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September 17, 2025Pharmacological Reports45 citationsOpen Access

The cortisol axis and psychiatric disorders: an updated review

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MGMina Y. GeorgeSMSherif S. Abdel MageedDMDaniel E. Mansour

Key Points

  • Elevated cortisol levels can lead to impairments in cognitive function and emotional stability.
  • Chronic stress and high cortisol exposure in children can result in long-term behavioral issues.
  • Adults with cortisol dysregulation may experience increased vulnerability to conditions like bipolar disorder.
  • Structural brain changes due to chronic cortisol exposure can profoundly impact memory and executive function.

Abstract

Cortisol, a key hormone in the body's stress response, plays a complex role in the development and progression of various psychiatric illnesses. Elevated or dysregulated cortisol levels are linked to mood disorders, including anxiety and depression, where both high and low cortisol can impair cognitive function and emotional stability. In children, chronic stress and high cortisol exposure can lead to long-term behavioral problems, affecting memory, decision-making, and emotional regulation, especially when early-life adversity is present. Similarly, in adults, prolonged cortisol dysregulation often contributes to cognitive decline, mood instability, and an increased vulnerability to psychiatric conditions like major depressive disorder and bipolar disorder. Structural changes in stress-sensitive brain regions, such as the hippocampus and amygdala, are common, as chronic cortisol exposure can cause atrophy in these areas, affecting memory, fear responses, and executive function. This relationship underscores the critical role of managing stress and cortisol levels to prevent or alleviate psychiatric symptoms across the lifespan. In this review, the authors highlight the latest findings regarding the cortisol-psychiatric illness relationship and the available treatment options involving this target.

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Cite This Study

George et al. (2025) studied this question.

synapsesocial.com/papers/68d45e5831b076d99fa5e969https://doi.org/10.1007/s43440-025-00782-x
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