title: Changes in cortisol secretion during antidepressive treatment and cognitive improvement in patients with major depression: a longitudinal study.
abstract: OBJECTIVE
  We have previously reported that cognitive deficits are cross-sectionally associated with elevated cortisol in depressed patients. Here, we longitudinally examined if changes in cortisol secretion during treatment are associated with improvement of cognition.
  
  
  METHODS
  Cognitive function and salivary cortisol levels were longitudinally examined in 52 patients with major depression before and after 3 weeks of standardized selective serotonin reuptake inhibitor (SSRI) and an add-on treatment modulating the mineralocorticoid receptor and compared to a healthy control group (n=50) matched for age, gender and years of education.
  
  
  RESULTS
  Across add-on treatment groups, SSRI treatment reduced salivary cortisol in patients to levels of healthy controls (time×group interaction p=.05). In patients, reduction of cortisol significantly correlated with improvement in depressive symptoms (r=.52, p<.01), speed of information processing (r=.50, p<.01), and cognitive set-shifting (r=.34, p=.03). Improved depressive symptoms were only associated with improved attention and working memory.
  
  
  CONCLUSIONS
  Improvement of some cognitive domains during SSRI treatment was associated with decreasing cortisol secretion and was only to a lesser extent associated with improved depressive symptoms.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. hinkelma@uke.uni-hamburg.de
authors.forename: Kim
authors.initials: K
authors.lastname: Hinkelmann
authors.forename: Steffen
authors.initials: S
authors.lastname: Moritz
authors.forename: Johannes
authors.initials: J
authors.lastname: Botzenhardt
authors.forename: Christoph
authors.initials: C
authors.lastname: Muhtz
authors.forename: Klaus
authors.initials: K
authors.lastname: Wiedemann
authors.forename: Michael
authors.initials: M
authors.lastname: Kellner
authors.forename: Christian
authors.initials: C
authors.lastname: Otte
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001288:Attention / Q000187:drug effects; D003071:Cognition / Q000187:drug effects*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004359:Drug Therapy, Combination; D005260:Female; D005438:Fludrocortisone / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008137:Longitudinal Studies; D008297:Male; D008570:Memory, Short-Term / Q000187:drug effects; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D016032:Randomized Controlled Trials as Topic; D012463:Saliva / Q000737:chemistry / Q000187:drug effects; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013148:Spironolactone / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D005438:Fludrocortisone; D006854:Hydrocortisone; D000451:Mineralocorticoid Receptor Antagonists; D017367:Selective Serotonin Reuptake Inhibitors; D013148:Spironolactone