1
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Ahern E, White J, Slattery E. Change in Cognitive Function over the Course of Major Depressive Disorder: A Systematic Review and Meta-analysis. Neuropsychol Rev 2024:10.1007/s11065-023-09629-9. [PMID: 38315296 DOI: 10.1007/s11065-023-09629-9] [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] [Accepted: 11/29/2023] [Indexed: 02/07/2024]
Abstract
Major depressive disorder (MDD) is associated with significant cognitive deficits during the acute and remitted stages. The aim of this systematic review and meta-analysis was to examine the course of cognitive function whilst considering demographic, treatment, or clinical features of MDD that could moderate the extent of cognitive change. Databases were searched to identify studies that reported on cognitive function in MDD with a ≥12-week test-retest interval. Relevant studies were pooled using random effects modelling to generate an inverse-variance, weighted, mean effect size estimate (Hedges' g) of cognitive change for each cognitive variable and for an overall composite cognitive domain. Of 6898 records, 99 eligible studies were identified from which 69 were meta-analysed, consisting of 4639 MDD patients (agemean = 40.25 years, female% = 64.62%) across 44 cognitive variables. In over 95% of cognitive variables, improvements were either of non-significant, negligible, or of a small magnitude, and when compared to matched healthy controls, the possibility of practice effects could not be precluded. Depressive symptom improvement and the number of previous depressive episodes moderated the extent of cognitive change, demonstrating state- and scar-like features for one-quarter of the cognitive domains. Further longitudinal studies are required to elucidate the MDD cognitive trajectory from initial onset. Findings nonetheless suggest that following pharmacological and non-pharmacological treatment, cognitive change in MDD is typically small, but the capacity for change may be less with episode recurrence. Targeting cognition early in the course of illness may facilitate better prognosis and support a more complete functional recovery.
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Affiliation(s)
- Elayne Ahern
- School of Psychology, Dublin City University, Glasnevin, Dublin 9, Ireland.
- Department of Psychology, University of Limerick, Castletroy, Limerick, V94 T9PX, Ireland.
| | - Jessica White
- School of Psychology, Dublin City University, Glasnevin, Dublin 9, Ireland
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | - Eadaoin Slattery
- Department of Applied Social Sciences, Technological University of the Shannon Midwest, Limerick, Ireland
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2
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Guo W, Liu B, Wei X, Ju Y, Wang M, Dong Q, Lu X, Sun J, Zhang L, Guo H, Zhao F, Li W, Li Z, Liao M, Zhang L, Liu J, Zhang Y, Li L. The longitudinal change pattern of cognitive subtypes in medication-free patients with major depressive disorder: a cluster analysis. Psychiatry Res 2023; 327:115413. [PMID: 37579539 DOI: 10.1016/j.psychres.2023.115413] [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: 02/08/2023] [Revised: 07/24/2023] [Accepted: 08/11/2023] [Indexed: 08/16/2023]
Abstract
This study aimed to investigate whether there are different cognitive subtypes in patients with major depressive disorder (MDD) and the change pattern of cognitive clusters across the course of MDD. A battery of comprehensive cognitive tests was used to assess the executive function, processing speed, attention, and memory of 153 medication-free patients and 142 healthy controls (HCs). After 6 months of treatment with antidepressants, 87 patients completed cognitive tests again. K-means cluster analysis was performed to determine the cognitive subtypes. A preserved cognition cluster and an impaired cognition cluster were identified in the acute episode phase and the 6-month follow-up phase. 80.5% of the patients remained in their original subgroup after 6 months of treatment. The impaired cognition cluster during the 6-month follow-up period could be predicted by impaired cognition during the episode phase, disease state (remission or non-remission), current illness duration, and education level. This study supporting the heterogeneity of cognitive performance across the course of disease in patients with MDD using cluster analysis. It was found that cognitive impairment during depressive episodes was predictive of poorer cognitive performance even after treatment with antidepressants. Therefore, interventions targeting cognitive function from the early stages of MDD is essential.
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Affiliation(s)
- Weilong Guo
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Bangshan Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Xiyu Wei
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yumeng Ju
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Mi Wang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Qiangli Dong
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Xiaowen Lu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Jinrong Sun
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Liang Zhang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Hua Guo
- Zhumadian Psychiatric Hospital, Zhumadian, Henan, 463000, China
| | - Futao Zhao
- Zhumadian Psychiatric Hospital, Zhumadian, Henan, 463000, China
| | - Weihui Li
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Zexuan Li
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Mei Liao
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Li Zhang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Jin Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
| | - Yan Zhang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
| | - Lingjiang Li
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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3
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Zhong J, Xu J, Wang Z, Yang H, Li J, Yu H, Huang W, Wan C, Ma H, Zhang N. Changes in brain functional networks in remitted major depressive disorder: a six-month follow-up study. BMC Psychiatry 2023; 23:628. [PMID: 37641013 PMCID: PMC10464087 DOI: 10.1186/s12888-023-05082-3] [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: 12/09/2022] [Accepted: 08/06/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Patients with remitted major depressive disorder (rMDD) show abnormal functional connectivity of the central executive network (CEN), salience networks (SN) and default mode network (DMN). It is unclear how these change during remission, or whether changes are related to function. METHODS Three spatial networks in 17 patients with rMDD were compared between baseline and the six-month follow-up, and to 22 healthy controls. Correlations between these changes and psychosocial functioning were also assessed. RESULTS In the CEN, patients at baseline had abnormal functional connectivity in the right anterior cingulate, right dorsolateral prefrontal cortex (DLPFC) and inferior parietal lobule (IPL) compare with HCs. There were functional connection differences in the right DLPFC and left IPL at baseline during follow-up. Abnormal connectivity in the right DLPFC and medial prefrontal cortex (mPFC) were found at follow-up. In the SN, patients at baseline had abnormal functional connectivity in the insula, left anterior cingulate, left IPL, and right precuneus; compared with baseline, patients had higher connectivity in the right DLPFC at follow-up. In the DMN, patients at baseline had abnormal functional connectivity in the right mPFC. Resting-state functional connectivity of the IPL and DLPFC in the CEN correlated with psychosocial functioning. CONCLUSIONS At six-month follow-up, the CEN still showed abnormal functional connectivity in those with rMDD, while anomalies in the SN and DMN has disappeared. Resting-state functional connectivity of the CEN during early rMDD is associated with psychosocial function. CLINICAL TRIALS REGISTRATION Pharmacotherapy and Psychotherapy for MDD after Remission on Psychology and Neuroimaging. https://www. CLINICALTRIALS gov/ , registration number: NCT01831440 (15/4/2013).
