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. Copyright Â
OBJECTIVES: We have previously reported that cognitive deficits are cross-sectionally associated with elevated cortisol in depressedpatients. 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. Copyright Â
Authors: Jan Engelmann; Stefanie Wagner; Daniel Wollschläger; Sabine Kaaden; Konrad F Schlicht; Nadine Dreimüller; Dieter F Braus; Marianne B Müller; Oliver Tüscher; Helge Frieling; André Tadić; Klaus Lieb Journal: Eur Arch Psychiatry Clin Neurosci Date: 2019-03-30 Impact factor: 5.270
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