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Summary: The purpose of this study was to investigate subjective mood and the effect of a psychosocial stress challenge on cortisol response in patients remitted from depression in comparison to healthy controls. Only few studies on small samples have been conducted on the influence of psychosocial stress on HPA system responsivity in this group. Results regarding patients who have achieved clinical remission from depression remain inconclusive so far. In comparison to healthy controls, some studies found blunted cortisol responses to a psychological stressor in patients with remitted depression. However, others found no differences. This discrepancy may be due to use of heterogeneous stress measures or dissimilar sample sizes and characteristics, e.g. including patients with comorbid generalized anxiety or patients with an unknown duration of remission. The present study included 77 healthy controls and 70 unipolar depressed patients who had achieved stable, full remission for at least 6 months (average 31 months) with no further Axis I disorder. Participants underwent the Trier Social Stress Test and salivary cortisol levels and mood were assessed repeatedly during the experimental procedure. For both groups, we observed a marked cortisol response and worsening of mood after the stress challenge. However, no differences between formerly depressed patients and healthy participants were observed. Assuming a disturbed HPA system regulation in acute depression, we interpret these findings as evidence for a restored HPA axis function in fully remitted patients. [Copyright &y& Elsevier]

Abstract: While numerous studies have focused on neuropsychological deficits during acute depressive episodes, results have been inconsistent for patients in remission. This case–control study aimed to explore whether remitted patients show deficits in an affective shifting task that has proven sensitive to assess emotional–cognitive deficits in acute depression. 69 fully remitted depressed patients were compared with 76 matched healthy subjects in their performance of a picture-based affective shifting task. Compared to healthy subjects, remitted patients show impaired go/no-go performance during shift, but not during non-shift conditions, reflecting a specific deficit in affective set-shifting. Impaired performance concerns omissions rather than false alarms or response times and is correlated with the duration of illness, but not the number of depressive episodes, time since remission or age. Our findings suggest that affective set-shifting deficits are also present during remission of depressive symptoms. These deficits may particularly concern enhanced inhibitory control and seem to develop over the course of the illness independent of acute episodes. [Copyright &y& Elsevier]