Steroids and depression

• Published in: Journal of Steroid Biochemistry and Molecular Biology Vol. 38; no. 5; pp. 537 - 559
• Main Author: Pearson Murphy, Beverley E.
• Format: Book Review Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.05.1991; Elsevier Science
• Subjects: Adrenal Cortex - metabolism; Adrenocorticotropic Hormone - pharmacology; Adult and adolescent clinical studies; Affect - drug effects; Biological and medical sciences; Cushing Syndrome - psychology; Depression; Depression - metabolism; Depressive Disorder - metabolism; Glucocorticoids - pharmacology; Humans; Hydrocortisone - metabolism; Medical sciences; Mood disorders; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; CBG; TRH; THE; S; THF; UFC; DOC; oCRH; 17-OHCS; DSM-III-R; GH; hCRH; 17-KS; DST; TSH; 17-KGS; RIA; ATHF; CT; CPB; ECT; GCR; CRH; GABA; HPA; VIP; RTA; Adenohypophyseal hormone; Etiology; Steroid hormone; Adrenal hormone; ACTH; Depression; Cortisol; Review; Glucocorticoid
• ISSN: 0960-0760; 1879-1220
• DOI: 10.1016/0960-0760(91)90312-S

Patients with endogenous depression (major affective disorder) frequently have high cortisol levels, but the diurnal rhythm is usually maintained and they do not develop the physical signs of Cushing's syndrome. On the other hand, depression is a frequent feature of Cushing's syndrome regardless of etiology, and it is often relieved when the cortisol levels are reduced, by whatever means. The mechanisms of the hypercortisolemia and resistance to dexamethasone suppression commonly found in endogenous depression are poorly understood; contrary to expectations, ACTH levels are not clearly elevated. There is striking difference in the psychiatric features seen in endogenous hypercorticism compared to those seen after exogenous administration of glucocorticoids or ACTH. This suggests that either there are other stimulating or modifying factors besides ACTH or that the steroids stimulated by ACTH or other peptides differ from those in control subjects, i.e. there may be an alteration in the metabolism of steroids in depression. Little is known about the metabolic changes or the many steroids besides glucocorticoids produced by the hyperactive steroid-producing tissue. Preliminary studies suggest that major depression may be improved by steroid suppression. It is hypothesized that steroids themselves may be important in causing and perpetuating depression.