Adrenal Steroids

This chapter focuses on the observations that variations in adrenal steroid levels, particularly cortisol, contribute to psychopathology and major depression in particular. The associations are complex due to clinical heterogeneity together with physiological and genetic variations, influencing corticoid production, function and activation by environmental adversities. There is evidence that genetic differences in adrenal function, the impact of chronic early adversity, excess corticoid production or exogenous corticoids each contribute to the risk of depression, delay in clinical recovery and relapse. Further, psychiatric illnesses, mainly but not exclusively depression, may induce changes in corticoid activity. Elevated corticoids can affect psychological function, in particular reduced memory acuity for recall of and emotional responses to life experiences.