Hypercortisolemia and Depression

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