The role of glucocorticoids in the modulation of mood symptoms: a review

The objective of this study was to make a literature review on associations between high plasma levels of corticosteroids and psychiatry symptoms, as well as to identify the most common clinical manifestations and treatments suggested. Hipercortisolemia resulting from alterations in the HPA axis would be associated with mood disorders, especially depression, whereas the use of glucocorticoid drugs would be related to the occurrence of psychiatric symptoms such as mania, depression, affective lability and psychosis. The review was performed via Medline and Bireme indexes, and articles published in English, French and Spanish between 1993 and 2003 were included. The following keywords were used: cortisol, corticosteroids, depression, bipolar disorder and psychosis. Original (33) and review (22) articles were included in the review; case reports were excluded. Some studies suggest that long-term high plasma cortisol concentrations may cause depression, and that the use of antiglucocorticoid drugs would have an antidepressant effect. On the other hand, other studies do not show association between hypercortisolemia and depressive episodes.

Cortisol; corticosteroids; depression; bipolar disorder and psychosis