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Salivary Cortisol sampling has confirmed the presence of increased Cortisol secretion in depression and has also revealed that some aspects of hypothalamo-pituitary-adrenal (HPA) axis disturbance have trait-like characteristics that may predict the risk of future illness. Persistent hypersecretion of Cortisol in individuals vulnerable to depression also has implications for the medical co-morbidities associated with mood disorder. Pharmacological treatments targeted at the HPA axis represent a novel approach to the management of depression and its complications; however, a better understanding of the molecular basis of HPA axis dysfunction in depressed patients will be needed before this promise can be fulfilled.

(C) Cambridge University Press 2010