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Affiliation(s)
- Jiaqi Zhong
- Affiliated Nanjing Brain Hospital of Nanjing Medical University, No.264 Guangzhou Street, Gulou District, Nanjing, 210029, Jiangsu, China
- Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Jingren Xu
- Affiliated Nanjing Brain Hospital of Nanjing Medical University, No.264 Guangzhou Street, Gulou District, Nanjing, 210029, Jiangsu, China
| | - Zhenzhen Wang
- Affiliated Nanjing Brain Hospital of Nanjing Medical University, No.264 Guangzhou Street, Gulou District, Nanjing, 210029, Jiangsu, China
- School of psychological and cognitive sciences, Peking University, Beijing, 100871, China
| | - Hao Yang
- Affiliated Nanjing Brain Hospital of Nanjing Medical University, No.264 Guangzhou Street, Gulou District, Nanjing, 210029, Jiangsu, China
| | - Jiawei Li
- Affiliated Nanjing Brain Hospital of Nanjing Medical University, No.264 Guangzhou Street, Gulou District, Nanjing, 210029, Jiangsu, China
| | - Haoran Yu
- Affiliated Nanjing Brain Hospital of Nanjing Medical University, No.264 Guangzhou Street, Gulou District, Nanjing, 210029, Jiangsu, China
| | - Wenyan Huang
- Affiliated Nanjing Brain Hospital of Nanjing Medical University, No.264 Guangzhou Street, Gulou District, Nanjing, 210029, Jiangsu, China
| | - Cheng Wan
- Department of Medical Informatic, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Hui Ma
- Affiliated Nanjing Brain Hospital of Nanjing Medical University, No.264 Guangzhou Street, Gulou District, Nanjing, 210029, Jiangsu, China.
| | - Ning Zhang
- Affiliated Nanjing Brain Hospital of Nanjing Medical University, No.264 Guangzhou Street, Gulou District, Nanjing, 210029, Jiangsu, China.
- Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
- Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
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4
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Liu J, Zhao X, Wei X, Yan D, Ou W, Liao M, Ji S, Peng Y, Wu S, Wang M, Ju Y, Zhang L, Li Z, Liu B, Li L, Zhang Y. Empirical evidence for the neurocognitive effect of nitrous oxide as an adjunctive therapy in patients with treatment resistant depression: A randomized controlled study. Psychiatry Res 2023; 326:115326. [PMID: 37390601 DOI: 10.1016/j.psychres.2023.115326] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 05/30/2023] [Accepted: 06/25/2023] [Indexed: 07/02/2023]
Abstract
Nitrous oxide (N2O) has demonstrated an antidepressant effect for treatment-resistant depression (TRD), but no studies investigated the effects of N2O on different cognition domains. This study aimed to test whether N2O would display pro-cognitive effects. We conducted a double-blinded, placebo-controlled, randomized controlled trial, 44 patients with TRD were randomized to N2O group (one-hour inhalation of 50% N2O/50% oxygen) or placebo group (50% air/50% oxygen). Thirty-four patients completed cognitive tests at the pre-treatment phase, 1-week, and 2 weeks post-treatment including subjective cognitive function, processing speed, attention, and executive function. Although the antidepressant effect of N2O was not significant at 1 week, patients still showed better performance of executive function at 1 week after receiving N2O compared with the placebo. Moreover, this significant improvement still existed at 1 week after controlling for the change in depressive symptoms over-time. Additionally, no significant difference was observed in subjective cognitive function, processing speed, and attention between these two groups across the 2-week follow-up period. As the first study investigating the treatment effects of N2O on improving cognitive function in TRD patients, the current study indicated that N2O has a potential pro-cognitive effect on executive function and this effect might be independent from improvements in depressive symptoms.
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Affiliation(s)
- Jin Liu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Xiaotian Zhao
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Xiyu Wei
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Danfeng Yan
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; Shanxi Mental Health Center, Taiyuan Fifth People's Hospital, Taiyuan, Shanxi 030045, China
| | - Wenwen Ou
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Mei Liao
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Shanling Ji
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Yan Peng
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Shibin Wu
- Nanning Fifth People's Hospital, Nanning, Guangxi 530028, China
| | - Mi Wang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Yumeng Ju
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Li Zhang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Zexuan Li
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Bangshan Liu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China.
| | - Lingjiang Li
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China.
| | - Yan Zhang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China.
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5
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Angleitner A, Dehn L, Driessen M, Beblo T. Kognitive Beeinträchtigungen alkoholabhängiger Patient_innen im Abstinenzverlauf und die Relevanz depressiver Komorbidität. ZEITSCHRIFT FÜR NEUROPSYCHOLOGIE 2022. [DOI: 10.1024/1016-264x/a000361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Zusammenfassung: Hintergrund: Mit dieser Studie wird der Frage nachgegangen, inwieweit sich kognitive Beeinträchtigungen alkoholabhängiger Patient_innen in Abhängigkeit von Abstinenz und Depressivität im Behandlungsverlauf verbessern. Methode: Alkoholabhängige Patient_innen mit ( n = 22) und ohne Depression ( n = 58) wurden neuropsychologisch und hinsichtlich der Depressivität zu drei Zeitpunkten untersucht (nach Entzug und 6 Wochen bzw. 6 Monate später). 33 gesunde Kontrollproband_innen wurden zusätzlich zum ersten Zeitpunkt untersucht. Ergebnisse: Alkoholabhängige Patient_innen zeigten verglichen mit gesunden Kontrollpersonen eine verminderte Leistung im schlussfolgernden Denken. Im Behandlungsverlauf zeigte sich eine trendweise günstigere Entwicklung für abstinente verglichen mit rückfälligen Patient_innen und eine größere Depressivität war mit schwächeren Leistungen assoziiert. Diskussion: Alkoholabhängige Patient_innen leiden an kognitiven Defiziten, die sich z. T. im weiteren Behandlungsverlauf zu verbessern scheinen, v. a. bei Abstinenz.
