Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,
Centre for Mental Health, University Health Network, Toronto, Ontario, Canada,
Neuropsychobiology. 2021;80(4):313-320. doi: 10.1159/000512081. Epub 2021 Jan 13.
Major depressive disorder (MDD) is associated with hypothalamic-pituitary-adrenal axis dysfunction that may persist into remission. Preliminary evidence suggests that this dysfunction may be associated with impaired neuropsychological performance in remitted MDD. MDD with psychotic features ("psychotic depression") is associated with greater neuropsychological and functional impairment than nonpsychotic depression, including in remission. Therefore, the aim of this exploratory study was to examine the relationships among hair cortisol concentration (HCC) - a marker of longer term endogenous cortisol exposure - and history of psychotic features, neuropsychological performance, and functioning in remitted MDD.
This cross-sectional study compared the relationship between HCC and (i) history of psychosis, (ii) neuropsychological performance, and (iii) everyday functioning in a group of 60 participants with remitted later-life MDD using Pearson's correlation coefficients. This study also measured HCC in a group of 36 nonpsychiatric volunteers to examine the clinical significance of HCC in the patient group.
There were no statistically significant correlations between HCC and history of psychotic features, neuropsychological performance, or functioning. Furthermore, there was no clinically meaningful difference in HCC between patients and nonpsychiatric volunteers.
This study is the first to examine HCC in psychotic depression. The results do not support the hypothesis that impaired neuropsychological performance, and everyday function in remitted psychotic depression is due to a sustained elevation of cortisol.
重度抑郁症（MDD）与下丘脑-垂体-肾上腺轴功能障碍有关，这种功能障碍在缓解期可能持续存在。初步证据表明，这种功能障碍可能与缓解期 MDD 的神经认知表现受损有关。伴有精神病特征的 MDD（“精神病性抑郁症”）与神经认知和功能障碍的相关性比非精神病性抑郁症更大，包括缓解期。因此，本探索性研究的目的是研究头发皮质醇浓度（HCC） - 一种长期内源性皮质醇暴露的标志物 - 与缓解期 MDD 的精神病特征史、神经认知表现和功能之间的关系。
本横断面研究比较了 60 名缓解期老年 MDD 患者 HCC 与（i）精神病特征史、（ii）神经认知表现和（iii）日常生活功能之间的关系，使用 Pearson 相关系数。本研究还测量了 36 名非精神科志愿者的 HCC，以检查 HCC 在患者组中的临床意义。
HCC 与精神病特征史、神经认知表现或功能之间无统计学显著相关性。此外，患者与非精神科志愿者之间的 HCC 无明显临床差异。
本研究首次检查了精神病性抑郁症中的 HCC。结果不支持皮质醇持续升高导致缓解期精神病性抑郁症的神经认知表现和日常功能受损的假设。
