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Fiorillo A, Albert U, Dell'Osso B, Pompili M, Sani G, Sampogna G. The clinical utility and relevance in clinical practice of DSM-5 specifiers for major depressive disorder: A Delphi expert consensus study. Compr Psychiatry 2024; 133:152502. [PMID: 38810371 DOI: 10.1016/j.comppsych.2024.152502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 05/06/2024] [Accepted: 05/18/2024] [Indexed: 05/31/2024] Open
Abstract
Major depressive disorder (MDD) is a heterogeneous syndrome, associated with different levels of severity and impairment on the personal functioning for each patient. Classification systems in psychiatry, including ICD-11 and DSM-5, are used by clinicians in order to simplify the complexity of clinical manifestations. In particular, the DSM-5 introduced specifiers, subtypes, severity ratings, and cross-cutting symptom assessments allowing clinicians to better describe the specific clinical features of each patient. However, the use of DSM-5 specifiers for major depressive disorder in ordinary clinical practice is quite heterogeneous. The present study, using a Delphi method, aims to evaluate the consensus of a representative group of expert psychiatrists on a series of statements regarding the clinical utility and relevance of DSM-5 specifiers for major depressive disorder in ordinary clinical practice. Experts reached an almost perfect agreement on statements related to the use and clinical utility of DSM-5 specifiers in ordinary clinical practice. In particular, a complete consensus was found regarding the clinical utility for ordinary clinical practice of using DSM-5 specifiers. The use of specifiers is considered a first step toward a "dimensional" approach to the diagnosis of mental disorders.
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Affiliation(s)
- Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste and Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina - ASUGI, Italy
| | - Bernardo Dell'Osso
- Neuroscience Research Center, Department of Biomedical and Clinical Sciences and Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, Milano, Italy; Department of Psychiatry and Behavioural Sciences, Stanford University, USA
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, University Cattolica del Sacro Cuore, Rome, Italy; Department of Neuroscience, Sensory organs and Thorax, Department of Psychiatry, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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Jian YL, Jia S, Shi S, Shi Z, Zhao Y. A nomogram to predict the risk of cognitive impairment in patients with depressive disorder. Res Nurs Health 2024; 47:302-311. [PMID: 38149849 DOI: 10.1002/nur.22364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 12/03/2023] [Accepted: 12/13/2023] [Indexed: 12/28/2023]
Abstract
This study was to describe the cognitive function status in patients with depressive disorder and to construct a nomogram model to predict the risk factors of cognitive impairment in these patients. From October 2019 to February 2021, a total of 141 patients with depressive disorder completed the survey in two hospitals. The Montreal cognitive assessment (MoCA) was used with a cutoff score of 26 to differentiate cognitive impairment. Univariable and multivariable logistic regression analyses were conducted to identify independent risk factors. A nomogram was then constructed based on the results of the multivariable logistic regression analysis. The patients had an average MoCA score of 23.99 ± 3.02. The multivariable logistic regression analysis revealed that age (OR: 1.096, 95% CI: 1.042-1.153, p < 0.001), education (OR: 0.065, 95% CI: 0.016-0.263, p < 0.001), depression severity (OR: 1.878, 95% CI: 1.021-3.456, p = 0.043), and sleep quality (OR: 2.454, 95% CI: 1.400-4.301, p = 0.002) were independent risk factors for cognitive impairment in patients with depressive disorder. The area under receiver operating characteristic (ROC) curves was 0.868 (95% CI: 0.807-0.929), indicating good discriminability of the model. The calibration curve of the model and the Hosmer-Lemeshow test (p = 0.571) demonstrated a well-fitted model with high calibration. Age, education, depression severity, and sleep quality were found to be significant predictors of cognitive function. A nomogram model was developed to predict cognitive impairment in patients with depressive disorder, providing a solid foundation for clinical interventions.
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Affiliation(s)
| | - Shoumei Jia
- School of Nursing, Fudan University, Shanghai, China
| | - Shenxun Shi
- Department of Psychiatry, Fudan University Huashan Hospital, Shanghai, China
| | | | - Ying Zhao
- School of Nursing, Fudan University, Shanghai, China
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Sakamoto MS, Thomas GA, Bradson ML, Arnett PA. Examining the role of depression on the relationship between performance-based and self-reported cognitive functioning after sport-related concussion. Arch Clin Neuropsychol 2024:acae043. [PMID: 38798034 DOI: 10.1093/arclin/acae043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE Little is known about the relationship between neuropsychological test performance, cognitive symptom reporting, and depressive symptoms after sport-related concussion. Accordingly, this cross-sectional study examined these relationships in collegiate athletes. It was hypothesized that depressive symptoms would moderate and mediate the relationship between performance-based and self-reported cognitive functioning after concussion. METHODS After sustaining a sport-related concussion, 110 collegiate athletes completed a neuropsychological battery, the Post-Concussion Symptoms Scale, and the Beck Depression Inventory-Fast Screen. Neuropsychological test performance, depressive symptoms, and their interactions were entered into distinct hierarchical linear regression analyses with self-reported cognition as the dependent variable to assess moderation. Mediation was analyzed using the PROCESS macro with 5000 bootstrap samples and a 95% confidence interval. RESULTS There was a significant interaction between the mean memory composite and depressive symptoms when predicting cognitive symptom reporting, p = 0.047. Simple effects tests revealed that for athletes who had a lower memory composite score, an increase in depressive symptoms led to an increase in self-reported cognitive dysfunction, p < 0.001, ηp2 = 0.11. Depressive symptoms partially mediated the relationship between the memory composite and cognitive symptom reporting, indirect effect = -0.26, 95%CI[-0.58,0.001], but this relationship was not found for any other neurocognitive domain. CONCLUSIONS For tests of memory, depressive symptoms moderated and partially mediated the relationship between performance-based and self-reported cognitive functioning after sport-related concussion. Athletes reporting high depressive symptoms and cognitive dysfunction may need more comprehensive evaluations to inform return-to-play decisions, and depression could be a treatment target for athletes who report high levels of cognitive dysfunction after concussion.
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Affiliation(s)
- McKenna S Sakamoto
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802, USA
| | - Garrett A Thomas
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802, USA
| | - Megan L Bradson
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802, USA
| | - Peter A Arnett
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802, USA
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Yavuz BE, Turan S, Mutlu C, Çamlı ŞE. A comparison of the social cognition and neurocognitive characteristics of adolescents with suicide behavior, adolescent with depression and healthy controls. Suicide Life Threat Behav 2024. [PMID: 38738815 DOI: 10.1111/sltb.13090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/31/2024] [Accepted: 04/18/2024] [Indexed: 05/14/2024]
Abstract
INTRODUCTION Deficits in neurocognition and social-cognition have been suggested to be an endophenotype for suicidal behavior. We aimed to compare the social-cognition and neurocognitive characteristics of adolescents diagnosed with depression with and without suicidal behavior and to investigate whether these functions predict suicide. METHOD Adolescents diagnosed with Major Depressive Disorder (MDD) with suicidal behavior (n = 42); MDD without suicidal behavior (n = 44) and age- and sex-matched controls (n = 43) were included. The University of Pennsylvania Computerized Neurobehavioral Test Battery and Autism Spectrum Screening Questionnaire (ASSQ) were used to evaluate social-cognition and neurocognitive characteristics. RESULTS Several neurocognitive domain values of MDD groups, were significantly different from the control group. Neutral emotion recognition task (p = 0.025) and ASSQ scores were found to be significantly impaired in the patient groups (p < 0.001). Logistic regression analysis showed that, only the increase in the Suicide Probability Scale score was found to be significant as a risk factor predicting suicide (p = 0.007, OR: 1.246). CONCLUSION While the neurocognitive and social-cognitive performances of adolescents with MDD were significantly lower than the control group, these performances in the two depression groups were similar. When the predictors of suicidal behavior were examined, it was found that only the increase in suicidal ideation scores predicted suicide.