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Affiliation(s)
- Alexander Angleitner
- Universitätsklinik für Psychiatrie und Psychotherapie, Universität Bielefeld, Deutschland
| | - Lorenz Dehn
- Universitätsklinik für Psychiatrie und Psychotherapie, Universität Bielefeld, Deutschland
- Fakultät für Psychologie und Sportwissenschaft, Universität Bielefeld, Deutschland
| | - Martin Driessen
- Universitätsklinik für Psychiatrie und Psychotherapie, Universität Bielefeld, Deutschland
- Fakultät für Psychologie und Sportwissenschaft, Universität Bielefeld, Deutschland
| | - Thomas Beblo
- Universitätsklinik für Psychiatrie und Psychotherapie, Universität Bielefeld, Deutschland
- Fakultät für Psychologie und Sportwissenschaft, Universität Bielefeld, Deutschland
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6
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Neurocognitive deficits in depression: a systematic review of cognitive impairment in the acute and remitted state. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01479-5. [PMID: 36048295 PMCID: PMC10359405 DOI: 10.1007/s00406-022-01479-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/17/2022] [Indexed: 11/03/2022]
Abstract
Previous research suggests a broad range of deficits in major depressive disorder. Our goal was to update the current assumptions and investigate the extent of cognitive impairment in depression in the acute and remitted state. A systematic review of the existing literature between 2009 and 2019 assessing the risk of bias within the included studies was performed. Of the 42 articles reviewed, an unclear risk of bias was shown overall. The risk of bias mainly concerned the sample selection, inadequate remedial measures, as well as the lack of blinding the assessors. In the acute phase, we found strong support for impairment in processing speed, learning, and memory. Follow-up studies and direct comparisons revealed less pronounced deficits in remission, however, deficits were still present in attention, learning and memory, and working memory. A positive correlation between the number of episodes and cognitive deficits as well as depression severity and cognitive deficits was reported. The results also demonstrate a resemblance between the cognitive profiles in bipolar disorder and depression. Comparisons of depression with schizophrenia led to unclear results, at times suggesting an overlap in cognitive performance. The main findings support the global deficit hypothesis and align with results from prior meta-analyses and reviews. Recommendations for future research are also presented.
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7
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Sun J, Chen L, He J, Du Z, Ma Y, Wang Z, Guo C, Luo Y, Gao D, Hong Y, Zhang L, Xu F, Cao J, Hou X, Xiao X, Tian J, Fang J, Yu X. Altered Brain Function in First-Episode and Recurrent Depression: A Resting-State Functional Magnetic Resonance Imaging Study. Front Neurosci 2022; 16:876121. [PMID: 35546875 PMCID: PMC9083329 DOI: 10.3389/fnins.2022.876121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/30/2022] [Indexed: 01/10/2023] Open
Abstract
Background Studies on differences in brain function activity between the first depressive episode (FDE) and recurrent depressive episodes (RDE) are scarce. In this study, we used regional homogeneity (ReHo) and amplitude of low-frequency fluctuations (ALFF) as indices of abnormal brain function activity. We aimed to determine the differences in these indices between patients with FDE and those with RDE, and to investigate the correlation between areas of abnormal brain function and clinical symptoms. Methods A total of 29 patients with RDE, 28 patients with FDE, and 29 healthy controls (HCs) who underwent resting-state functional magnetic resonance imaging were included in this study. The ReHo and ALFF measurements were used for image analysis and further analysis of the correlation between different brain regions and clinical symptoms. Results Analysis of variance showed significant differences among the three groups in ReHo and ALFF in the frontal, parietal, temporal, and occipital lobes. ReHo was higher in the right inferior frontal triangular gyrus and lower in the left inferior temporal gyrus in the RDE group than in the FDE group. Meanwhile, ALFF was higher in the right inferior frontal triangular gyrus, left anterior cingulate gyrus, orbital part of the left middle frontal gyrus, orbital part of the left superior frontal gyrus, and right angular gyrus, but was lower in the right lingual gyrus in the RDE group than in the FDE group. ReHo and ALFF were lower in the left angular gyrus in the RDE and FDE groups than in the HC group. Pearson correlation analysis showed a positive correlation between the ReHo and ALFF values in these abnormal areas in the frontal lobe and the severity of depressive symptoms (P < 0.05). Abnormal areas in the temporal and occipital lobes were negatively correlated with the severity of depressive symptoms (P < 0.05). Conclusion The RDE and FDE groups had abnormal neural function activity in some of the same brain regions. ReHo and ALFF were more widely distributed in different brain regions and had more complex neuropathological mechanisms in the RDE group than in the FDE group, especially in the right inferior frontal triangular gyrus of the frontal lobe.
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Affiliation(s)
- Jifei Sun
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Limei Chen
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiakai He
- Graduate School, China Academy of Chinese Medical Sciences, Beijing, China.,Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhongming Du
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yue Ma
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhi Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chunlei Guo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yi Luo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Deqiang Gao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yang Hong
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lei Zhang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fengquan Xu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiudong Cao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaobing Hou
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Xue Xiao
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Jing Tian
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Jiliang Fang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xue Yu
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
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8
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Varghese S, Frey BN, Schneider MA, Kapczinski F, de Azevedo Cardoso T. Functional and cognitive impairment in the first episode of depression: A systematic review. Acta Psychiatr Scand 2022; 145:156-185. [PMID: 34758106 DOI: 10.1111/acps.13385] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 10/27/2021] [Accepted: 11/07/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To describe the cognitive and functional impairment in individuals with the first episode of major depressive disorder (MDD) as compared to controls and individuals with recurrent MDD. Also to describe the functional and cognitive trajectory after the first episode of MDD. METHODS A total of 52 studies were included in our systematic review. 32 studies compared the cognitive performance between first episode of depression (FED) and controls, 11 studies compared the cognitive performance between recurrent depression (RD) and FED, 10 compared global functioning between RD and FED, four studies assessed cognition in FED over time, and two studies assessed global functioning in FED over time. RESULTS The majority of studies (n = 22/32, 68.8%) found that FED subjects performed significantly worse than controls on cognitive tests, with processing speed (n = 12) and executive/working memory (n = 11) being the most commonly impaired domains. Seven out of 11 studies (63.6%) found that RD performed significantly worse than FED, with verbal learning and memory being the most commonly impaired domain (n = 4). Most studies (n = 7/10, 70%) did not find a significant difference in global functioning between RD and FED. In three of four longitudinal studies assessing cognition, subgroup analyses were used instead of directly assessing cognition in FED over time while the remaining study found significant cognitive declines over time in FED when compared to controls. The two longitudinal studies assessing functional trajectory found that functioning significantly improved over time, possibly due to the improvement of depressive symptoms. CONCLUSION There is strong evidence that cognitive impairment is present during the first episode of depression, and individuals with multiple episodes display greater cognitive impairment than individuals with a single episode. Future studies aimed at identifying predictors of cognitive and functional impairment after the first episode of depression are needed to describe the functional and cognitive trajectory of individuals with the first episode of MDD over time.
