Elevated cortisol/DHEA ratio mediates the association between symptom severity and working memory impairment in drug-naive, first-episode OCD

This study provides novel evidence that an elevated cortisol/DHEA ratio is not only a hallmark of drug-naive OCD but also independently predicts inhibitory dysfunction. Furthermore, this ratio appears to mediate the impact of clinical symptomatology on working memory capacity. These findings highlight the potential utility of the cortisol/DHEA ratio as a state-dependent biomarker and suggest that restoring the neuroendocrine balance could offer a therapeutic avenue for ameliorating cognitive deficits in OCD.