Gomez Rowena G, Fleming Shelley H, Keller Jennifer, Flores Benjamin, Kenna Heather, DeBattista Charles, Solvason Brent, Schatzberg Alan F
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305-5723, USA.
Biol Psychiatry. 2006 Sep 1;60(5):472-8. doi: 10.1016/j.biopsych.2005.11.010. Epub 2006 Feb 17.
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.
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.
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.
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.
我们的研究描述了与非精神病性重度抑郁症（NPMD）患者及精神健康对照者（HC）相比，精神病性重度抑郁症（PMD）患者的神经心理学特征。我们预测较高的皮质醇水平将与更严重的认知缺陷相关。
在斯坦福大学医学中心招募了29例PMD患者、24例NPMD患者和26例HC。获取了精神科评定、18:00至09:00时段的皮质醇水平以及神经心理学测试数据。
与NPMD患者和HC相比，除简单言语注意力外，PMD患者存在更严重的认知障碍。PMD患者在18:00至01:00时段的平均皮质醇水平升高，这与较差的言语记忆和精神运动速度表现显著相关。18:00至01:00时段的皮质醇斜率也与言语记忆和工作记忆显著相关。
虽然PMD患者被动关注信息的能力似乎完好无损，但他们在处理、操作和编码新信息方面存在更多困难。如PMD患者所见，皮质醇水平升高与较差的认知表现相关，尤其是与单词列表的言语记忆和工作记忆有关。