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Affiliation(s)
- Shawn Varghese
- Undergraduate Medical Education (UGME), McMaster University, Hamilton, Ontario, Canada
| | - Benicio N Frey
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Maiko A Schneider
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Youth Wellness Centre, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Flavio Kapczinski
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Rio Grande do Sul, Brazil.,Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.,Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Taiane de Azevedo Cardoso
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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9
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Hammar Å, Ronold EH, Rekkedal GÅ. Cognitive Impairment and Neurocognitive Profiles in Major Depression-A Clinical Perspective. Front Psychiatry 2022; 13:764374. [PMID: 35345877 PMCID: PMC8957205 DOI: 10.3389/fpsyt.2022.764374] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 01/03/2022] [Indexed: 11/13/2022] Open
Abstract
Increasingly, studies have investigated cognitive functioning from the perspective of acute state- to remitted phases of Major Depressive Disorder (MDD). Some cognitive deficits observed in the symptomatic phase persist in remission as traits or scars. The etiological origin and clinical consequences of the neurocognitive profiles reported in the literature are still unclear and may vary across populations. Deficits are suspected to influence the association between MDD and neurodegenerative disorders and could thus be of particular clinical consequence. The aim of this review is to describe the clinical neuropsychological profile in MDD and how it is related to research during the past decade on cognitive deficits in MDD from a state, trait, and scar perspective. This review, with a clinical perspective, investigates research from the past decade regarding cognitive functioning in MDD in a long-term perspective. We focus on the clinical manifestation of deficits, and the potential neurodegenerative consequences of the neurocognitive profile in MDD. Searches in Medline, PsycINFO and Embase were conducted targeting articles published between 2010 and 2020. Examination of the evidence for long-lasting neurocognitive deficits in major depression within the cognitive domains of Memory, Executive Functions, Attention, and Processing Speed was conducted and was interpreted in the context of the State, Scar and Trait hypotheses. Defining the neurocognitive profiles in MDD will have consequences for personalized evaluation and treatment of residual cognitive symptoms, and etiological understanding of mood disorders, and treatments could potentially reduce or delay the development of neurodegenerative disorders.
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Affiliation(s)
- Åsa Hammar
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, University of Bergen, Bergen, Norway
| | - Eivind Haga Ronold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, University of Bergen, Bergen, Norway
| | - Guro Årdal Rekkedal
- Division of Psychiatry, Haukeland University Hospital, University of Bergen, Bergen, Norway
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10
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Suciu BD, Păunescu RL, Micluţia IV. Assessment of cognitive performances in major depressed patients: a 6-month follow-up study. Int J Psychiatry Clin Pract 2021; 25:378-384. [PMID: 33118408 DOI: 10.1080/13651501.2020.1840595] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Our study aimed to assess the longitudinal change of cognitive functions in depressed patients after a 6-month interval free of mood symptoms. METHODS In a longitudinal study, 65 patients diagnosed with recurrent major depressive disorder were evaluated twice with neurocognitive tests, during an acute depressed episode and after 6 months of euthymia. The cognitive dimension was assessed with neuropsychological tests of attention and processing speed, memory, verbal fluency, psychomotor speed and executive functions. The severity of depression was evaluated through Hamilton Depression Rating Scale - 17 items. All the results were compared with the outcomes of 35 healthy controls, both in depression and euthymia. RESULTS Depressed patients compared to controls displayed significant statistical differences for most cognitive tests applied, verbal and working memory being the most severely impaired. They were still impaired at the second evaluation. Significant differences were noted between the euthymic and control group, too. Between the depression phase and euthymia, patients obtained significant improvement for attention and processing speed, verbal fluency, motor speed and executive functions. CONCLUSIONS Results from the current study indicate that cognitive impairment is more severe for depressed patients, decreases for euthymic subjects, and lasts longer after depressive symptoms remit.
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Affiliation(s)
- Bianca Daniela Suciu
- Department of Neurosciences, Psychiatry and Pediatric Psychiatry Chair, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ramona Liana Păunescu
- Department of Neurosciences, Psychiatry and Pediatric Psychiatry Chair, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Psychiatric Clinic, Emergency County Hospital, Cluj-Napoca, Romania
| | - Ioana Valentina Micluţia
- Department of Neurosciences, Psychiatry and Pediatric Psychiatry Chair, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Psychiatric Clinic, Emergency County Hospital, Cluj-Napoca, Romania
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11
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Functional connectivity evidence for state-independent executive function deficits in patients with major depressive disorder. J Affect Disord 2021; 291:76-82. [PMID: 34023750 DOI: 10.1016/j.jad.2021.04.080] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 01/14/2021] [Accepted: 04/25/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Persistent neurocognitive deficits are often associated with poor outcomes of major depressive disorder (MDD). Executive dysfunction is the most common cognitive deficit in MDD. However, it remains unclear which subcomponent of executive dysfunction is state-independent with distinct neural substrates. METHODS A comprehensive neurocognitive test battery was used to assess four subcomponents of executive function (working memory, inhibition, shifting, and verbal fluency) in 95 MDD patients and 111 matched healthy controls (HCs). After 6 months of paroxetine treatment, 56 patients achieved clinical remission (rMDD) and completed the second-time neurocognitive test. Network-based statistics analysis was utilized to explore the changes in functional connectivity (FC). RESULTS Compared with the HCs, all the four subcomponents of MDD patients were significantly impaired. After treatment, there was a significant improvement in working memory, inhibition, and verbal fluency in the rMDD group. And shifting and verbal fluency of the rMDD group remained impaired compared with the HCs. Fifteen functional connections were interrupted in the MDD group, and 11 connections remained in a disrupted state after treatment. Importantly, verbal fluency was negatively correlated with the disrupted FC between the right dorsal prefrontal cortex and the left inferior parietal lobule in patients with MDD and remitted MDD. LIMITATIONS The correlation analysis of the association between cognitive impairment and connectivity alterations precluded us from making causal inferences. CONCLUSIONS Verbal fluency is the potential state-independent cognitive deficit with distinct neural basis in patients with MDD.
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12
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Villalobos D, Pacios J, Vázquez C. Cognitive Control, Cognitive Biases and Emotion Regulation in Depression: A New Proposal for an Integrative Interplay Model. Front Psychol 2021; 12:628416. [PMID: 33995183 PMCID: PMC8119761 DOI: 10.3389/fpsyg.2021.628416] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/15/2021] [Indexed: 12/12/2022] Open
Abstract
Research traditions on cognition and depression focus on relatively unconnected aspects of cognitive functioning. On one hand, the neuropsychological perspective has concentrated on cognitive control difficulties as a prominent feature of this condition. On the other hand, the clinical psychology perspective has focused on cognitive biases and repetitive negative patterns of thinking (i.e., rumination) for emotional information. A review of the literature from both fields reveals that difficulties are more evident for mood-congruent materials, suggesting that cognitive control difficulties interact with cognitive biases to hinder cognitive switching, working memory updating, and inhibition of irrelevant information. Connecting research from these two traditions, we propose a novel integrative cognitive model of depression in which the interplay between mood-congruent cognitive control difficulties, cognitive biases, and rumination may ultimately lead to ineffective emotion-regulation strategies to downregulate negative mood and upregulate positive mood.
