Cortisol activity and cognitive changes in psychotic major depression.
OBJECTIVE
The theory that psychotic major depression is a distinct syndrome is supported by reports of statistically significant differences between psychotic and nonpsychotic major depression in presenting features, biological measures, familial transmission, course and outcome, and response to treatment. This study examined differences in performance on a verbal memory test and in cortisol levels between patients with psychotic and nonpsychotic major depression and healthy volunteers.


METHODS
Ten patients with psychotic major depression, 17 patients with nonpsychotic major depression, and 10 healthy volunteers were administered the Wallach Memory Recognition Test and had blood drawn at half-hour intervals over the course of an afternoon to assay cortisol levels.


RESULTS
Subjects with psychotic major depression had a higher rate of errors of commission on the verbal memory test (incorrectly identified distracters as targets) than did subjects with nonpsychotic major depression or healthy volunteers; errors of omission were similar among the three groups. Subjects with psychotic major depression had higher cortisol levels throughout the afternoon than subjects with nonpsychotic major depression or healthy volunteers. This effect became even more pronounced later in the afternoon.


CONCLUSIONS
Psychotic major depression is endocrinologically different from nonpsychotic major depression and produces cognitive changes distinct from those seen in nonpsychotic major depression.
Belanoff
J K
JK
Department of Psychiatry, Stanford University School of Medicine, Stanford, CA 94305, USA. belanoff@leland.stanford.edu
Kalehzan
M
M
Sund
B
B
Fleming Ficek
S K
SK
Schatzberg
A F
AF
D000328:Adult; D000341:Affective Disorders, Psychotic / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D000368:Aged; D002940:Circadian Rhythm / Q000502:physiology; D003072:Cognition Disorders / Q000097:blood / Q000175:diagnosis*; D003866:Depressive Disorder / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D017397:Prefrontal Cortex / Q000502:physiology; D014706:Verbal Learning / Q000502:physiology; D014888:Wechsler Scales / Q000706:statistics & numerical data
D006854:Hydrocortisone