Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.
Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2019 Mar;4(3):310-320. doi: 10.1016/j.bpsc.2018.11.007. Epub 2018 Dec 4.
Decades of research point to cortisol insensitivity as a biomarker of depression. Despite a vast literature on cortisol's effects on memory, the role of cortisol insensitivity in core psychological features of depression, such as emotional memory biases, is unknown.
Sixty-five premenopausal women with varying levels of depression completed this study involving an at-home low-dose dexamethasone suppression test and four experimental sessions (i.e., two visits for memory encoding of emotionally arousing pictures, each of which was followed 48 hours later by a recall test). Participants received 20 mg of oral cortisol (CORT) or placebo prior to encoding. We tested whether systemic cortisol insensitivity measured with the dexamethasone suppression test predicted cognitive sensitivity to CORT, which was operationalized as the change in negatively biased memory formation for pictures encoded following CORT versus placebo administration.
Cortisol insensitivity was associated with more severe depression and flatter diurnal cortisol levels. Cortisol insensitivity predicted negative memory bias for pictures encoded during the placebo session and reduction in negative memory bias for pictures encoded during the CORT (compared with placebo) session, even after accounting for psychiatric symptomatology.
Our findings replicate research showing that cortisol insensitivity predicts depression severity and flatter diurnal cortisol levels. The results further suggest that systemic cortisol insensitivity is related to negative memory bias and its alleviation by cortisol administration. These novel cognitive findings tie together knowledge regarding endocrine and psychological dysfunction in depression and suggest that boosting cortisol signal may cognitively benefit individuals with cortisol insensitivity.
几十年来的研究表明，皮质醇不敏感是抑郁症的生物标志物。尽管有大量关于皮质醇对记忆影响的文献，但皮质醇不敏感在抑郁症的核心心理特征（如情绪记忆偏差）中的作用尚不清楚。
65 名有不同程度抑郁的绝经前妇女参与了这项研究，包括在家进行低剂量地塞米松抑制试验和四次实验（即两次情绪唤起图片的记忆编码实验，每次实验后 48 小时进行回忆测试）。参与者在编码前接受 20 毫克口服皮质醇（CORT）或安慰剂。我们测试了用地塞米松抑制试验测量的全身皮质醇不敏感是否预测了对 CORT 的认知敏感性，这表现为 CORT 与安慰剂给药后对图片的负面记忆形成的变化。
皮质醇不敏感与更严重的抑郁和更平坦的日间皮质醇水平相关。皮质醇不敏感预测了在安慰剂治疗期间编码的图片的负面记忆偏差，以及在 CORT（与安慰剂相比）治疗期间编码的图片的负面记忆偏差的减少，即使在考虑了精神病症状之后。
我们的发现复制了研究结果，表明皮质醇不敏感预测了抑郁严重程度和更平坦的日间皮质醇水平。结果进一步表明，全身皮质醇不敏感与负面记忆偏差有关，并且皮质醇给药可减轻负面记忆偏差。这些新的认知发现将关于抑郁的内分泌和心理功能障碍的知识联系起来，并表明增强皮质醇信号可能在认知上使皮质醇不敏感的个体受益。