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Affiliation(s)
- Dolores Villalobos
- Department of Experimental Psychology, School of Psychology, Complutense University of Madrid, Madrid, Spain.,Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Technical University of Madrid, Madrid, Spain
| | - Javier Pacios
- Department of Experimental Psychology, School of Psychology, Complutense University of Madrid, Madrid, Spain.,Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Technical University of Madrid, Madrid, Spain
| | - Carmelo Vázquez
- Department of Clinical Psychology, School of Psychology, Complutense University of Madrid, Madrid, Spain
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13
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Liu J, Liu B, Wang M, Ju Y, Dong Q, Lu X, Sun J, Zhang L, Guo H, Zhao F, Li W, Zhang L, Li Z, Zhang Y, Liao M, Li L. Evidence for Progressive Cognitive Deficits in Patients With Major Depressive Disorder. Front Psychiatry 2021; 12:627695. [PMID: 33664684 PMCID: PMC7921310 DOI: 10.3389/fpsyt.2021.627695] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/25/2021] [Indexed: 01/24/2023] Open
Abstract
Background: Cognitive deficits have shown progressive feature in major depressive disorder (MDD). However, it remains unknown which component of cognitive function is progressively impaired across episodes of MDD. Here we aim to identify the progressively impaired cognitive components in patients with MDD. Methods: A comprehensive neurocognitive test battery was used to assess the cognitive components (executive function, attention, processing speed, memory, working memory, inhibition, shifting, and verbal fluency) in 35 patients with first-episode MDD (FED), 60 patients with recurrent MDD (RD) and 111 matched healthy controls (HCs). After 6 months of treatment with antidepressant, 20 FED and 36 RD patients achieved clinical remission and completed their second-time neurocognitive tests. Statistical analyses were conducted to identify the impaired cognitive components in the FED and RD groups before and after treatment, and to assess the relationship between the cognitive components and the number of episodes and total illness duration in the MDD patient group. Results: At baseline, both the FED and RD groups showed impairments in all of the cognitive components; the FED and RD groups showed no significant difference in all of the components except for shifting. After remission, only shifting in the RD group showed no significant improvement and remained in an impaired status. Furthermore, shifting was the only component negatively correlated with the number of episodes as well as the total illness duration. Conclusions: Shifting may serve as the progressive cognitive deficit across episodes of MDD. Clinical Trials Registration: Registry name: HPA function and MRI study of trauma-related depression; Registration number: ChiCTR1800014591; URL: http://www.chictr.org.cn/edit.aspx?pid=24669&htm=4.
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Affiliation(s)
- Jin Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Bangshan Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Mi Wang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Yumeng Ju
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Qiangli Dong
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Xiaowen Lu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Jinrong Sun
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Liang Zhang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Hua Guo
- Zhumadian Psychiatric Hospital, Zhumadian, China
| | - Futao Zhao
- Zhumadian Psychiatric Hospital, Zhumadian, China
| | - Weihui Li
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Li Zhang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Zexuan Li
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Yan Zhang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Mei Liao
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Lingjiang Li
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
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14
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Listunova L, Kienzle J, Bartolovic M, Jaehn A, Grützner TM, Wolf RC, Aschenbrenner S, Weisbrod M, Roesch-Ely D. Cognitive remediation therapy for partially remitted unipolar depression: A single-blind randomized controlled trial. J Affect Disord 2020; 276:316-326. [PMID: 32871662 DOI: 10.1016/j.jad.2020.07.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 06/16/2020] [Accepted: 07/04/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND There is an urgent need for the development and evaluation of targeted interventions for cognitive impairment (CI) in patients with (partially) remitted major depressive disorder (MDD). The aim of our study was therefore to evaluate the effect of cognitive remediation therapy (CRT) on cognitive and psychosocial functioning in a sample of patients with MDD, taking into account comorbidity, psychopathology, remission status and CI profile. Furthermore, we compared a generalized training (GT) with an individualized training (IT) approach regarding their effects on cognition. METHODS Sixty-two MDD patients in partial remission with CI were randomly assigned to a control group (CG), IT or GT. Participants of GT trained six cognitive subdomains (divided attention, selective attention, alertness, working memory, planning and response inhibition), whereas participants of IT trained their three most deficient cognitive subdomains as identified at baseline. Participants of both intervention groups trained three times per week over a five-week period. Both training groups received additional 30-minute compensatory-transfer sessions once per week. RESULTS Attention appeared to be the most frequently impaired cognitive domain as well as the domain which was significantly improved by CRT, with medium to large effect sizes. No difference in improvement was found between IT and GT. The analyses also revealed greater improvement in self-assessed psychosocial functioning in training participants (GT and IT combined) compared to the CG. LIMITATIONS Due to the small sample size, the present results are preliminary in nature. CONCLUSION CRT was well accepted, and patients transferred the attentional improvement to real life, as measured by self-assessed psychosocial functioning. IT yielded no additional advantages over GT. We propose CRT as an integral part of the treatment plan for patients with depression suffering from CI.
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Affiliation(s)
- Lena Listunova
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University Hospital, Voßstraße 4, 69115 Heidelberg, Germany.
| | - Johanna Kienzle
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University Hospital, Voßstraße 4, 69115 Heidelberg, Germany
| | - Marina Bartolovic
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University Hospital, Voßstraße 4, 69115 Heidelberg, Germany
| | - Anna Jaehn
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University Hospital, Voßstraße 4, 69115 Heidelberg, Germany
| | - Thea Marianne Grützner
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University Hospital, Voßstraße 4, 69115 Heidelberg, Germany
| | - Robert Christian Wolf
- Centre for Psychosocial Medicine, Department of General Psychiatry, Cognitive Neuropsychiatry Section, Heidelberg University Hospital, Voßstraße 4, 69115 Heidelberg, Germany
| | | | - Matthias Weisbrod
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University Hospital, Voßstraße 4, 69115 Heidelberg, Germany; Department of Adult Psychiatry, SRH-Klinik, Karlsbad-Langensteinbach, Germany
| | - Daniela Roesch-Ely
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University Hospital, Voßstraße 4, 69115 Heidelberg, Germany
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15
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Abstract
Patients diagnosed with unipolar disorder usually experience impaired cognitive functioning during an acute depressive episode. The purpose of the current study was to investigate the association of specific clinical factors with cognitive dysfunction in a group of major depressed patients. 65 subjects diagnosed with recurrent major depressive disorder were evaluated during an acute episode. The cognitive functions were assessed with neuropsychological tests for attention and processing speed, memory, verbal fluency, psychomotor speed and executive functions. Hamilton Depression Rating Scale - 17 items was used to quantify the severity of depression. Clinical variables consisted in age at onset, number of previous depressive episodes, presence of psychotic symptoms or suicide attempts. The group had a mean age of 48.48 years, with predominance of females, with a history of 5.43 episodes and associated psychotic symptoms (23.1%) and suicide attempts (20%). Cognitive domains for which we found significant results (p < 0.05) were executive functions and attention, being associated with the number of previous depressive episodes. Psychomotor speed was significantly associated with the severity of depression. Also, patients with psychotic symptoms obtained altered results for psychomotor speed and verbal memory. For almost all cognitive domains we found significant statistical association with different clinical aspects, such as number of depressive episodes, severity of depression, presence of psychotic symptoms and suicide attempts. Since each of them had an influence over cognition, further studies involving larger samples are necessary to establish if there is a direct relationship between cognitive impairment and clinical variables.