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Affiliation(s)
- B Ece Yavuz
- Department of Child and Adolescent Psychiatry, TC Sağlık Bakanlığı Cizre Dr. Selahattin Cizrelioğlu Devlet Hastanesi, Şırnak, Turkey
| | - Serkan Turan
- Department ofChild and Adolescent Psychiatry, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Caner Mutlu
- Department ofChild and Adolescent Psychiatry, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Şafak Eray Çamlı
- Department ofChild and Adolescent Psychiatry, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
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Liao QM, Zhang ZJ, Yang X, Wei JX, Wang M, Dou YK, Du Y, Ma XH. Changes of structural functional connectivity coupling and its correlations with cognitive function in patients with major depressive disorder. J Affect Disord 2024; 351:259-267. [PMID: 38266932 DOI: 10.1016/j.jad.2024.01.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 01/05/2024] [Accepted: 01/17/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Previous neuroimaging studies have reported structural and functional brain abnormalities in major depressive disorder (MDD). This study aimed to explore whether the coherence of structural-functional networks was affected by disease and investigate its correlation with clinical manifestations. METHODS The severity of symptoms and cognitive function of 121 MDD patients and 139 healthy controls (HC) were assessed, and imaging data, including diffusion tensor imaging, T1 structural magnetic resonance imaging (MRI) and resting-state functional MRI, were collected. Spearman correlation coefficients of Kullback-Leibler similarity (KLS), fiber number (FN), fractional anisotropy (FA) and functional connectivity (FC) were calculated as coupling coefficients. Double-weight median correlation analysis was conducted to investigate the correlations between differences in brain networks and clinical assessments. RESULTS The percentage of total correct response of delayed matching to sample and the percentage of delayed correct response of pattern recognition memory was lower in MDD. Compared with the HC, KLS-FC coupling between the parietal lobe and subcortical area, FA-FC coupling between the temporal and parietal lobe, and FN-FC coupling in the frontal lobe was lower in MDD. Several correlations between structural-functional connectivity and clinical manifestations were identified. LIMITATIONS First, our study lacks longitudinal follow-up data. Second, the sample size was relatively small. Moreover, we only used the Anatomical Automatic Labeling template to construct the brain network. Finally, the validation of the causal relationship of neuroimaging-behavior factors was still insufficient. CONCLUSIONS The alternation in structural-functional coupling were related to clinical characterization and might be involved in the neuropathology of depression.
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Affiliation(s)
- Qi-Meng Liao
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Zi-Jian Zhang
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiao Yang
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Jin-Xue Wei
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Min Wang
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yi-Kai Dou
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yue Du
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiao-Hong Ma
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China.
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Ren FF, Hillman CH, Wang WG, Li RH, Zhou WS, Liang WM, Yang Y, Chen FT, Chang YK. Effects of aerobic exercise on cognitive function in adults with major depressive disorder: A systematic review and meta-analysis. Int J Clin Health Psychol 2024; 24:100447. [PMID: 38371396 PMCID: PMC10869919 DOI: 10.1016/j.ijchp.2024.100447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/30/2024] [Indexed: 02/20/2024] Open
Abstract
Background Major Depressive Disorder (MDD) is a highly prevalent psychiatric disorder that impairs the cognitive function of individuals. Aerobic exercise stands out as a promising non-pharmacological intervention for enhancing cognitive function and promoting brain health.While positive impacts of aerobic exercise on executive function in adults with depression have been documented, a comprehensive understanding of its benefits on overall cognitive function, including memory, attention, and processing speed, along with key moderating factors in adults with MDD, remains unexplored. The purpose of the systematic review and meta-analysis was to investigate the effects of aerobic exercise on overall cognitive function in adults with MDD, and to explore whether cognitive sub-domains, aerobic exercise characteristics, and study and sample variables modify the effects of aerobic exercise on cognition. Methods Six English electronic databases (Embase, Cochrane Central, Scopus, APA PsycInfo, PubMed, Web of Science) were searched from inception to 2 April 2023. Randomized trials, including adults aged 18 years or above with a diagnosis of clinical depression, of the effects of aerobic exercise on cognitive function in adults with MDD compared to non-aerobic exercise groups were included. A three-level meta-analysis was conducted utilizing a random-effects model in R. The quality of the studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. The PROSPERO registration number is CRD42022367350. Results Twelve randomized trials including 945 adults with MDD were included. Results indicated that aerobic exercise significantly improved overall cognitive function (g = 0.21; 95 % confidence intervals [CI] = 0.07, 0.34), and the sub-domains of memory (g = 0.25; 95 % CI = 0.06, 0.44) and executive function (g = 0.12; 95 % CI = 0.04, 0.20). Significant benefits in cognitive function were found from moderate-to-vigorous (mixed) intensity (g = 0.19; 95 % CI = 0.02, 0.37), aerobic exercise conducted 3 times per week (g = 0.23; 95 % CI = 0.10, 0.38), in sessions < 45 min (g = 0.59; 95 % CI = 0.28, 0.90), and 45-60 min (g = 0.16; 95 % CI = 0.07, 0.26), in aerobic exercise intervention ≤ 12 weeks (g = 0. 26; 95 % CI = 0.08, 0.44). Limitations This review only included peer-reviewed English-language studies, which may lead to a language bias. The results of the Egger's test suggested a potential publication bias. Conclusions Aerobic exercise is efficacious in improving overall cognitive function and the sub-domains of memory and executive function in adults with major depressive disorder.
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Affiliation(s)
- Fei-Fei Ren
- Department of Physical Education, Beijing Language and Culture University, Beijing, China
| | - Charles H. Hillman
- Department of Psychology, Northeastern University, Boston, MA, USA
- Department of Physical Therapy, Movement, and Rehabilitation, Northeastern University, Boston, MA, USA
| | - Wei-Guang Wang
- Department of Physical Education, Beijing Language and Culture University, Beijing, China
| | - Ruei-Hong Li
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
| | - Wen-Sheng Zhou
- Department of Physical Education, Jiangsu Second Normal University, Jiangsu, China
| | - Wen-Ming Liang
- Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Yong Yang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Chaohu University, Anhui, China
| | - Feng-Tzu Chen
- Department of Kinesiology, National Tsing Hua University, Hsinchu, Taiwan
| | - Yu-Kai Chang
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
- Social Emotional Education and Development Center, National Taiwan Normal University, Taipei, Taiwan
- Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan
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Boesl F, Goereci Y, Schweitzer F, Finke C, Schild AK, Bittner S, Steffen F, Schröder M, Quitschau A, Heine J, Warnke C, Franke C. Cognitive decline in post-COVID-19 syndrome does not correspond with persisting neuronal or astrocytic damage. Sci Rep 2024; 14:5326. [PMID: 38438479 PMCID: PMC10912552 DOI: 10.1038/s41598-024-55881-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 02/27/2024] [Indexed: 03/06/2024] Open
Abstract
Cognitive impairment is the most frequent symptom reported in post-COVID-19 syndrome (PCS). Aetiology of cognitive impairment in PCS is still to be determined. Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) are increased in acute COVID-19. Their role as biomarkers in other neurological disorders is under debate. We analysed serum levels of NfL and GFAP as markers for neuronal and astrocytic damage in 53 patients presenting to a PCS Neurology outpatient clinic. Only individuals with self-reported cognitive complaints were included. In these individuals, cognitive complaints were further assessed by comprehensive neuropsychological assessment (NPA). Patients were categorized into subgroups of subjective cognitive decline, single domain impairment, or multi-domain impairment. Serum NfL was in normal range, however an increase of serum GFAP was detected in 4% of patients. Serum NfL and GFAP levels correlated with each other, even when adjusting for patient age (r = 0.347, p = 0.012). NPA showed deficits in 70%; 40% showing impairment in several tested domains. No significant differences were found between serum NfL- and GFAP-levels comparing patients with subjective cognitive decline, single domain impairment, or multi-domain impairment. Persistent neuronal or astrocytic damage did not correlate with cognitive impairment in PCS.
