C-20 * Examining the Effects of Negative Psychotic Symptoms and Cortisol Levels on Verbal Memory in Psychotic Major Depression

Abstract

Objective: This study examined the interactions between cortisol levels and negative symptoms (i.e., blunted affect, psychomotor retardation, and emotional withdrawal) of psychotic major depression (PMD) on verbal memory, after controlling for depression. Method: Archival data were used from the Hypothalamic-Pituitary-Adrenal (HPA) Axis Study. Forty-five PMD patients completed measures that included the Hamilton Depression Rating Scale (HDRS), Brief Psychotic Rating Scale (BPRS), and the California Verbal Learning Scale – II (CVLT-II). Results: Hierarchical regressions were conducted for verbal memory with cortisol and negative psychotic symptoms as predictors, after controlling for depression. Negative psychotic symptoms were a significant predictor of learning (CVLT-II Trials 1−5; r2 = 0.151, p < 0.05) and delayed memory (CVLT-II Long Delayed Free Recall; r2 = 0.154, p < 0.05) abilities. Insignificant results were noted between the individual predictors and verbal recognition memory and for the interactions between cortisol and negative symptoms on verbal memory (p > 0.05). Conclusion(s): The results indicate that negative psychotic symptoms uniquely predict verbal memory, specifically learning and delayed memory, independent of depression severity in PMD patients. Clinically, the findings suggest that negative symptoms may be an important factor to consider for treatment to help PMD patients cognitively perform in their daily lives.