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Affiliation(s)
- Bianca Daniela Suciu
- Department of Neurosciences, Psychiatry and Pediatric Psychiatry Chair, "Iuliu Hațieganu", University of Medicine and Pharmacy, 43 Victor Babeș Street, Cluj-Napoca, Romania.
| | - Ioana Valentina Micluţia
- Department of Neurosciences, Psychiatry and Pediatric Psychiatry Chair, "Iuliu Hațieganu", University of Medicine and Pharmacy, 43 Victor Babeș Street, Cluj-Napoca, Romania.,Psychiatric Clinic, Emergency County Hospital, Cluj-Napoca, Romania
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16
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Crowe M, Porter R, Douglas K, Inder M, Lacey C, Jordan J, Wells H. Patients' experiences of cognitive functioning in recurrent depression: A qualitative study. J Psychiatr Ment Health Nurs 2020; 27:321-329. [PMID: 31981272 DOI: 10.1111/jpm.12603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/16/2020] [Accepted: 01/21/2020] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Recurrent depressive episodes involve significant morbidity, suicide risk and recurrent hospitalizations. In both major depressive disorder and bipolar disorder, there are significant impairments in functioning following resolution of acute symptoms. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper provides an in-depth qualitative understanding of the subjective experience of cognitive impairment following a depressive episode in a recurrent mood disorder. It identifies descriptions of two types of experience (being stuck and being preoccupied with one's thoughts) that led to impairments in concentration, memory, organization and decision-making. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses need to develop an awareness of the impact of cognitive difficulties in the process of recovery from recurrent mood disorders. Mental health nurses need to provide knowledgeable reassurance, information and interventions to people who experience cognitive difficulties to provide a framework of understanding that promotes recovery. ABSTRACT: Introduction People who experience recurrent depressive episodes often have ongoing cognitive problems that impact on their functional recovery. These cognitive difficulties have been identified as impacting on social, interpersonal and occupational functioning and can result in vulnerability to relapse. Aim The aim of this qualitative study was to explore participants' subjective experiences of cognitive impairment after discharge from mental health services following treatment for recurrent depression. Methods The study was designed as a qualitative study in order to best capture participants' subjective experiences. Data were collected by semi-structured interviews and were analysed using a process of thematic analysis. Results Twenty participants took part in this study. All participants described experiences of either 1) "being stuck"; or 2) "being preoccupied with own thoughts"; however, all participants described the experiences in the third theme: "it stops you living to your potential." Implications for practice In order to promote recovery in a meaningful way, mental health nurses need to provide information about and strategies for managing cognitive difficulties associated with recurrent mood disorders.
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Affiliation(s)
- Marie Crowe
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Richard Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Katie Douglas
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Maree Inder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Cameron Lacey
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Hayley Wells
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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17
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Abnormal functional connectivity strength in first-episode, drug-naïve adult patients with major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2020; 97:109759. [PMID: 31499128 DOI: 10.1016/j.pnpbp.2019.109759] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 08/14/2019] [Accepted: 09/03/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND The pathogenesis of major depressive disorder (MDD) is complicated and equivocal. Previous studies have found an incidence of abnormal changes of neural networks, with plentiful evidence pointing the finger of suspicion firmly at the default mode network (DMN) and cortico-limbic networks. The aim of the present study was to use the approach of functional connectivity strength (FCS) to directly investigate the features of spontaneous brain activity in the case of first-episode, drug-naïve adult patients with MDD at rest. METHODS Resting-state functional magnetic resonance imaging (MRI) scans were performed on 23 first-episode drug-naïve major depressive disorder (MDD) patients and 20 healthy controls (HCs). In this study, using graph-theory approaches(FCS), we computed the characteristics of brain connectivity. Simultaneously, we used a series of validated test procedures to evaluate the patients' cognitive function. Subsequently, the results were compared with the peak of FCS value and a correlation analysis was conducted. RESULTS Compared with the HCs group, MDD patients showed significantly decreased FCS in bilateral posterior cingulate cortex (PCC)/precuneus and bilateral prefrontal cortex(PFC) and increased FCS in right posterior central gyrus, left thalamus and left temporal lobe. These brain regions belongs to the default-mode network and cortico-limbic networks. Finally, the correlation analyses showed the negative correlation of the FCS values in the left posterior cingulate cortex (PCC)/precuneus and Hamilton Anxiety Rating Scale (HAMA, r = -0.472, p = .023), Stroop Color Word Test-A(SCWT-A, r = -0.451, p = .031), Stroop Color Word Test-B(SCWT-B, r = -0.588, p = .003).Meanwhile, there was negative correlation between the FCS values in the left thalamus and SCWT-A(r = -0.473, p = .023), SCWT-B(r = -0.465, p = .025), SCWTC(r = -0.524, p = .010).In addition, the FCS values in the right PCC has negative correlation with Montgomery Asberg Depression Rating Scale (MADRS) (r = -0.433, p = .039). CONCLUSIONS DMN is an important node of MDD. FCS within the default mode network and cortico-limbic networks in patients with major depressive disorder has been changed in the early stage of MDD. FCS can provide favourable and additional evidence in the investigation of brain pathophysiology and therapy in depression.
