, No. 2, 16.07.1998, p. 293-307.

Research output: Contribution to journalArticle

@article{d6c8d7edfc7e48beb4c44444afa3ee36,
title = "Psychoneuroendocrinology of depression: Hypothalamic-pituitary-adrenal axis",
abstract = "Among the more consistent observations in patients with major depression is dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis presenting as elevation of basal cortisol, dexamethasone-mediated negative feedback resistance, increased cerebrospihal fluid levels of corticotropin-releasing factor (CRF), and a blunted adrenocorticotropic hormone (ACTH) response to challenge with exogenous CRF. These features appear to be state, rather than trait markers, and are normalized upon successful treatment. These pathophysiologic adaptations may arise from defects in central drive to the neuroendocrine hypothalamus, disruption of normal adrenocortical hormone receptor function or a modification of HPA axis function at any level. Functional assessment of the HPA axis is thought to provide a window into central nervous system operation that may be of diagnostic value in this and other affective disorders regardless of whether CRF and glucocorticoids are directly involved in the origin of major depression or merely exacerbate the consequences of other primary defects.",
author = "Plotsky, {P. M.} and Owens, {M. J.} and Charles Nemeroff",
year = "1998",
month = "7",
day = "16",
doi = "10.1016/S0193-953X(05)70006-X",
language = "English",
volume = "21",
pages = "293--307",
journal = "Psychiatric Clinics of North America",
issn = "0193-953X",
publisher = "W.B. Saunders Ltd",
number = "2",

}

TY - JOUR

T1 - Psychoneuroendocrinology of depression

T2 - Hypothalamic-pituitary-adrenal axis

AU - Plotsky, P. M.

AU - Owens, M. J.

AU - Nemeroff, Charles

PY - 1998/7/16

Y1 - 1998/7/16

N2 - Among the more consistent observations in patients with major depression is dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis presenting as elevation of basal cortisol, dexamethasone-mediated negative feedback resistance, increased cerebrospihal fluid levels of corticotropin-releasing factor (CRF), and a blunted adrenocorticotropic hormone (ACTH) response to challenge with exogenous CRF. These features appear to be state, rather than trait markers, and are normalized upon successful treatment. These pathophysiologic adaptations may arise from defects in central drive to the neuroendocrine hypothalamus, disruption of normal adrenocortical hormone receptor function or a modification of HPA axis function at any level. Functional assessment of the HPA axis is thought to provide a window into central nervous system operation that may be of diagnostic value in this and other affective disorders regardless of whether CRF and glucocorticoids are directly involved in the origin of major depression or merely exacerbate the consequences of other primary defects.

AB - Among the more consistent observations in patients with major depression is dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis presenting as elevation of basal cortisol, dexamethasone-mediated negative feedback resistance, increased cerebrospihal fluid levels of corticotropin-releasing factor (CRF), and a blunted adrenocorticotropic hormone (ACTH) response to challenge with exogenous CRF. These features appear to be state, rather than trait markers, and are normalized upon successful treatment. These pathophysiologic adaptations may arise from defects in central drive to the neuroendocrine hypothalamus, disruption of normal adrenocortical hormone receptor function or a modification of HPA axis function at any level. Functional assessment of the HPA axis is thought to provide a window into central nervous system operation that may be of diagnostic value in this and other affective disorders regardless of whether CRF and glucocorticoids are directly involved in the origin of major depression or merely exacerbate the consequences of other primary defects.

UR - http://www.scopus.com/inward/record.url?scp=0031807854&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031807854&partnerID=8YFLogxK

U2 - 10.1016/S0193-953X(05)70006-X

DO - 10.1016/S0193-953X(05)70006-X

M3 - Article

C2 - 9670227

AN - SCOPUS:0031807854

VL - 21

SP - 293

EP - 307

JO - Psychiatric Clinics of North America

JF - Psychiatric Clinics of North America

SN - 0193-953X

IS - 2

ER -