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Depression and Endocrine Disorders: Focus on the Thyroid and Adrenal System

Published online by Cambridge University Press:  06 August 2018

Dominique L. Musselman  and
Charles B. Nemeroff
Dominique L. Musselman
Affiliation:
Emory University School of Medicine, Atlanta, Georgia, US
Charles B. Nemeroff*
Affiliation:
Emory University School of Medicine, Atlanta, Georgia, US
*
Charles B. Nemeroff, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, PO Drawer AF, 1529 Pierce Drive, Suite 4000, Atlanta, GA 30322, US
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Abstract

Of the various hypothalamic–pituitary–end organ axes, the thyroid and adrenal systems have been implicated most often in affective disorders. Patients with primary thyroid disease have high rates of depression, and patients with Addison's disease or Cushing's syndrome have relatively high rates of affective and anxiety symptoms. However, the major support for these endocrine axes in the pathophysiology of mood disorders comes from studies in which alterations in components of the hypothalamic–pituitary–thyroid (HPT) and the hypothalamic–pituitary–adrenal (HPA) axes have been documented in patients with primary depression. Concerning the HPT axis, depressed patients have been reported to have: (a) alterations in thyroid-stimulating hormone response to thyrotropin-releasing hormone (TRH); (b) an abnormally high rate of antithyroid antibodies; and (c) elevated cerebrospinal fluid (CSF) TRH concentrations. Moreover, tri-iodothyronine has been shown conclusively to augment the efficacy of various antidepressants. Concerning the HPA axis, depressed patients have been reported to exhibit: (a) adrenocorticoid hypersecretion; (b) enlarged pituitary and adrenal gland size; and (c) elevated CSF corticotropin-releasing factor concentrations. All of the HPA axis alterations in depression studied thus far are state-dependent, whereas the HPT axis alterations may be partially trait and partially state markers.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 168 , Issue S30: Comorbidity of Mood Disorders , June 1996 , pp. 123 - 128
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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