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18
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Listunova L, Bartolovic M, Kienzle J, Jaehn A, Grützner TM, Wolf RC, Weisbrod M, Roesch-Ely D. Predictors of cognitive remediation therapy improvement in (partially) remitted unipolar depression. J Affect Disord 2020; 264:40-49. [PMID: 31846901 DOI: 10.1016/j.jad.2019.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 11/26/2019] [Accepted: 12/04/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND There is urgent need for development and evaluation of targeted interventions for cognitive deficits in (partially) remitted major depression. Until now the analyses of the moderators of treatment efficacy were only examined in mixed samples of patients with schizophrenia, affective spectrum and schizoaffective disorders. Thus, the aim of our study was to evaluate the predictors of cognitive remediation therapy (CRT) improvement in a sample of (partially) remitted major depressive disorder patients. METHODS Reliable Change Index with corrections for practice effects was calculated for each participant as an indicator for training improvement. Thirty eight patients, who were randomized within our previously conducted CRT clinical trial, were divided into "Improvers" and "Nonimprovers" in the attention domain, to compare them on sociodemographic, psychopathological, neurocognitive, psychosocial and training factors. RESULTS We detected 13 training participants who improved reliably in the attention domain. Illness duration was the only factor which significantly differentiated between Improvers and Nonimprovers. No significant differences between Improvers and Nonimprovers in terms of other clinical variables, sociodemographic and neuropsychological factors were found. LIMITATIONS Exploratory research results should be taken with caution. Focus on the attention domain could have led to a limited point of view. CONCLUSION Our findings represent a first analysis of the predictors of cognitive remediation training improvement in (partially) remitted unipolar depression. Much more work should be done to refine cognitive treatment approaches. An initiation of cognitive training in early stages of the disease could be beneficial for the affected patients.
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Affiliation(s)
- Lena Listunova
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University, Voßstraße 4, 69115 Heidelberg, Germany.
| | - Marina Bartolovic
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University, Voßstraße 4, 69115 Heidelberg, Germany
| | - Johanna Kienzle
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University, Voßstraße 4, 69115 Heidelberg, Germany
| | - Anna Jaehn
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University, Voßstraße 4, 69115 Heidelberg, Germany
| | - Thea Marianne Grützner
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University, Voßstraße 4, 69115 Heidelberg, Germany
| | - Robert Christian Wolf
- Centre for Psychosocial Medicine, Department of General Psychiatry, Cognitive Neuropsychiatry Section, Heidelberg University, Voßstraße 4, 69115 Heidelberg, Germany
| | - Matthias Weisbrod
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University, Voßstraße 4, 69115 Heidelberg, Germany; Department of Adult Psychiatry, SRH-Klinik, Karlsbad-Langensteinbach, Germany
| | - Daniela Roesch-Ely
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University, Voßstraße 4, 69115 Heidelberg, Germany
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Grützner TM, Sharma A, Listunova L, Bartolovic M, Weisbrod M, Roesch-Ely D. Neurocognitive performance in patients with depression compared to healthy controls: Association of clinical variables and remission state. Psychiatry Res 2019; 271:343-350. [PMID: 30529317 DOI: 10.1016/j.psychres.2018.11.047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 11/27/2022]
Abstract
Cognitive impairment in Major Depressive Disorder (MDD) has been postulated to persist into remission. However, inconsistent definitions of clinical remission, patterns and influencing factors, isolated cognitive tasks, and the lack of appropriately matched controls (HCs) present significant limitations of previous studies. Furthermore, studies investigating cognition in partially remitted patients are particularly scarce. This study compares the cognition of MDD patients (N = 65) and HCs (N = 65), matched by one-to-one recruitment strategy for age, sex, and education (ages 19-60). The neuropsychological (NPS) performance was measured via an extensive NPS-test battery and analysed retrospectively, accounting for demographic and clinical variables. Full remission was defined as HAMD cut off ≤7, partial remission as HAMD 8-18. The findings show entire MDD group and partially remitted MDD with significantly poorer NPS performance compared to HCs, while remitted MDD patients did not differ significantly from HCs. This underscores how critical a clear definition of remission is to compare studies on MDD. The clinical variable 'number of hospitalizations' had a significant effect on cognition, whereas current symptom severity did not correlate with performance on any cognitive domain. Higher number of hospitalizations may be associated with higher burden of illness and greater neurobiological "scar effects".
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Affiliation(s)
- Thea Marianne Grützner
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Voßstraße 4, 69115, Heidelberg, Baden-Württemberg, Germany.
| | - Anuradha Sharma
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Voßstraße 4, 69115, Heidelberg, Baden-Württemberg, Germany
| | - Lena Listunova
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Voßstraße 4, 69115, Heidelberg, Baden-Württemberg, Germany
| | - Marina Bartolovic
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Voßstraße 4, 69115, Heidelberg, Baden-Württemberg, Germany
| | - Matthias Weisbrod
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Voßstraße 4, 69115, Heidelberg, Baden-Württemberg, Germany; Department of Psychiatry and Psychotherapy, SRH Hospital Karlsbad-Langensteinbach, Guttmannstraße 1, 76307, Karlsbad, Germany
| | - Daniela Roesch-Ely
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Voßstraße 4, 69115, Heidelberg, Baden-Württemberg, Germany
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Discrepancy between objective and subjective cognition in major depressive disorder. Eur Neuropsychopharmacol 2019; 29:46-56. [PMID: 30503099 DOI: 10.1016/j.euroneuro.2018.11.1104] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/27/2018] [Accepted: 11/09/2018] [Indexed: 12/25/2022]
Abstract
Objective and subjective cognitive measures are altered in major depressive disorder (MDD), but there is a poor correlation between them. This study aims to explore such discrepancy and the characteristics explaining this phenomenon. 229 patients with MDD subdivided into remitted (n = 57), partially remitted (n = 90) and acute (n = 82) underwent a clinical interview, completed self-report questionnaires and a neuropsychological assessment. The association between objective and subjective cognition was evaluated in the areas of attention and memory. Also, dependent measures of concordance and self-appraisal were calculated for each patient. Potential predictors of these outcomes were evaluated through regression analysis. Depressive symptoms correlated negatively with objective but especially with subjective cognition. Patients in an acute episode showed a significant correlation between objective and subjective attention/memory measures, but also the greatest underestimation of their cognitive performance. In those with fewer depressive symptoms, objective and subjective cognition showed poor correspondence between them. In the regression analyses with the full MDD sample, higher scores on depressive symptoms, intelligence quotient and executive functions predicted lower self-appraisal. Objective and subjective cognition show poor concordance in MDD patients, especially in those with residual mood symptoms. Higher executive functions also explain this discrepancy. Assessments of both subjective cognitive complaints and objective performance seem necessary as they may be measuring different aspects of cognitive functioning.
