The neuropsychological profile of psychotic major depression and its relation to cortisol.
BACKGROUND
Our study described the neuropsychological profile of psychotic major depression (PMD) compared to nonpsychotic major depression (NPMD) patients and psychiatrically healthy controls (HC). We predicted that higher cortisol levels would be associated with greater cognitive deficits.


METHODS
Twenty-nine PMDs, 24 NPMDs, and 26 HCs were recruited at Stanford University Medical Center. Psychiatric ratings, cortisol levels from 1800-0900 hours, and neuropsychological test data were obtained.


RESULTS
PMDs had more severe cognitive impairments compared with NPMDs and HCs with the exception of simple verbal attention. PMDs had elevated mean cortisol levels from 1800 to 0100 hours which were significantly correlated with poorer verbal memory and psychomotor speed performance. Cortisol slopes from 1800 to 0100 hours were also significantly correlated with verbal memory and working memory.


CONCLUSIONS
While PMDs' ability to attend passively to information appears intact, they have more difficulty processing, manipulating, and encoding new information. Elevated cortisol levels, as seen in PMD patients, are associated with poorer cognitive performance especially related to verbal memory for lists of words and working memory.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305-5723, USA. rggomez@stanford.edu
Rowena G
RG
Gomez
Shelley H
SH
Fleming
Jennifer
J
Keller
Benjamin
B
Flores
Heather
H
Kenna
Charles
C
DeBattista
Brent
B
Solvason
Alan F
AF
Schatzberg
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000704:Analysis of Variance; D001288:Attention / Q000502:physiology; D003072:Cognition Disorders / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D003865:Major Depressive Disorder / Q000097:blood* / Q000150:complications; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000097:blood* / Q000150:complications; D012016:Reference Values; D012720:Severity of Illness Index; D014706:Verbal Learning / Q000502:physiology
D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone