Assessment of HPA axis functioning in patients with depression through baseline measures: a systematic literature review and analysis of the used methodologies

Objective

We performed a systematic literature review in order to assess the hypothalamic-pituitary-adrenal (HPA) axis activity in depressed considering the baseline measurements of the hormones of this axis and perform a critical analysis of the methodologies used.

Methods

We performed search for articles in the databases PubMed and SciELO. In the first database, was introduced the keywords: “depressive disorder”, “HPA axis” and in the second used the terms “depression” or “depressão” and “HPA” or “HPA axis”. We limit to research in adult humans, in English and Portuguese, from the year 2000 until 2011.

Results

Of the 27 selected articles, obtained HPA axis hyperactivity, unregulated activity, hypoactivity or remains unchanged. These results depend on the variables and hormones studied, collected fluid: plasma, urine, saliva, cerebrospinal fluid; the time of collection, the number of collections, the subtype of the depressive disease, among others.

Conclusion

The results do not have consensus on HPA activity. Considering the variables studied, the HPA axis, in most cases, it appears dysfunctional in the presence of depression.

Depression; HPA axis; systematic review; critical analisys; baseline measurement; cortisol