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Association between cortisol awakening response and memory function in major depression

Published online by Cambridge University Press:  27 February 2013

K. Hinkelmann ,
C. Muhtz ,
L. Dettenborn ,
A. Agorastos ,
S. Moritz ,
K. Wingenfeld ,
C. Spitzer ,
S. M. Gold ,
K. Wiedemann  and
C. Otte
K. Hinkelmann*
Affiliation:
Department of Psychiatry and Psychotherapy, Charité University Medical Center, Campus Benjamin Franklin, Berlin, Germany
C. Muhtz
Affiliation:
Department of Psychosomatic Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
L. Dettenborn
Affiliation:
Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
A. Agorastos
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
S. Moritz
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
K. Wingenfeld
Affiliation:
Department of Psychiatry and Psychotherapy, Charité University Medical Center, Campus Benjamin Franklin, Berlin, Germany
C. Spitzer
Affiliation:
Asklepios Fachklinikum Tiefenbrunn, Rosdorf, Germany
S. M. Gold
Affiliation:
Center for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf, Germany
K. Wiedemann
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
C. Otte
Affiliation:
Department of Psychiatry and Psychotherapy, Charité University Medical Center, Campus Benjamin Franklin, Berlin, Germany
*
*Address for correspondence: K. Hinkelmann, M.D., Department of Psychiatry and Psychotherapy, Charité University Medical Center, Campus Benjamin Franklin, Eschenallee 3, 14050 Berlin, Germany. (Email: kim.hinkelmann@charite.de)
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Abstract

Background

While impaired memory and altered cortisol secretion are characteristic features of major depression, much less is known regarding the impact of antidepressant medication. We examined whether the cortisol awakening response (CAR) is increased in depressed patients with and without medication compared with healthy controls (HC) and whether CAR is associated with memory function in each group.

Method

We examined 21 patients with major depression without medication, 20 depressed patients on antidepressant treatment, and 41 age-, sex- and education-matched healthy subjects. We tested verbal (Auditory Verbal Learning Task) and visuospatial (Rey figure) memory and measured CAR on two consecutive days.

Results

Patient groups did not differ in severity of depression. We found a significant effect of group (p = 0.03) for CAR. Unmedicated patients exhibited a greater CAR compared with medicated patients (p = 0.04) with no differences between patient groups and HC. We found a significant effect of group for verbal (p = 0.03) and non-verbal memory (p = 0.04). Unmedicated patients performed worse compared with medicated patients and HC in both memory domains. Medicated patients and HC did not differ. Regression analyses revealed a negative association between CAR and memory function in depressed patients, but not in HC.

Conclusions

While in unmedicated depressed patients the magnitude of CAR is associated with impaired memory, medicated patients showed a smaller CAR and unimpaired cognitive function compared with HC. Our findings are compatible with the idea that antidepressants reduce CAR and partially restore memory function even if depressive psychopathology is still present.

Keywords

Awakening responsecognitive functioncortisoldepressionhypothalamus–pituitary–adrenal axisneuropsychology
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 11 , November 2013 , pp. 2255 - 2263
Copyright
Copyright © Cambridge University Press 2013 

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