Hypothalamic-pituitary-adrenal axis activity and cognition in major depression: The role of remission status

Neus Salvat-Pujol, Javier Labad, Mikel Urretavizcaya, Aida de Arriba-Arnau, Cinto Segalàs, Eva Real, Alex Ferrer, José M. Crespo, Susana Jiménez-Murcia, Carles Soriano-Mas, José M. Menchón, Virginia Soria

Research output: Contribution to journalArticleResearchpeer-review

27 Citations (Scopus)


© 2016 Elsevier Ltd Objectives Neuropsychological deficits and hypothalamic-pituitary-adrenal (HPA) axis dysfunction have been described in major depressive disorder (MDD). We conducted an exploratory study to investigate the role of remission status in the relationship between HPA axis and cognition in MDD. Methods Ninety-seven MDD patients (44 remitted, 53 non-remitted) and 97 healthy controls (HC) were evaluated. We measured verbal and visual memory, working memory, processing speed, attention, and executive function. Three HPA axis measures were assessed: cortisol awakening response (CAR), diurnal cortisol slope, and cortisol suppression ratio with 0.25 mg of dexamethasone (DSTR). Multiple linear regression analyses were performed to study the relationship between cortisol measures and cognition while controlling for potential confounders. We conducted an overall analysis in all participants to compare both MDD-remitted and MDD non-remitted groups with respect to HC. Another analysis including MDD patients only was used to explore a moderating effect by remission status. Results MDD patients showed poorer cognitive performance compared with HC, without significant differences between remitters and non-remitters. Cortisol measures did not differ between remitters and non-remitters. Although most HPA axis measures were not associated with cognitive dysfunction, we found significant associations between cognitive performance in MDD-remitters and cortisol measures for visual memory, processing speed and executive function. A significant moderating effect for remission status was found between cortisol diurnal slope (but neither CAR nor DSTR) and performance in processing speed or executive function. Conclusions Remission status in MDD appears to moderate the association between some cognitive domains (processing speed and executive function) and HPA axis activity.
Original languageEnglish
Pages (from-to)38-48
Publication statusPublished - 1 Feb 2017


  • Cognitive function
  • Cortisol
  • Cortisol awakening response
  • HPA axis
  • Major depression
  • Memory


Dive into the research topics of 'Hypothalamic-pituitary-adrenal axis activity and cognition in major depression: The role of remission status'. Together they form a unique fingerprint.

Cite this