<b><i>Background:</i></b> Alterations of the hypothalamic-pituitary-adrenal (HPA) axis are common in patients diagnosed with major depressive disorder (MDD). Nevertheless, these alterations are not found in every patient. There is evidence to indicate a possible mediating role of early life stress (ELS) in the relation between dysfunction of the HPA axis and MDD. We conducted a systematic review to understand if the alterations of the HPA axis commonly found in patients with MDD are due to early life stress or are caused by the disorder itself. <b><i>Methods:</i></b> The review was conducted by following the PRISMA guidelines. Original articles were found in PubMed and via a manual search. Only studies whose design allowed comparison of the HPA functioning in the 4 groups no-MDD/no-ELS, MDD/no-ELS, no-MDD/ELS, and MDD/ELS were included. <b><i>Results:</i></b> Hyperactivity or hypoactivity of the HPA axis was found in 8 articles. A greater number of abnormalities and a higher rate of posttraumatic stress disorder comorbidity were found in the MDD/ELS group. Dysfunction of the HPA axis was also found in the no-MDD/ELS groups. <b><i>Conclusion:</i></b> HPA dysfunction found in MDD seems to be more related to the presence of ELS rather than to the MDD itself. Future studies are needed to clarify the exact mechanisms involved.

The need for remote psychological assessment came to the fore during the Covid‐19 pandemic lockdown. This paper examines the qualitative experiences of psychologists and patients using remote video interfaces for psychological assessment during that period. The aim was to gain qualitative data on the personal experiences of both parties and explore whether remote assessment via video interface is a satisfactory method for psychological evaluations. Patients were seen for psychological assessments by consultant Clinical and Counselling Psychologists via through videoconference. Consultants and patients were asked about their experience of the video assessment and the consultant recorded their responses. Content Analysis was used to analyse the responses. The remote mode of assessment was found to be satisfactory to both patient and psychologist, although technical issues were highlighted to be the most disruptive to assessments. Consultants reported a certain level of fatigue, particularly after evaluations, and some of them commented that they had to try harder than in a face‐to‐face evaluation. Distraction in the patient environment was considered detrimental. The small sample size which requires further replication studies. Overall, the use of videoconference was found to be a satisfactory method for psychological assessment with some areas for improvement, such as technical difficulties and fatigue.