The roles of comorbidity and trauma exposure and its timing in shaping HPA axis patterns in depression

Mayer, Simone; Peckins, Melissa K.; Kuhlman, Kate R.; Rajaram, Nirmala; Lopez-Duran, Nestor L.; Young, Elizabeth A.; Abelson, James L.

doi:10.1016/j.psyneuen.2020.104776

Cited by 19 publications

(11 citation statements)

References 61 publications

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“…Although no differences were demonstrated in long term hair cortisol assays between those with childhood trauma vs. those without, patients who were unresponsive to treatment revealed lower cortisol levels prior to psychological treatment (154). A further study investigating differences in baseline cortisol in patients with comorbid psychiatric illnesses found no baseline cortisol differences in either children or adults with comorbid MDD and PTSD (155).…”

Section: High Daily Cortisol Is Not Specifically Associated With Mdd ...mentioning

confidence: 89%

Childhood Trauma, the HPA Axis and Psychiatric Illnesses: A Targeted Literature Synthesis

et al. 2022

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Studies of early life stress (ELS) demonstrate the long-lasting effects of acute and chronic stress on developmental trajectories. Such experiences can become biologically consolidated, creating individual vulnerability to psychological and psychiatric issues later in life. The hippocampus, amygdala, and the medial prefrontal cortex are all important limbic structures involved in the processes that undermine mental health. Hyperarousal of the sympathetic nervous system with sustained allostatic load along the Hypothalamic Pituitary Adrenal (HPA) axis and its connections has been theorized as the basis for adult psychopathology following early childhood trauma. In this review we synthesize current understandings and hypotheses concerning the neurobiological link between childhood trauma, the HPA axis, and adult psychiatric illness. We examine the mechanisms at play in the brain of the developing child and discuss how adverse environmental stimuli may become biologically incorporated into the structure and function of the adult brain via a discussion of the neurosequential model of development, sensitive periods and plasticity. The HPA connections and brain areas implicated in ELS and psychopathology are also explored. In a targeted review of HPA activation in mood and psychotic disorders, cortisol is generally elevated across mood and psychotic disorders. However, in bipolar disorder and psychosis patients with previous early life stress, blunted cortisol responses are found to awakening, psychological stressors and physiological manipulation compared to patients without previous early life stress. These attenuated responses occur in bipolar and psychosis patients on a background of increased cortisol turnover. Although cortisol measures are generally raised in depression, the evidence for a different HPA activation profile in those with early life stress is inconclusive. Further research is needed to explore the stress responses commonalities between bipolar disorder and psychosis in those patients with early life stress.

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Section: High Daily Cortisol Is Not Specifically Associated With Mdd ...mentioning

confidence: 89%

Childhood Trauma, the HPA Axis and Psychiatric Illnesses: A Targeted Literature Synthesis

et al. 2022

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“…of this subtype is particularly important for improving diagnosis, prognosis, and treatment (31). This work also found that BMI, SBP, and triglyceride in patients with depression complicated with anxiety were significantly higher than those in patients with depression.…”

Section: Discussionmentioning

confidence: 58%

“…Depression complicated with anxiety, a specific subtype of depression, is associated with poorer clinical outcomes, such as worse psychosocial functioning and treatment response. Therefore, uncovering the neurobiology of this subtype is particularly important for improving diagnosis, prognosis, and treatment ( 31 ). This work also found that BMI, SBP, and triglyceride in patients with depression complicated with anxiety were significantly higher than those in patients with depression.…”

Section: Discussionmentioning

confidence: 99%

Changes of adrenocorticotropic hormone rhythm and cortisol circadian rhythm in patients with depression complicated with anxiety and their effects on the psychological state of patients

Xie

Deng²,

Xie³

et al. 2023

Front. Psychiatry

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Objective: This work was to explore the rhythm of adrenocorticotropic hormone (ACTH) and cortisol in patients with depression and anxiety and their effects on mental state. In this work, with depression complicated with anxiety patients as the A-MDD group (n = 21), and depression without anxiety symptoms as the NA-MDD group (n = 21). Firstly, data features were extracted according to the electroencephalo-graph (EEG) data of different patients, and a DR model was constructed for diagnosis. The Hamilton Depression Scale 24 (HAMD-24) was employed to evaluate the severity, and the ACTH and cortisol levels were detected and compared for patients in the A-MDD group and NA-MDD group. In addition, the psychological status of the patients was assessed using the Toronto Alexithymia Scale (TAS). As a result, the AI-based DR model showed a high recognition accuracy for depression. The HAMD-24 score in the A-MDD group (31.81 ± 5.39 points) was statistically higher than the score in the NA-MDD group (25.25 ± 5.02 points) (P < 0.05). No visible difference was found in ACTH levels of patients in different groups (P > 0.05). The incidence of cortisol rhythm disorder (CRD) in the A-MDD group was much higher (P < 0.05). The differences in TAS scores between the two groups were significantly statistically significant (P < 0.01). In conclusion, the AI-based DR Model achieves a more accurate identification of depression; depression with or without anxiety has different effects on the mental state of patients. CRD may be one of the biological markers of depression combined with anxiety.

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“…Patients with MDD with childhood trauma (CT) have a low baseline cortisol level, together with reduced ACTH levels at the baseline and Trier Social Stress Test ( Mayer et al, 2020 ). PS causes a higher basic level of ACTH in animals ( Lolait et al, 2007 ).…”

Section: Hypothalamic Pituitary Adrenocortical Axis Functionmentioning

confidence: 99%

Sex Differences in Depression Caused by Early Life Stress and Related Mechanisms

Guo

et al. 2022

Front. Neurosci.

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Depression is a common psychiatric disease caused by various factors, manifesting with continuous low spirits, with its precise mechanism being unclear. Early life stress (ELS) is receiving more attention as a possible cause of depression. Many studies focused on the mechanisms underlying how ELS leads to changes in sex hormones, neurotransmitters, hypothalamic pituitary adrenocortical (HPA) axis function, and epigenetics. The adverse effects of ELS on adulthood are mainly dependent on the time window when stress occurs, sex and the developmental stage when evaluating the impacts. Therefore, with regard to the exact sex differences of adult depression, we found that ELS could lead to sex-differentiated depression through multiple mechanisms, including 5-HT, sex hormone, HPA axis, and epigenetics.

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The roles of comorbidity and trauma exposure and its timing in shaping HPA axis patterns in depression

Cited by 19 publications

References 61 publications

Childhood Trauma, the HPA Axis and Psychiatric Illnesses: A Targeted Literature Synthesis

Childhood Trauma, the HPA Axis and Psychiatric Illnesses: A Targeted Literature Synthesis

Changes of adrenocorticotropic hormone rhythm and cortisol circadian rhythm in patients with depression complicated with anxiety and their effects on the psychological state of patients

Sex Differences in Depression Caused by Early Life Stress and Related Mechanisms

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