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KMID : 1007420140120010015
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Mood and Emotion
2014 Volume.12 No. 1 p.15 ~ p.18
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Diagnostic Implications of Hypothalamic-Pituitary-Adrenal Axis Changes in Major Depressive Disorder
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Seok Jeong-Ho
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Abstract
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Functional changes of hypothalamic-pituitary-adrenal (HPA) axis have been gathering attention from many investigators since HPA axis is a main neuroendocrine system in acute and chronic stress responses. HPA axis dysfunction may be one of the important pathophysiologic mechanisms in the development of major depressive disorder (MDD). Various laboratory tests including dexamethasone suppression test (DST) and cortisol awakening response assessing HPA axis functional reactivity have been conducted to investigate diagnostic validities in MDD. Major depressive disorder is a heterogeneous clinical syndrome in which various subtypes of major depressive disorder exist. Although researchers have not reached an unequivocal conclusion about HPA axis function changes in MDD, they have found differences in HPA axis hyperactivity among melancholic and atypical depression and Cushing’s disease. Functional changes in HPA axis may have diagnostic implications in differentiating subtypes of MDD. In addition, pituitary response to corticotropin releasing hormone may be associated with phenotypic difference of hypercortisolism between melancholic depression and Cushing’s disease. Further integration about this issue should be pursued in the future.
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KEYWORD
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Major depressive disorder, Melancholia, Atypical depression, Cushing’s disease, Dexamethasone suppression test
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