Objective: Cushing's disease (CD) and Psychotic Major Depression (PMD) are characterized by elevated cortisol and cognitive impairments. The project examined commonalities in the cognitive profiles of these conditions using healthy controls (HC) and nonpsychotic major depression (NPMD) for comparisons. Method: Patients with CD (n = 10), PMD (n = 27) and NPMD (n = 33) and HCs (n = 27) agreed to participate through Stanford University's Depression Research or Endocrine Clinics. As all CD patients were female, only women were included. NPMD, PMD and HCs were historical controls. Groups did not differ on education, but CDs were significantly older than PMDs. Depression levels (Hamilton Depression Rating Scale; HDRS) differed between groups (PMD > NPMD > CD > HC). Neuropsychological test results were compared across groups using ANCOVA statistics. Depression and positive psychotic symptoms were covaried. Results: Groups did not differ significantly on processing speed, working memory or executive functions. CD patients performed worse than HC on contextual story memory (p = .04) but were similar to PMD and NPMDs. On the California Verbal Learning Test-II, all patient groups performed worse than HCs on short (p = .04) and long (p = .02) delayed free recall. Furthermore, CD and NPMD patients outperformed PMD patients (p < .05). Only PMDs showed recognition deficits (p < .04). Conclusion: After controlling for psychiatric symptoms, the groups differed primarily on verbal memory. Interestingly, memory impairments in CD were comparable to NPMD but less severe than PMD. These more severe deficits in PMD occur in the context of generally lower cortisol and more severe depression than CD patients. Further research should investigate the relationship and interactions of cortisol and depression in cognition in CD.
The Cognitive Profiles of Cushing's Disease and Psychotic Major Depression
A Staffaroni, R Gomez, L Trettin, A Schatzberg, L Katznelson, J Keller; A-16
The Cognitive Profiles of Cushing's Disease and Psychotic Major Depression. Arch Clin Neuropsychol 2015; 30 (6): 491-492. doi: 10.1093/arclin/acv047.16
Download citation file:
© 2017 Oxford University Press×