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The Neuropsychological Profile of Psychotic Major Depression and its Relation to Cortisol
Abstract
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.
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“The pathophysiology of MDD is related to several neurobiological changes, including hypothalamic-pituitary-adrenal (HPA) axis malfunction and consequent increase [2][3][4] or decrease [5][6][7] in basal cortisol levels.”
From Can physical exercise modulate cortisol level in subjects with depression? A systematic review and meta-analysis (2018) · cites this paper as [2]
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Metadata
- Authors
- Gomez, R. G., Fleming, S. H., Keller, J., Flores, B., Kenna, H., DeBattista, C., Solvason, B., & Schatzberg, A. F.
- Affiliations
- Stanford Medicine (US)
- Corresponding author
- Gomez, Rowena G.
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2006-09
- Volume
- 60
- Issue
- 5
- Pages
- 472-478
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W2073044473
- Cited by
- 127
- References
- 41
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 10 · 2022: 7 · 2021: 4 · 2020: 3 · 2019: 6 · 2018: 10 · 2017: 3 · 2016: 7 · 2015: 4 · 2014: 3 · 2013: 5 · 2012: 10
- FWCI
- 4.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R01MH050604, MH50604)
- National Center for Research Resources (RR 00 070, M01RR000070)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- psychotic depression, cortisol, neuropsychological profile, cognitive impairment, verbal memory, working memory, psychomotor speed, attention, diurnal cortisol rhythm
- MeSH terms
- Adrenocorticotropic Hormone, Adult, Analysis of Variance, Attention, Cognition Disorders, Major Depressive Disorder, Female, Humans, Hydrocortisone, Male, Memory, Middle Aged, Neuropsychological Tests, Psychotic Disorders, Reference Values, Severity of Illness Index, Verbal Learning
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