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Affiliation(s)
- Fabian Boesl
- Department of Neurology, Charité-University Medicine Berlin, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany.
| | - Yasemin Goereci
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Finja Schweitzer
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Carsten Finke
- Department of Neurology, Charité-University Medicine Berlin, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Ann-Katrin Schild
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stefan Bittner
- Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University Mainz, Rhine-Main Neuroscience Network (rmn2), Mainz, Germany
| | - Falk Steffen
- Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University Mainz, Rhine-Main Neuroscience Network (rmn2), Mainz, Germany
| | - Maria Schröder
- Department of Neurology, Charité-University Medicine Berlin, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Anneke Quitschau
- Department of Neurology, Charité-University Medicine Berlin, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Josephine Heine
- Department of Neurology, Charité-University Medicine Berlin, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Clemens Warnke
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christiana Franke
- Department of Neurology, Charité-University Medicine Berlin, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany
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Fahri Aydın E, Güleç M, Oral E, Gökhan Daloğlu A. The Effects of Fluoxetine and Agomelatine on Neurocognitive Functions and Sleep in Patients with Major Depressive Disorder. PSYCHIAT CLIN PSYCH 2024; 34:9-18. [PMID: 38883888 PMCID: PMC11177640 DOI: 10.5152/pcp.2024.22498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/21/2023] [Indexed: 06/18/2024] Open
Abstract
Background We aimed to evaluate the effects of 6 weeks of agomelatine versus fluoxetine treatment on cognition and sleep. Methods Agomelatine 25 mg/day and fluoxetine 20 mg/day were administered to major depressive disorder (MDD) patients. Assessments were conducted before the treatment and at the sixth week of treatment via psychometric measures and comprehensive neurocognitive assessments of various functions, including executive skills, attention, memory, verbal fluency, and speed of processing. Results They both improved the evaluated neurocognitive test scores (P < .05), except for the scores of the Digit Span Test (P > .05), but only fluoxetine significantly improved the scores of the Controlled Oral Word Association Test (P = .018). Only in relation to the subjective sleep quality part of the Pittsburgh Sleep Quality Index (P = .035) and the Trail Making Test-B (TMT-B) (P = .046) was there an important difference between the study groups, and agomelatine showed better effects than fluoxetine in these measures. Conclusion Both drugs improved the neurocognitive functioning in the participants. However, the better effect of agomelatine in improving the TMT-B scores suggests that it is a suitable option for MDD patients with noticeable executive disturbances.
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Affiliation(s)
- Esat Fahri Aydın
- Department of Psychiatry, Atatürk University, Faculty of Medicine, Erzurum, Turkey
| | - Mustafa Güleç
- Department of Psychiatry, Izmir Katip Çelebi University, Atatürk Education and Training Hospital, İzmir, Turkey
| | - Elif Oral
- Department of Psychiatry, Izmir Katip Çelebi University, Atatürk Education and Training Hospital, İzmir, Turkey
| | - Ali Gökhan Daloğlu
- Department of Psychiatry, Mersin City Training and Research Hospital, Mersin, Turkey
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9
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Little B, Anwyll M, Norsworthy L, Corbett L, Schultz-Froggatt M, Gallagher P. Processing speed and sustained attention in bipolar disorder and major depressive disorder: A systematic review and meta-analysis. Bipolar Disord 2024; 26:109-128. [PMID: 37973384 DOI: 10.1111/bdi.13396] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Cognitive impairment is a core feature of bipolar disorder (BD) and major depressive disorder (MDD). Deficits in processing speed (PS) and sustained attention (SA) may be particularly impaired and may underpin a broader profile of deficits, however current knowledge of the nature of these impairments is limited by heterogeneous results in the literature. Few reviews to date have attempted to disentangle sources of heterogeneity to assess the presence and magnitude of impairments in PS and SA in BD and MDD. METHODS One hundred and three studies were reviewed to examine performance in tests of PS and SA in BD (n = 3452) and MDD (n = 5461) compared to healthy controls (n = 8016). Neuropsychological methodology used in the literature was summarised. Data were meta-analysed to assess impairments in PS and SA for each neuropsychological test separately. Subgroup analysis was performed across mood states to investigate sources of heterogeneity. RESULTS Impairments were found across most neuropsychological tests, with small to large effect sizes for BD (range: d = 0.19-0.96) and MDD (range: d = 0.29-0.86). Impairments were present in symptomatic states and euthymia in most cases. Some outcome measures were not impaired in euthymia. Heterogeneity was observed for most neuropsychological tests and remained after separating by mood state. There inadequate data to meta-analyse some outcome measures, particularly for symptomatic groups. CONCLUSION Impairments in PS and SA in BD and MDD can be observed across most neuropsychological tests. Future research should further investigate the nature of these impairments across mood states, controlling for clinical confounds.
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Affiliation(s)
- Bethany Little
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- CNNP Lab, Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, UK
| | - Megan Anwyll
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Laura Norsworthy
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Luke Corbett
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Mia Schultz-Froggatt
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Peter Gallagher
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Minihan S, Kumle L, Maston K, Bal D, Werner‐Seidler A, Christensen H, Schweizer S. The relationship between cognitive and affective control and adolescent mental health. JCPP ADVANCES 2024; 4:e12204. [PMID: 38486950 PMCID: PMC10933673 DOI: 10.1002/jcv2.12204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/08/2023] [Indexed: 03/17/2024] Open
Abstract
Background Cognitive control problems have been implicated in the etiology and maintenance of mental health problems, including depression, in adults. Studies in adolescents have been more equivocal, with some showing changes in cognitive control in adolescents with mental health problems, whereas others fail to show an association. This study examines whether adolescent mental health is associated with affective control, the application of cognitive control in affective contexts, which shows more protracted development than cognitive control. Methods The present study investigated the association of cognitive and affective control with depressive symptomatology and self-reported diagnostic history of mental health problems in adolescents. The study included 1929 participants (M age = 13.89) from the Future Proofing Study (N = 6,388, 11-16 years), who completed affective (incl., affective stimuli) and/or cognitive (incl., neutral stimuli) versions of a working memory (backward digit-span) and/or shifting (card-sorting) task at least once within 3 weeks of assessing mental health. Results Poorer working memory was associated with greater depressive symptomatology in adolescents (β = -0.06, p = .004), similarly across cognitive and affective control conditions (β = -0.02, p = .269). Adolescents with self-reported diagnostic history of mental health problems had significantly poorer shifting ability in affective compared to cognitive control conditions (b = 0.05, p = .010), whereas for adolescents with no self-reported diagnoses, shifting ability did not differ between conditions (b = -0.00, p = .649). Conclusions The present analyses suggest that working memory difficulties, in particular, may be associated with the experience of current depressed mood in adolescents. Problems with affective shifting may be implicated in a range of mental health problems in adolescents. Given the ubiquitous need for efficient cognitive functioning in daily life, enhancing cognitive and affective control in adolescents may be a promising means of improving functioning across a range of domains, including affective functioning, and by extension, adolescent mental health.
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Affiliation(s)
- Savannah Minihan
- School of PsychologyUniversity of New South WalesSydneyNew South WalesAustralia
| | - Levi Kumle
- Department of Experimental PsychologyUniversity of OxfordOxfordUK
| | - Kate Maston
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
- Discipline of Psychiatry and Mental HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Debopriyo Bal
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Aliza Werner‐Seidler
- School of PsychologyUniversity of New South WalesSydneyNew South WalesAustralia
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Helen Christensen
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
- Discipline of Psychiatry and Mental HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Susanne Schweizer
- School of PsychologyUniversity of New South WalesSydneyNew South WalesAustralia
- Department of PsychologyUniversity of CambridgeCambridgeUK
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11
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Lai H, Treisman G, Celentano DD, Gerstenblith G, Mandler RN, Khalsa J, Charurat M, Lai S, Pearson G. Elevated homocysteine levels may moderate and mediate the association between HIV and cognitive impairment among middle-aged and older adults in an underserved population in Baltimore, Maryland. Int J STD AIDS 2024; 35:296-307. [PMID: 38065684 DOI: 10.1177/09564624231218762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Background: In the antiretroviral therapy (ART) era, HIV-associated neurocognitive disorders (HAND) remain a considerable challenge for people with HIV, yet not all such disorders can be attributed to HIV alone. This study aimed to: (1) identify factors influencing neurocognitive impairment (NCI) utilizing the NIH Toolbox Cognition Battery (NIHTB-CB) as per the revised research criteria for HAND; (2) ascertain the moderating role of high homocysteine levels in the association between NCI and HIV; and (3) assess the mediating effect of elevated homocysteine levels on this association.Methods: We analyzed data from 788 adults (≥45 years) participating in a study on HIV-related comorbidities in underserved Baltimore communities, using NIHTB-CB to gauge neurocognitive performance. Special attention was given to results from the Dimensional Change Card Sort (DCCS) test within the executive function domain during causal mediation analysis.Results: Overall, HIV was not associated with NCI presence. However, HIV was associated with NCI among individuals with homocysteine >14 μmol/L. Furthermore, HIV was both directly and indirectly associated with NCI in DCCS test scores. Notably, the mediating role of elevated homocysteine in DCCS scores was only observable among individuals who had never used cocaine or had used it for ≤ 10 years, suggesting that extended cocaine use may have a substantial influence on cognitive performance.Conclusions: The findings from this study suggest elevated homocysteine levels may moderate and mediate the association between HIV and neurocognitive impairment.
