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Changes in cortisol secretion during antidepressive treatment and cognitive improvement in patients with major depression: A longitudinal study
Abstract
Objectives 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.
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“Essentially, the HPA axis appears to become less responsive with aging, contributing to the dysregulation of stress responses and the resultant development of cognitive decline (111, 112).”
From Signalling cognition: The gut microbiota and hypothalamic-pituitary-adrenal axis (2023) · cites this paper as [112]
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Metadata
- Authors
- Hinkelmann, K., Moritz, S., Botzenhardt, J., Muhtz, C., Wiedemann, K., Kellner, M., & Otte, C.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- Corresponding author
- Hinkelmann, Kim
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2012-05
- Volume
- 37
- Issue
- 5
- Pages
- 685-692
- ISSN
- 0306-4530 (ISSN-L)
- OpenAlex
- W2145586396
- Cited by
- 103
- References
- 37
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 8 · 2023: 11 · 2022: 13 · 2021: 7 · 2020: 6 · 2019: 6 · 2018: 9 · 2017: 4 · 2016: 7 · 2015: 4 · 2014: 6 · 2013: 11 · 2012: 3
- FWCI
- 2.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- AstraZeneca
- Servier
- H. Lundbeck A/S
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- major depressive disorder, cortisol, salivary cortisol, antidepressant treatment, selective serotonin reuptake inhibitors, cognitive impairment, cognitive enhancement, set-shifting, processing speed, working memory, attention, depressive symptoms
- MeSH terms
- Adult, Mineralocorticoid Receptor Antagonists, Antidepressive Agents, Attention, Cognition, Major Depressive Disorder, Drug Therapy, Combination, Female, Fludrocortisone, Humans, Hydrocortisone, Longitudinal Studies, Male, Memory, Short-Term, Middle Aged, Neuropsychological Tests, Psychiatric Status Rating Scales, Saliva, Spironolactone, Randomized Controlled Trials as Topic, Selective Serotonin Reuptake Inhibitors, Young Adult
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