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Hypothalamo-pituitary-adrenal axis abnormalities in depression: a review and a model

Published online by Cambridge University Press:  09 July 2009

Bruce G. Charlton  and
I. Nicol Ferrier
Bruce G. Charlton*
Affiliation:
Department of Physiological Sciences, University of Newcastle upon Tyne, and MRC Neurochemical Pathology Unit, Newcastle General Hospital, Newcastle upon Tyne
I. Nicol Ferrier
Affiliation:
Department of Physiological Sciences, University of Newcastle upon Tyne, and MRC Neurochemical Pathology Unit, Newcastle General Hospital, Newcastle upon Tyne
*
1Address for correspondence: Dr Bruce G. Charlton. Department of Physiological Sciences, University of Newcastle-upon-Tyne, Newcastle-upon-Tyne NE2 4HH.
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Synopsis

A wide range of abnormalities of the hypothalamo-pituitary-adrenal (HPA) axis has been described in depression. This paper reviews recent advances in the understanding of this system, and draws them together to construct a model for the purposes of further research and discussion. It is proposed that there are two fundamental changes which both originate in the hypothalamus: an increased secretion of corticotropin-releasing hormone, and a neurally mediated adrenal hyper-responsivity to ACTH. The resulting changes in hormone regulation would be expected to produce all the characteristic HPA axis abnormalities commonly seen in depression. The model makes several predictions which could be tested by future experiment.

Type
Research Article
Information
Psychological Medicine , Volume 19 , Issue 2 , May 1989 , pp. 331 - 336
Copyright
Copyright © Cambridge University Press 1989

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