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Affiliation(s)
- Hong Lai
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Glenn Treisman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - David D Celentano
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Gary Gerstenblith
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Raul N Mandler
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Jag Khalsa
- Department of Microbiology, Immunology and Tropical Diseases, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Man Charurat
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Shenghan Lai
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Godfrey Pearson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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12
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Zang JCS, Hohoff C, Van Assche E, Lange P, Kraft M, Sandmann S, Varghese J, Jörgens S, Knight MJ, Baune BT. Immune gene co-expression signatures implicated in occurence and persistence of cognitive dysfunction in depression. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110826. [PMID: 37451594 DOI: 10.1016/j.pnpbp.2023.110826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/29/2023] [Accepted: 07/09/2023] [Indexed: 07/18/2023]
Abstract
Cognitive dysfunction contributes significantly to the burden caused by Major Depressive Disorder (MDD). Yet, while compelling evidence suggests that different biological processes play a part in both MDD aetiology and the development of cognitive decline more generally, we only begin to understand the molecular underpinnings of depression-related cognitive impairment. Developments in psychometric assessments, molecular high-throughput methods and systems biology derived analysis strategies advance this endeavour. Here, we aim to identify gene expression signatures associated with cognitive dysfunction and cognitive improvement following therapy using RNA sequencing to analyze the whole blood-derived transcriptome of altogether 101 MDD patients who enrolled in the CERT-D study. The mRNA(Nova)Seq based transcriptome was analyzed from whole blood taken at baseline assessment, and patients' cognitive performance was measured twice at baseline and following eight weeks of therapy by means of the THINC integrated tool. Thirty-six patients showed comparatively low cognitive performance at baseline assessment, and 32 patients showed comparatively strong cognitive improvement following therapy. Differential gene expression analysis was performed using limma to a significance threshold of 0.05 and a logFC cutoff of |1.2|. Although we observed some indications for expression differences related to low cognitive performance and cognitive therapy response, signals did not withstand adjustment for multiple testing. Applying WGCNA, we retrieved altogether 25 modules of co-expressed genes and we used a combination of correlational and linear analyses to identify modules related to baseline cognitive performance and cognitive improvement following therapy. Three immune modules reflected distinct but interrelated immune processes (the yellow module: neutrophil-mediated immunity, the darkorange module: interferon signaling, the tan module: platelet activation), and higher expression of the yellow (r = -0.21, p < .05), the dark orange (r = 0.2, p < .05), and the tan (r = -0.23, p < .05) module correlated significantly negatively with patients' cognitive baseline performance. Patients' cognitive baseline performance was a significant predictor of the darkorange module (b = -0.039, p < .05) and the tan module's expression (b = 0.02, p < .05) and was close to becoming a significant predictor of the yellow module's expression (b = -0.02, p = .05). Furthermore, patients characterized by comparatively low cognitive performance at baseline showed significantly higher expression of the tan module when compared to all other patients F(1,97) = 4.32, p < .05, η= 0.04. Following eight weeks of treatment, we observed altogether significant improvement in patients' cognitive performance (b = 0.30, p < .001), and patients with comparatively high cognitive gain showed noticeably lower, but not significantly lower F(1,98) = 3.76, p = .058, expression of a dark turquoise module, which reflects complement and B-cell-associated immune processes. Noteworthy, the relation between cognitive performance and module expression remained observable after controlling for symptom severity and BMI, which partly accounted for variance in module expression. As such, our findings provide further evidence for the involvement of immune processes in MDD related cognitive dysfunction and they suggest that different immune processes contribute to the development and long-term persistence of cognitive dysfunction in the context of depression.
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Affiliation(s)
- Johannes C S Zang
- Department of Psychiatry, University of Münster, 48149 Münster, Germany.
| | - Christa Hohoff
- Department of Psychiatry, University of Münster, 48149 Münster, Germany.
| | - Evelien Van Assche
- Department of Psychiatry, University of Münster, 48149 Münster, Germany.
| | - Pia Lange
- Institute of Medical Informatics, University of Münster, Münster, Germany.
| | - Manuel Kraft
- Department of Psychiatry, University of Münster, 48149 Münster, Germany.
| | - Sarah Sandmann
- Institute of Medical Informatics, University of Münster, Münster, Germany.
| | - Julian Varghese
- Institute of Medical Informatics, University of Münster, Münster, Germany.
| | - Silke Jörgens
- Department of Psychiatry, University of Münster, 48149 Münster, Germany.
| | - Matthew J Knight
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, 48149 Münster, Germany; Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, VIC 3010, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia.
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13
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Samaryn E, Galińska-Skok B, Nobis A, Zalewski D, Maciejczyk M, Gudowska-Sawczuk M, Mroczko B, Zalewska A, Waszkiewicz N. The Effect of Antidepressant Treatment on Neurocognitive Functions, Redox and Inflammatory Parameters in the Context of COVID-19. J Clin Med 2023; 12:7049. [PMID: 38002663 PMCID: PMC10671940 DOI: 10.3390/jcm12227049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
Inflammation is an important component of the etiopathology of depression that uses oxidative and nitrosative stress (O&NS) and elevated inflammatory markers. SARS-CoV-2 infection is also associated with abnormal inflammatory processes, which may impair effective treatment of depression in COVID-19 survivors. In the presented study, thirty-three hospitalized patients with major depressive disorder (MDD) were started on antidepressant treatment, and twenty-one were re-evaluated after 4-6 weeks. The control group consisted of thirty healthy volunteers. All participants underwent neuropsychiatric evaluation, biochemical blood and urine analyses. The results of the research demonstrated positive correlations of the Hamilton Depression Rating Scale (HAM-D) scores with serum catalase (CAT) and urinary S-Nitrosothiols levels, and the Beck Depression Inventory (BDI) scores with serum reduced glutathione (GSH) and superoxide dismutase (SOD) levels. Depressed patients with a history of COVID-19 prior to the treatment had higher urinary nitric oxide (NO) levels and lower serum glutathione peroxidase (GPx) levels. In the control group, COVID-19 survivors had higher levels of urinary N-formylkynurenine (NFK). Our results suggest that the antidepressant treatment has a modulating effect on O&NS, reduces depressive symptoms and improves cognitive functions The present study does not indicate that clinical response to antidepressant treatment is associated with COVID-19 history and baseline SARS-CoV-2 antibody levels. Nevertheless, further research in this area is needed to systematize antidepressant treatment in COVID-19 survivors.
