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Hypercortisolemia and Depression

From the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.

Address correspondence and reprint requests to Charles B. Nemeroff, MD, PhD, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 101 Woodruff Circle, Suite 4000 WMRB, Atlanta, GA 30322. E-mail: cnemero{at}emory.edu

Hypercortisolemia and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis are often found in severe forms of depression. The authors review the history of techniques used to assess the functions of the HPA axis, evidence for hypercortisolemia as a state rather than trait component of depression, and treatment implications.

Key Words: depression • hypercortisolemia • cortisol • corticotropin-releasing factor • dexamethasone

Abbreviations: HPA = hypothalamic-pituitary-adrenal; DST = dexamethasone suppression test; ACTH = adrenocorticotropic hormone; NS = nonsuppression; CRF = corticotropin-releasing factor.

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