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Objectives:

To summarize quantitatively the literature comparing hypothalamic-pituitary-adrenal (HPA) axis function between depressed and nondepressed individuals and to describe the important sources of variability in this literature. These sources include methodological differences between studies, as well as demographic or clinical differences between depressed samples.

Methods:

The current study used meta-analytic techniques to compare 671 effect sizes (cortisol, adrenocorticotropic hormone, or corticotropin-releasing hormone) across 361 studies, including 18,454 individuals.

Results:

Although depressed individuals tended to display increased cortisol (d= 0.60; 95% confidence interval [CI], 0.54-0.66) and adrenocorticotropic hormone levels (d= 0.28; 95% CI, 0.16-0.41), they did not display elevations in corticotropin-releasing hormone (d= 0.02; 95% CI,− 0.47-0.51). The magnitude of the cortisol effect was …