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Affiliation(s)
- Eliza Samaryn
- Department of Psychiatry, Medical University of Bialystok, 15-272 Bialystok, Poland (D.Z.)
| | - Beata Galińska-Skok
- Department of Psychiatry, Medical University of Bialystok, 15-272 Bialystok, Poland (D.Z.)
| | - Aleksander Nobis
- Department of Psychiatry, Medical University of Bialystok, 15-272 Bialystok, Poland (D.Z.)
| | - Daniel Zalewski
- Department of Psychiatry, Medical University of Bialystok, 15-272 Bialystok, Poland (D.Z.)
| | - Mateusz Maciejczyk
- Department of Hygiene, Epidemiology, and Ergonomics, Medical University of Bialystok, 15-022 Bialystok, Poland
| | - Monika Gudowska-Sawczuk
- Department of Biochemical Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland
| | - Barbara Mroczko
- Department of Biochemical Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland
| | - Anna Zalewska
- Department of Restorative Dentistry, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Napoleon Waszkiewicz
- Department of Psychiatry, Medical University of Bialystok, 15-272 Bialystok, Poland (D.Z.)
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Hashimoto K. Arketamine for cognitive impairment in psychiatric disorders. Eur Arch Psychiatry Clin Neurosci 2023; 273:1513-1525. [PMID: 36786865 PMCID: PMC9925943 DOI: 10.1007/s00406-023-01570-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/01/2023] [Indexed: 02/15/2023]
Abstract
Cognitive impairment has been observed in patients with various psychiatric disorders, including schizophrenia, major depressive disorder (MDD), and bipolar disorder (BD). Although modern therapeutic drugs can improve certain symptoms (i.e., psychosis, depression) in these patients, these drugs have not been found to improve cognitive impairment. The N-methyl-D-aspartate receptor antagonist (R,S)-ketamine has attracted attention as a rapidly acting antidepressant. In addition to its robust antidepressant effects, (R,S)-ketamine has been suggested to improve cognitive impairment in patients with MDD and BD, despite causing cognitive impairment in healthy control subjects. (R,S)-ketamine is a racemic mixture of equal amounts of (R)-ketamine (or arketamine) and (S)-ketamine (or esketamine). Arketamine has been found to have more potent antidepressant-like actions than esketamine in rodents. Interestingly, arketamine, but not esketamine, has been suggested to improve phencyclidine-induced cognitive deficits in mice. Furthermore, arketamine has been suggested to ameliorate cognitive deficits in rodent offspring after maternal immune activation. In the current article, it is proposed that arketamine has therapeutic potential for treating cognitive impairment in patients with psychiatric disorders. Additionally, the potential role of the gut-microbiome-brain axis in cognitive impairment in psychiatric disorders is discussed.
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Affiliation(s)
- Kenji Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, 1-8-1 Inohana, Chiba, 260-8670, Japan.
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15
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Valencia-Cifuentes V, Cañas CA, Rivas JC. Major depression associated with a levonorgestrel-releasing intrauterine system mimicking frontotemporal dementia: a case report. Front Psychiatry 2023; 14:1266419. [PMID: 37779626 PMCID: PMC10535084 DOI: 10.3389/fpsyt.2023.1266419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
This case illustrates the adverse cognitive and affective effects associated with the use of an intrauterine hormonal contraceptive, which could be confused with symptoms of early onset dementia. We present a case of a 42-year-old woman diagnosed with seronegative spondyloarthropathy who subsequently developed anxiety and depressive symptoms after the implantation of a Levonorgestrel-Releasing Intrauterine System (LNG-IUS). Three years later, she began to experience memory and attentional failures, refractory pain, and severe depression. The progression of psychiatric symptoms led to a diagnosis of bipolar affective disorder and treatment with antidepressants and anxiolytics. Due to cognitive and psychiatric symptoms, autoimmune encephalitis was considered, but no improvement was shown with treatment. Early onset dementia was suspected, and a brain PET scan revealed frontal lobe hypometabolism. An adverse effect of LNG-IUS was considered; after its removal, mood and cognitive function improvements were observed. This case report emphasizes the importance of considering organic causes of unexplained psychiatric manifestations and highlights the potential impact of hormonal interventions on mental health.
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Affiliation(s)
- Valeria Valencia-Cifuentes
- Department of Neurology, Fundación Valle del Lili, Cali, Colombia
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
| | - Carlos A. Cañas
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
- Universidad ICESI, CIRAT: Centro de Investigación en Reumatología, Autoinmunidad y Medicina Traslacional, Cali, Colombia
- Department of Rheumatology, Fundación Valle del Lili, Cali, Colombia
| | - Juan Carlos Rivas
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
- Department of Psychiatry, Fundación Valle del Lili, Cali, Colombia
- Department of Psychiatry, Universidad del Valle, Cali, Colombia
- Hospital Departamental Psiquiátrico, Universitario del Valle, Cali, Colombia
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16
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Vancappel A, Dansou Y, Godin O, Haffen E, Yrondi A, Stephan F, Richieri RM, Molière F, Holtzmann J, Horn M, Allauze E, Genty JB, Bouvard A, Dorey JM, Hennion V, Camus V, Fond G, Peran B, Walter M, Anguill L, Scotto D'apolina C, Vilà E, Fredembach B, Petrucci J, Rey R, Nguon AS, Etain B, Carminati M, Courtet P, Vaiva G, Llorca PM, Leboyer M, Aouizerate B, Bennabi D, El Hage W. Evolution of Cognitive Impairments in Treatment-Resistant Depression: Results from the Longitudinal French Centers of Expertise for Treatment-Resistant Depression (FACE-DR) Cohort. Brain Sci 2023; 13:1120. [PMID: 37509050 PMCID: PMC10377578 DOI: 10.3390/brainsci13071120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/10/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
Previous studies set out profound cognitive impairments in subjects with treatment-resistant depression (TRD). However, little is known about the course of such alterations depending on levels of improvement in those patients followed longitudinally. The main objective of this study was to describe the course of cognitive impairments in responder versus non-responder TRD patients at one-year follow-up. The second aim was to evaluate the predictive aspect of cognitive impairments to treatment resistance in patients suffering from TRD. We included 131 patients from a longitudinal cohort (FACE-DR) of the French Network of Expert TRD Centers. They undertook comprehensive sociodemographic, clinical, global functioning, and neuropsychological testing (TMT, Baddeley task, verbal fluencies, WAIS-4 subtests, D2 and RLRI-16) at baseline (V0) and one-year follow-up (V1). Most patients (n = 83; 63.36%) did not respond (47 women, 49.47 ± 12.64 years old), while one-third of patients responded (n = 48, 30 women, 54.06 ± 12.03 years old). We compared the cognitive performances of participants to average theoretical performances in the general population. In addition, we compared the cognitive performances of patients between V1 and V0 and responder versus non-responder patients at V1. We observed cognitive impairments during the episode and after a therapeutic response. Overall, each of them tended to show an increase in their cognitive scores. Improvement was more prominent in responders at V1 compared to their non-responder counterparts. They experienced a more marked improvement in code, digit span, arithmetic, similarities, and D2 tasks. Patients suffering from TRD have significant cognitive impairments that persist but alleviate after therapeutic response. Cognitive remediation should be proposed after therapeutic response to improve efficiency and increase the daily functioning.
