Hypercortisolism and Depression

To the Editor: Holsboer and associates report on the use of human corticotropin-releasing factor to investigate the basis for the hypercortisolism frequently observed in depression (Oct. 25 issue).¹ As previously discussed, the availability of corticotropin-releasing factor offers a new approach for the study of the pathophysiology of various disorders of the hypothalamic–pituitary–adrenal axis.² However, we believe it is premature for Holsboer et al. to suggest that the basis for the elevated serum cortisol levels in depressed patients is due to a suprapituitary defect. They report that after administration of human corticotropin-releasing factor (100 μg, intravenously), depressed patients had a blunted.