Dynamics of cortisol in depression and anxiety disorders

Author(s):
Veen, G.
Published
2010
Publication type
Doctoral Thesis

Abstract

In this thesis, we provide evidence in research on endophenotypes of psychopathology that it is fruitful not to take the clinical picture central, but the hypothalamus-pituitary-adrenal (HPA) axis as a core stress system underlying psychopathophysiology in stress-related disorders. Homeostatic systems, including the HPA axis, are by nature nonlinear in their function, with suboptimal states of function at both sides of the curve, e.g. hyper- versus hypofunction. By taken the HPA axis as starting point, we were able redefine the clinical phenotype in relation to both dysfunctional states, i.e., hyper- and hypocortisolism. Furthermore, starting with the stress system enabled us to investigate the effects of HPA axis dysfunction on the metabolic and immune system. Based on the studies presented in this thesis, we hypothesize that the nonlinear aspect of HPA axis function reflects different time points during the stress process, from a hyperactive HPA axis when the stress begins to, eventually, a hypoactive HPA axis when stress holds on. Secondly, we hypothesize that both dysfunctional states of the HPA axis, i.e., hyper- and hypocortisolism, differ in their effects on the metabolic and immune system.

Hypothalamus-pituitary-adrenal axisCortisolDepressive disordersAnxiety disordersDSM-IV classificationComorbidityLipidsC-reactive proteinPolymorphisms
Defense date
2010-04-29
Language
English
Supervisor(s)
Zitman, F.G.
Advisor(s)
Vliet, I.M. van; Rijk, R.H. de
Qualification
Ph.D.
Degree granting institution
Leiden University Medical Center (LUMC), Leiden University, Leiden
hdl
1887/15340

Funding

Sponsorship
The funding for this study was provided by the Leiden University Medical Center (LUMC) and Rivierduinen Mental Health Center. Part of this study was funded by a grant from the Netherlands Brain Foundation (Hersenstichting Nederland, grantnr. 15F07(2).24).