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Affiliation(s)
- Alexis Vancappel
- Fondation FondaMental, 94000 Créteil, France
- CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France
- EE 1901 Qualipsy, Université de Tours, 37000 Tours, France
| | | | - Ophelia Godin
- Fondation FondaMental, 94000 Créteil, France
- INSERM U955, Équipe de Psychiatrie Translationnelle, Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, 94000 Créteil, France
| | - Emmanuel Haffen
- Fondation FondaMental, 94000 Créteil, France
- Department of Clinical Psychiatry, CIC-1431 INSERM, CHU de Besançon, UR481 Neurosciences and Cognition, University of Franche-Comté, 25000 Besançon, France
| | - Antoine Yrondi
- Fondation FondaMental, 94000 Créteil, France
- Service de Psychiatrie et de Psychologie Médicale de l'adulte, CHU de Toulouse, Hôpital Purpan, Université Paul Sabatier Toulouse 3, 31062 Toulouse, France
| | - Florian Stephan
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale, 29200 Brest, France
| | - Raphaelle Marie Richieri
- Fondation FondaMental, 94000 Créteil, France
- Equipe Imothep, Institut Fresnel, UMR 7249, Aix-Marseille Université, CNRS, Ecole Centrale Marseille, 13284 Marseille, France
| | - Fanny Molière
- Fondation FondaMental, 94000 Créteil, France
- Department of Emergency Psychiatry and Post Acute Care, Hôpital Lapeyronie, CHU Montpellier, 34000 Montpellier, France
| | - Jérôme Holtzmann
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie, CHU Grenoble Alpes, University Grenoble Alpes, 38400 Grenoble, France
| | | | | | | | - Alex Bouvard
- Fondation FondaMental, 94000 Créteil, France
- Centre de Référence Régional des Pathologies Anxieuses et de la Dépression, Centre Expert Dépression Résistante, Pôle de Psychiatrie Générale et Universitaire, CH Charles Perrens, 33076 Bordeaux, France
- Laboratoire Nutrition et Neurobiologie Intégrée (UMR INRAE 1286), Université de Bordeaux, 33076 Bordeaux, France
| | | | - Vincent Hennion
- Fondation FondaMental, 94000 Créteil, France
- INSERM UMR-S 1144 Optimisation Thérapeutique en Neurospsychopharmacologie, Département de Psychiatrie et de Médecine Addictologique, OTeN, Hôpitaux Lariboisière-Fernand Widal, GHU APHP Nord_Université Paris Cité, 75006 Paris, France
| | - Vincent Camus
- Fondation FondaMental, 94000 Créteil, France
- CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France
| | - Guillaume Fond
- Fondation FondaMental, 94000 Créteil, France
- Clinical Research Unit, Academic Hospitals of Marseille (APHM), School of Medicine-La Timone Medical Campus, EA 3279, Department of Epidemiology and Health Economics, Aix-Marseille University, 13284 Marseille, France
| | - Barbara Peran
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale, 29200 Brest, France
| | - Michel Walter
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale, 29200 Brest, France
| | - Loic Anguill
- Fondation FondaMental, 94000 Créteil, France
- Service de Psychiatrie et de Psychologie Médicale de l'adulte, CHU de Toulouse, Hôpital Purpan, Université Paul Sabatier Toulouse 3, 31062 Toulouse, France
| | - Charlotte Scotto D'apolina
- Fondation FondaMental, 94000 Créteil, France
- Service de Psychiatrie et de Psychologie Médicale de l'adulte, CHU de Toulouse, Hôpital Purpan, Université Paul Sabatier Toulouse 3, 31062 Toulouse, France
| | - Estelle Vilà
- Fondation FondaMental, 94000 Créteil, France
- Centre de Référence Régional des Pathologies Anxieuses et de la Dépression, Centre Expert Dépression Résistante, Pôle de Psychiatrie Générale et Universitaire, CH Charles Perrens, 33076 Bordeaux, France
- Laboratoire Nutrition et Neurobiologie Intégrée (UMR INRAE 1286), Université de Bordeaux, 33076 Bordeaux, France
| | - Benjamin Fredembach
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie, CHU Grenoble Alpes, University Grenoble Alpes, 38400 Grenoble, France
| | | | - Romain Rey
- Fondation FondaMental, 94000 Créteil, France
| | - Anne Sophie Nguon
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie, CHU Grenoble Alpes, University Grenoble Alpes, 38400 Grenoble, France
| | - Bruno Etain
- Fondation FondaMental, 94000 Créteil, France
- INSERM UMR-S 1144 Optimisation Thérapeutique en Neurospsychopharmacologie, Département de Psychiatrie et de Médecine Addictologique, OTeN, Hôpitaux Lariboisière-Fernand Widal, GHU APHP Nord_Université Paris Cité, 75006 Paris, France
| | - Mathilde Carminati
- Fondation FondaMental, 94000 Créteil, France
- INSERM UMR-S 1144 Optimisation Thérapeutique en Neurospsychopharmacologie, Département de Psychiatrie et de Médecine Addictologique, OTeN, Hôpitaux Lariboisière-Fernand Widal, GHU APHP Nord_Université Paris Cité, 75006 Paris, France
| | - Philippe Courtet
- Fondation FondaMental, 94000 Créteil, France
- Department of Emergency Psychiatry and Post Acute Care, Hôpital Lapeyronie, CHU Montpellier, 34000 Montpellier, France
| | - Guillaume Vaiva
- Fondation FondaMental, 94000 Créteil, France
- Inserm-U1172-LilNCog-Lille Neuroscience & Cognition, Centre National de Ressources & Résilience pour les Psychotraumatismes (Cn2r Lille Paris), Université de Lille (CHU Lille), 59000 Lille, France
| | | | | | - Bruno Aouizerate
- Fondation FondaMental, 94000 Créteil, France
- Centre de Référence Régional des Pathologies Anxieuses et de la Dépression, Centre Expert Dépression Résistante, Pôle de Psychiatrie Générale et Universitaire, CH Charles Perrens, 33076 Bordeaux, France
- Laboratoire Nutrition et Neurobiologie Intégrée (UMR INRAE 1286), Université de Bordeaux, 33076 Bordeaux, France
| | - Djamila Bennabi
- Fondation FondaMental, 94000 Créteil, France
- Department of Clinical Psychiatry, CIC-1431 INSERM, CHU de Besançon, UR481 Neurosciences and Cognition, University of Franche-Comté, 25000 Besançon, France
| | - Wissam El Hage
- Fondation FondaMental, 94000 Créteil, France
- CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France
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Anita NZ, Kwan F, Ryoo SW, Major-Orfao C, Lin WZ, Noor S, Lanctôt KL, Herrmann N, Oh PI, Shah BR, Gilbert J, Assal A, Halperin IJ, Taha AY, Swardfager W. Cytochrome P450-soluble epoxide hydrolase derived linoleic acid oxylipins and cognitive performance in type 2 diabetes. J Lipid Res 2023; 64:100395. [PMID: 37245563 PMCID: PMC10394387 DOI: 10.1016/j.jlr.2023.100395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/03/2023] [Accepted: 05/21/2023] [Indexed: 05/30/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) increases the risk of cognitive decline and dementia. Disruptions in the cytochrome P450-soluble epoxide hydrolase (CYP450-sEH) pathway have been reported in T2DM, obesity and cognitive impairment. We examine linoleic acid (LA)-derived CYP450-sEH oxylipins and cognition in T2DM and explore potential differences between obese and nonobese individuals. The study included 51 obese and 57 nonobese participants (mean age 63.0 ± 9.9, 49% women) with T2DM. Executive function was assessed using the Stroop Color-Word Interference Test, FAS-Verbal Fluency Test, Digit Symbol Substitution Test, and Trails Making Test-Part B. Verbal memory was assessed using the California Verbal Learning Test, second Edition. Four LA-derived oxylipins were analyzed by ultra-high-pressure-LC/MS, and the 12,13-dihydroxyoctadecamonoenoic acid (12,13-DiHOME) considered the main species of interest. Models controlled for age, sex, BMI, glycosylated hemoglobin A1c, diabetes duration, depression, hypertension, and education. The sEH-derived 12,13-DiHOME was associated with poorer executive function scores (F1,98 = 7.513, P = 0.007). The CYP450-derived 12(13)-epoxyoctadecamonoenoic acid (12(13)-EpOME) was associated with poorer executive function and verbal memory scores (F1,98 = 7.222, P = 0.008 and F1,98 = 4.621, P = 0.034, respectively). There were interactions between obesity and the 12,13-DiHOME/12(13)-EpOME ratio (F1,97 = 5.498, P = 0.021) and between obesity and 9(10)-epoxyoctadecamonoenoic acid (9(10)-EpOME) concentrations (F1,97 = 4.126, P = 0.045), predicting executive function such that relationships were stronger in obese individuals. These findings suggest that the CYP450-sEH pathway as a potential therapeutic target for cognitive decline in T2DM. For some markers, relationships may be obesity dependent.
