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Glucocorticoids. Mood, memory, and mechanisms.

Owen M Wolkowitz1, Heather Burke, Elissa S Epel

  • 1Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, California, USA. Owen.Wolkowitz@ucsf.edu

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Elevated glucocorticoids link to psychiatric symptoms, but whether they cause or result from these conditions remains unclear. Research reviews evidence to understand this complex relationship and potential therapeutic targets.

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Area of Science:

  • Neuroendocrinology
  • Psychiatry
  • Hormone Research

Background:

  • Elevated glucocorticoids are linked to psychiatric symptoms in conditions like depression and Cushing's syndrome.
  • The causal relationship between hypercortisolemia and psychiatric conditions is not fully understood.
  • Glucocorticoid resistance and homeostatic responses may influence these associations.

Purpose of the Study:

  • To review correlational and causal evidence linking glucocorticoids and psychiatric symptoms.
  • To examine the role of glucocorticoids in Cushing's syndrome, major depression, and steroid psychosis.
  • To explore potential therapeutic avenues based on glucocorticoid actions in the brain.

Main Methods:

  • Review of correlational and causal evidence.
  • Analysis of psychiatric symptoms in endocrine disorders (Cushing's syndrome) and mood disorders (major depression).
  • Examination of effects of exogenous glucocorticoids in healthy volunteers.

Main Results:

  • Glucocorticoid levels and psychiatric symptoms show complex associations across various conditions.
  • Similarities and differences in these relationships are observed between different patient groups.
  • Potential brain mediators and pro-aging effects of glucocorticoids are discussed.

Conclusions:

  • The precise role of glucocorticoids in psychiatric symptom development requires further elucidation.
  • Understanding glucocorticoid-brain interactions may reveal novel therapeutic strategies.
  • A conceptual model is proposed to guide future research and treatment development.