Abstract
Cortisol—the most important steroid hormone with a significant effect on body metabolism—strongly affects peripheral tissues and the central nervous system. Fluctuations in cortisol secretion often accompany psychiatric disorders, and normalization of its levels correlates with improvement in the patient’s health. This indicates that cortisol may be useful as a biological marker that can help determine the likelihood of mental illness, its impending onset, and the severity of symptoms, which is especially important in the face of the increasing prevalence of mental disorders, including those associated with social isolation and anxiety during the COVID-19 pandemic. This publication reviews recent reports on cortisol levels in healthy participants and shows the current state of knowledge on changes in the levels of this hormone in people at risk for depression, bipolar disorder, and psychosis. It shows how people with psychiatric disorders react to stressful situations and how the applied therapies affect cortisol secretion. The influence of antidepressants and antipsychotics on cortisol levels in healthy people and those with mental disorders is also described. Finally, it reviews publications on the patterns of cortisol secretion in patients in remission.
Highlights
Prolonged exposure to stress causes changes in the body, such as an activation of the hypothalamic–pituitary–adrenal axis (HPA), which results in an elevated secretion of cortisol (Figure 1), one of the most important steroid hormones secreted by the adrenal cortex
Mineralocorticosteroid receptors have a stronger affinity for cortisol, such that they are saturated to about 90% regardless of the stronger affinity for cortisol, such that they are saturated to about 90% regardless of the level of cortisol secretion in the body, compared to 10% saturation of glucocorticosteroid level of cortisol in the body, to 10% saturation of glucocorticosteroid receptors, whichsecretion can increase to 90%
Another study comparing the effects of escitalopram and quetiapine in monotherapy and combination therapy on cortisol levels in patients treated for depression, found that the reduction in hormone levels was more pronounced in combination therapy, which may be reflected in patient improvement [75]
Summary
Under physiological conditions andSecretion in a stress-free situation, healthy adults secrete between. PET (positron emission tomography) and fMRI (functional magnetic resonance imaging) studies indicate that, in the case of diseases such as depression or post-traumatic stress disorder, there is a reduction in the volume of this region of the brain, as well as in that of the prefrontal cortex and amygdala [10] It is not certain, whether the increase in cortisol secretion itself or the dysregulation of cortisol secretion are the cause of atrophy. It is possible to use a modified DEX/CRH test During this test, a few hours after oral administration of dexamethasone and sampling for analysis, human corticoliberin is administered subcutaneously for stimulation of ACTH secretion and cortisol. This test is used in the diagnosis of depression [12]
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