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Affiliation(s)
- Natasha Z Anita
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Felicia Kwan
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Si Won Ryoo
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Chelsi Major-Orfao
- Sunnybrook Research Institute, Toronto, ON, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - William Z Lin
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Shiropa Noor
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Krista L Lanctôt
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Nathan Herrmann
- Sunnybrook Research Institute, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Paul I Oh
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Baiju R Shah
- Sunnybrook Research Institute, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | - Angela Assal
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | - Ameer Y Taha
- Department of Food Science and Technology, College of Agriculture and Environmental Sciences, University of California, Davis, CA, USA; West Coast Metabolomics Center, Genome Center, University of California, Davis, Davis, CA, USA; Center for Neuroscience, University of California, Davis, Davis, CA, USA
| | - Walter Swardfager
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada; KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.
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18
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Li J, Li J, Shen L, Wang H, Zheng T, Hui Y, Li X. Investigating the causal association of postpartum depression with cerebrovascular diseases and cognitive impairment: a Mendelian randomization study. Front Psychiatry 2023; 14:1196055. [PMID: 37426101 PMCID: PMC10324563 DOI: 10.3389/fpsyt.2023.1196055] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/18/2023] [Indexed: 07/11/2023] Open
Abstract
Background Postpartum depression (PPD) is considered the most widespread puerperium complication. The associations of major depressive disorder with certain types of cerebrovascular diseases and cognitive function have been proposed, but the potential causal effects of PPD on these phenotypes are still unknown. Methods A Mendelian randomization (MR) research design with various methods (e.g., inverse-variance weighted method and MR pleiotropy residual sum and outlier test) was adopted to establish a causal relationship between PPD with cerebrovascular diseases and cognitive impairment. Results No causal relationship between PPD with carotid intima media thickness and cerebrovascular diseases (i.e., stroke, ischemic stroke, and cerebral aneurysm) was found. However, MR analyses indicated a causal association between PPD and decreased cognitive function (P = 3.55 × 10-3), which remained significant even after multiple comparison corrections using the Bonferroni method. Sensitivity analyses using weighted median and MR-Egger methods indicated a consistent direction of the association. Conclusion The causal association between PPD and cognitive impairment indicates that cognitive impairment is a critical aspect of PPD and thus cannot be regarded as an epiphenomenon. Addressing cognitive impairment and lessening the symptoms associated with PPD independently play significant roles in the treatment of PPD.
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Affiliation(s)
- Jia Li
- Department of Nursing, Zhuhai Campus of Zunyi Medical University, Guangdong, China
| | - Jinqiu Li
- Department of Nursing, Zhuhai Campus of Zunyi Medical University, Guangdong, China
| | - Lan Shen
- Department of Nursing, Zhuhai Campus of Zunyi Medical University, Guangdong, China
| | - Huan Wang
- Department of Pediatrics, The Fifth Affiliated Hospital of Zunyi Medical University, Guangdong, China
| | - Tian Zheng
- Department of Nursing, Zhuhai Campus of Zunyi Medical University, Guangdong, China
| | - Ying Hui
- Department of Nursing, Zhuhai Campus of Zunyi Medical University, Guangdong, China
| | - Xiaoxuan Li
- Department of Obstetrics, Zhuhai Maternity and Child Health Care Hospital, Guangdong, China
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19
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Lundervold AJ, Hillestad EMR, Lied GA, Billing J, Johnsen TE, Steinsvik EK, Hausken T, Berentsen B, Lundervold A. Assessment of Self-Reported Executive Function in Patients with Irritable Bowel Syndrome Using a Machine-Learning Framework. J Clin Med 2023; 12:jcm12113771. [PMID: 37297966 DOI: 10.3390/jcm12113771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/23/2023] [Accepted: 05/27/2023] [Indexed: 06/12/2023] Open
Abstract
Introduction: Irritable bowel syndrome (IBS) is characterized as a disorder of the gut-brain interaction (DGBI). Here, we explored the presence of problems related to executive function (EF) in patients with IBS and tested the relative importance of cognitive features involved in EF. Methods: A total of 44 patients with IBS and 22 healthy controls (HCs) completed the Behavior Rating Inventory of Executive Function (BRIEF-A), used to identify nine EF features. The PyCaret 3.0 machine-learning library in Python was used to explore the data, generate a robust model to classify patients with IBS versus HCs and identify the relative importance of the EF features in this model. The robustness of the model was evaluated by training the model on a subset of data and testing it on the unseen, hold-out dataset. Results: The explorative analysis showed that patients with IBS reported significantly more severe EF problems than the HC group on measures of working memory function, initiation, cognitive flexibility and emotional control. Impairment at a level in need of clinical attention was found in up to 40% on some of these scales. When the nine EF features were used as input to a collection of different binary classifiers, the Extreme Gradient Boosting algorithm (XGBoost) showed superior performance. The working memory subscale was consistently selected with the strongest importance in this model, followed by planning and emotional control. The goodness of the machine-learning model was confirmed in an unseen dataset by correctly classifying 85% of the IBS patients. Conclusions: The results showed the presence of EF-related problems in patients with IBS, with a substantial impact of problems related to working memory function. These results suggest that EF should be part of an assessment procedure when a patient presents other symptoms of IBS and that working memory function should be considered a target when treating patients with the disorder. Further studies should include measures of EF as part of the symptom cluster characterizing patients with IBS and other DGBIs.
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Affiliation(s)
- Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Jonas Lies vei 91, 5009 Bergen, Norway
| | - Eline M R Hillestad
- Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway
- National Center for Functional Gastrointestinal Disorders, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
| | - Gülen Arslan Lied
- Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway
- National Center for Functional Gastrointestinal Disorders, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
| | - Julie Billing
- Department of Biological and Medical Psychology, University of Bergen, Jonas Lies vei 91, 5009 Bergen, Norway
| | - Tina E Johnsen
- Department of Biological and Medical Psychology, University of Bergen, Jonas Lies vei 91, 5009 Bergen, Norway
| | - Elisabeth K Steinsvik
- Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway
- National Center for Functional Gastrointestinal Disorders, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
| | - Trygve Hausken
- Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway
| | - Birgitte Berentsen
- Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway
- National Center for Functional Gastrointestinal Disorders, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
| | - Arvid Lundervold
- Department of Biomedicine, University of Bergen, 5020 Bergen, Norway
- Mohn Medical Imaging and Visualization Center, Department of Radiology, Haukeland University Hospital, 5021 Bergen, Norway
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Uchino T, Okubo R, Takubo Y, Aoki A, Wada I, Hashimoto N, Ikezawa S, Nemoto T. Mediation Effects of Social Cognition on the Relationship between Neurocognition and Social Functioning in Major Depressive Disorder and Schizophrenia Spectrum Disorders. J Pers Med 2023; 13:jpm13040683. [PMID: 37109069 PMCID: PMC10142841 DOI: 10.3390/jpm13040683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND In schizophrenia spectrum disorders (SSD), social cognition mediates the relationship between neurocognition and social functioning. Although people with major depressive disorder (MDD) also exhibit cognitive impairments, which are often prolonged, little is known about the role of social cognition in MDD. METHODS Using data obtained through an internet survey, 210 patients with SSD or MDD were selected using propensity score matching based on their demographics and illness duration. Social cognition, neurocognition, and social functioning were evaluated using the Self-Assessment of Social Cognition Impairments, Perceived Deficits Questionnaire, and Social Functioning Scale, respectively. The mediation effects of social cognition on the relationship between neurocognition and social functioning were examined in each group. Invariances of the mediation model across the two groups were then analyzed. RESULTS The SSD and MDD groups had mean ages of 44.49 and 45.35 years, contained 42.0% and 42.8% women, and had mean illness durations of 10.76 and 10.45 years, respectively. In both groups, social cognition had significant mediation effects. Configural, measurement, and structural invariances across the groups were established. CONCLUSION The role of social cognition in patients with MDD was similar to that in SSD. Social cognition could be a common endophenotype for various psychiatric disorders.
