Hormones

Deficiency of thyroid hormone or hormones from the adrenal gland is well recognized as a cause of depression. However, most patients with depression do not have conventional endocrine abnormalities. More subtle changes in hormones have nevertheless been proposed as the cause of depression, as in the response to stress of the adrenal gland. However, these have not so far led to major advances in treatment or understanding of the condition.

Cortisol secretion in some patients with severe depression is increased up to twice normal values. Diurnal variation in Cortisol levels is altered. The dexa-methasone suppression test was proposed as an aid to the diagnosis of depression, but has seen found to be too non-specific to be clinically useful.

• Thyroid-stimulating hormone response to thyrotrophin-releasing hormone is changed in depression.

• In women, the occurrence of postpartum and premenstrual depression suggests that sex hormone balance can affect mood.

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