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Affiliation(s)
- Takashi Uchino
- Department of Neuropsychiatry, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
- Department of Psychiatry and Implementation Science, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Ryo Okubo
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan
| | - Youji Takubo
- Department of Neuropsychiatry, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Akiko Aoki
- Department of Neuropsychiatry, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Izumi Wada
- Department of Neuropsychiatry, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita, Sapporo 060-8638, Japan
| | - Satoru Ikezawa
- Endowed Institute for Empowering Gifted Minds, Graduate School of Arts and Sciences, University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-0041, Japan
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
- Department of Psychiatry and Implementation Science, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
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21
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Tschentscher N, Woll CFJ, Tafelmaier JC, Kriesche D, Bucher JC, Engel RR, Karch S. Neurocognitive Deficits in First-Episode and Chronic Psychotic Disorders: A Systematic Review from 2009 to 2022. Brain Sci 2023; 13:brainsci13020299. [PMID: 36831842 PMCID: PMC9954070 DOI: 10.3390/brainsci13020299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 02/12/2023] Open
Abstract
Cognitive impairment in patients suffering from schizophrenia spectrum disorders has been discussed as a strong predictor for multiple disease outcome variables, such as response to psychotherapy, stable relationships, employment, and longevity. However, the consistency and severity of cognitive deficits across multiple domains in individuals with first-episode and chronic psychotic disorders is still undetermined. We provide a comprehensive overview of primary research from the years 2009 to 2022. Based on a Cochrane risk assessment, a systematic synthesis of 51 out of 3669 original studies was performed. Impairment of cognitive functioning in patients diagnosed with first-episode psychotic disorders compared with healthy controls was predicted to occur in all assessed cognitive domains. Few overall changes were predicted for chronically affected patients relative to those in the first-episode stage, in line with previous longitudinal studies. Our research outcomes support the hypothesis of a global decrease in cognitive functioning in patients diagnosed with psychotic disorders, i.e., the occurrence of cognitive deficits in multiple cognitive domains including executive functioning, memory, working memory, psychomotor speed, and attention. Only mild increases in the frequency of cognitive impairment across studies were observed at the chronically affected stage relative to the first-episode stage. Our results confirm and extend the outcomes from prior reviews and meta-analyses. Recommendations for psychotherapeutic interventions are provided, considering the broad cognitive impairment already observed at the stage of the first episode. Based on the risk of bias assessment, we also make specific suggestions concerning the quality of future original studies.
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Affiliation(s)
- Nadja Tschentscher
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU Hospital Munich, Nußbaumstr. 7, 80336 Munich, Germany
- Correspondence:
| | - Christian F. J. Woll
- Section of Clinical Psychology of Children and Adolescents, Department of Psychology and Educational Sciences, Ludwig Maximilian University of Munich, Leopoldstr. 13, 80802 Munich, Germany
| | - Julia C. Tafelmaier
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU Hospital Munich, Nußbaumstr. 7, 80336 Munich, Germany
| | - Dominik Kriesche
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU Hospital Munich, Nußbaumstr. 7, 80336 Munich, Germany
| | - Julia C. Bucher
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU Hospital Munich, Nußbaumstr. 7, 80336 Munich, Germany
| | - Rolf R. Engel
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU Hospital Munich, Nußbaumstr. 7, 80336 Munich, Germany
| | - Susanne Karch
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU Hospital Munich, Nußbaumstr. 7, 80336 Munich, Germany
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22
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Pavel A, Matei V, Paun R, Tudose C. How "Subjective" is Subjective Cognitive Decline? PSYCHIAT CLIN PSYCH 2022; 32:299-305. [PMID: 38764884 PMCID: PMC11082589 DOI: 10.5152/pcp.2022.22506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/25/2022] [Indexed: 05/21/2024] Open
Abstract
Background Subjective cognitive decline is presently considered to be the earliest clinical stage of neurodegeneration. By its current definition, subjective cognitive decline conceptually implies that the sufferer presents no psychometrically measurable cognitive impairment despite numerous articles stating the presence of discrete objective impairments. Our purpose was to evaluate differences in objective cognitive performance in subjective cognitive decline patients compared to healthy controls. Methods A total of 101 cognitively unimpaired participants were divided into a subjective cognitive decline group (n = 67) and healthy control group (n = 34). We conducted a thorough cognitive evaluation and collected social, demographic, and clinical data as well as data on personality traits, sleep quality, and physical activity. Both groups were matched for sex, age, education, and Mini-Mental State Examination score. Results The subjective cognitive decline group had a lower verbal learning capacity as shown by the worse performance on Rey auditory verbal learning test trial 1 (P = .021) and Rey auditory verbal learning test total scores (P = .023). The subjective cognitive decline group was significantly more impaired in executive functioning compared to controls, as shown by trail making test A (P = .012) evaluation. Conclusion Persons with subjective cognitive decline have subtle, objective cognitive impairments which may be undetected with widely used, brief cognitive evaluations, such as the Mini-Mental State Examination. Yet, these impairments are not severe enough to warrant the diagnosis of mild cognitive impairment. Current subjective cognitive decline criteria could be expanded in order to increase the diagnostic precision of subjective cognitive decline.
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Affiliation(s)
- Alexandru Pavel
- Department of Psychiatry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Valentin Matei
- Department of Psychiatry, Prof. Dr. Alexandru Obregia Psychiatric Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Radu Paun
- Department of Psychiatry, Prof. Dr. Alexandru Obregia Psychiatric Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Catalina Tudose
- Department of Psychiatry, Prof. Dr. Alexandru Obregia Psychiatric Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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23
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Contreras-Osorio F, Ramirez-Campillo R, Cerda-Vega E, Campos-Jara R, Martínez-Salazar C, Reigal RE, Hernández-Mendo A, Carneiro L, Campos-Jara C. Effects of Physical Exercise on Executive Function in Adults with Depression: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192215270. [PMID: 36429985 PMCID: PMC9690406 DOI: 10.3390/ijerph192215270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/16/2022] [Accepted: 11/16/2022] [Indexed: 05/31/2023]
Abstract
Executive function is among the most affected cognitive dimensions in depression. Physical exercise may improve executive function (e.g., working memory, inhibition, cognitive flexibility), although this is without consensus on adults with depression. Through this systematic review, we aim to elucidate the effects of physical exercise programs on executive functions in adults with depression. The literature search was performed in four relevant electronic databases, combining keywords and medical subject headings, from inception until September 2022. Controlled interventions, involving adults with depression, and reporting working memory, inhibition, and/or cognitive flexibility pre-post-intervention data, were considered includable. Results from meta-analyses included effect size (ES, i.e., Hedges' g) values reported with 95% confidence intervals (95%CIs), with p set at ≤0.05. Seven studies were included, including 202 men and 457 women (age: 21.0-51.2 years; mild-moderate depression). For working memory, a small favoring effect was observed in the experimental groups compared with controls (ES = 0.33, 95%CI = 0.04-0.61; p = 0.026; I2 = 64.9%). For inhibition, physical exercise had a small favoring non-significant effect compared with controls (ES = 0.28, 95%CI = -0.17-0.74; p = 0.222; I2 = 72.4%). Compared with the control group, physical exercise had a trivial effect on cognitive flexibility (ES = 0.09, 95%CI = -0.21-0.39; p = 0.554; I2 = 68.4%). In conclusion, physical exercise interventions may improve working memory behavioral measures in adults with mild-to-moderate depression when compared with active and passive control conditions. However, the reduced number of available high-quality studies precludes more lucid conclusions.
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Affiliation(s)
- Falonn Contreras-Osorio
- Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Department of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile
| | - Enrique Cerda-Vega
- Pedagogy in Physical Education and Health Career, Department of Health Science, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile
| | | | - Cristian Martínez-Salazar
- Department of Physical Education, Sports, and Recreation, Pedagogy in Physical Education, School of Education and Social Sciences and Humanities, Universidad de La Frontera, Temuco 4780000, Chile
| | - Rafael E. Reigal
- Department of Social Psychology, Social Anthropology, Social Work and Social Services, Universidad de Málaga, 29071 Málaga, Spain
| | - Antonio Hernández-Mendo
- Department of Social Psychology, Social Anthropology, Social Work and Social Services, Universidad de Málaga, 29071 Málaga, Spain
| | - Lara Carneiro
- Physical Education Department, College of Education, United Arab Emirates University, Abu Dhabi 112612, United Arab Emirates
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, ISMAI, 4475-690 Maia, Portugal
| | - Christian Campos-Jara
- Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile
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