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Harrison JE, Barry H, Baune BT, Best MW, Bowie CR, Cha DS, Culpepper L, Fossati P, Greer TL, Harmer C, Klag E, Lam RW, Lee Y, Mansur RB, Wittchen H, McIntyre RS. Stability, reliability, and validity of the THINC-it screening tool for cognitive impairment in depression: A psychometric exploration in healthy volunteers. Int J Methods Psychiatr Res 2018; 27:e1736. [PMID: 30088298 PMCID: PMC6174931 DOI: 10.1002/mpr.1736] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 06/15/2018] [Accepted: 06/21/2018] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES There is a need for a brief, reliable, valid, and sensitive assessment tool for screening cognitive deficits in patients with Major Depressive Disorders. This paper examines the psychometric characteristics of THINC-it, a cognitive assessment tool composed of four objective measures of cognition and a self-rated assessment, in subjects without mental disorders. METHODS N = 100 healthy controls with no current or past history of depression were tested on four sequential assessments to examine temporal stability, reliability, and convergent validity of the THINC-it tests. We examined temporal reliability across 1 week and stability via three consecutive assessments. Consistency of assessment by the study rater (intrarater reliability) was calculated using the data from the second and third of these consecutive assessments. RESULTS Test-retest reliability correlations varied between Pearson's r = 0.75 and 0.8. Intrarater reliability between 0.7 and 0.93. Stability for the primary measure for each test yielded within-subject standard deviation values between 5.9 and 11.23 for accuracy measures and 0.735 and 17.3 seconds for latency measures. Convergent validity for three tasks was in the acceptable range, but low for the Symbol Check task. CONCLUSIONS Analysis shows high levels of reliability and stability. Levels of convergent validity were modest but acceptable in the case of all but one test.
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Affiliation(s)
- John E. Harrison
- Alzheimer CenterVU Medical CenterAmsterdamThe Netherlands
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- Kilmington CommonMetis Cognition LtdWiltshireUK
| | | | | | | | - Christopher R. Bowie
- Department of PsychologyQueen's UniversityKingstonONCanada
- Centre for Addiction and Mental HealthTorontoONCanada
| | - Danielle S. Cha
- Mood Disorders Psychopharmacology UnitUniversity Health NetworkTorontoONCanada
| | - Larry Culpepper
- Department of Family MedicineBoston UniversityBostonMassachusettsUSA
| | - Philippe Fossati
- Sorbonne Universités, UPMC Univ Paris 06, Inserm, CNRS, APHPInstitut du cerveau et de la moelle (ICM)‐Hôpital Pitié SalpétrièreParisFrance
| | - Tracy L. Greer
- Centre for Depression Research and Clinical Care, Department of PsychiatryUniversity of TexasDallasTexasUSA
| | - Catherine Harmer
- Cognitive Neuroscience, Department of PsychiatryOxford UniversityOxfordUK
| | - Esther Klag
- Clinical Psychologist, Rehabilitation Neuropsychologist, PsychotherapistLondonUK
| | - Raymond W. Lam
- BC Leadership Chair in Depression ResearchVancouverBCCanada
- Department of PsychiatryUniversity of British ColumbiaVancouverBCCanada
- Djavad Mowafaghian Centre for Brain HealthMood Disorders CentreVancouverBCCanada
- Canadian Network for Mood and Anxiety Treatments (CANMAT)VancouverBCCanada
| | - Yena Lee
- Mood Disorders Psychopharmacology UnitUniversity Health NetworkTorontoONCanada
- Institute of Medical ScienceUniversity of TorontoTorontoONCanada
| | - Rodrigo B. Mansur
- Mood Disorders Psychopharmacology UnitUniversity Health NetworkTorontoONCanada
- Canadian Network for Mood and Anxiety Treatments (CANMAT)VancouverBCCanada
| | - Hans‐Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy and Centre of Clinical Epidemiology and Longitudinal Studies, (CELOS)Technische Universität DresdenDresdenGermany
- Department of Psychiatry and PsychotherapyLudwig‐Maximilians‐University MunichMunichGermany
- Clinical Psychology and Psychotherapy MPCBDresdenGermany
| | - Roger S. McIntyre
- Mood Disorders Psychopharmacology UnitUniversity Health NetworkTorontoONCanada
- Institute of Medical ScienceUniversity of TorontoTorontoONCanada
- Department of PsychiatryUniversity of TorontoTorontoONCanada
- Brain and Cognition Discovery Foundation (BCDF)TorontoONCanada
- Department of PharmacologyUniversity of TorontoTorontoONCanada
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22
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Association Between Depression and Antiretroviral Therapy Use Among People Living with HIV: A Meta-analysis. AIDS Behav 2018; 22:1542-1550. [PMID: 28439754 DOI: 10.1007/s10461-017-1776-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Depression is common among people living with HIV (PLHIV). Studies on the relationship between depression and use of antiretroviral therapy (ART) are inconclusive. A meta-analysis was conducted to summarize the relationship between depression and ART use among PLHIV. Ten electronic databases, conference abstracts, and dissertations were searched. A random effects meta-analysis was performed to pool the odds ratio estimates from eligible studies. Subgroup analyses and meta-regression were conducted for moderator analysis. Sensitivity analysis was performed to find influential studies. A funnel plot, the Egger test, and the trim and fill analysis were used to detect publication bias. The pooled sample size was 7375 PLHIV from nine eligible studies. The pooled prevalence of depression was 41% (95% confidence interval [CI] 29-53%). The pooled ART use rate was 52% (95% CI 37-67%). PLHIV with depression were 14% less likely (pooled odds ratio [OR] = 0.86; 95% CI 0.71-1.05) to use ART than those without depression. Subgroup analyses showed that depression was significantly associated with no ART use (pooled OR 0.84; 95% CI 0.71-0.99) among studies with a prospective study design (11 estimates from nine studies). Moderator analyses did not show any statistically significant effects. The publication bias analyses showed small study effects may not exist. Depression was associated with non-use of ART among PLHIV. Studies are needed to explore this association in other countries with varied populations, as most published studies have been conducted in the United States.
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Swallow DMA, Lawton MA, Grosset KA, Malek N, Smith CR, Bajaj NP, Barker RA, Ben-Shlomo Y, Burn DJ, Foltynie T, Hardy J, Morris HR, Williams N, Wood NW, Grosset DG. Variation in Recent Onset Parkinson's Disease: Implications for Prodromal Detection. JOURNAL OF PARKINSONS DISEASE 2017; 6:289-300. [PMID: 27003780 PMCID: PMC4927926 DOI: 10.3233/jpd-150741] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The detection of prodromal Parkinson's disease (PD) is desirable to test drugs with neuroprotective potential, but will be affected by known disease variations. OBJECTIVE To assess the prevalence of four key non-motor prodromal PD markers, and evaluate the sensitivity of case detection when non-motor screening tools for prodromal PD are implemented in an early clinical PD cohort. METHODS Hyposmia (University of Pennsylvania smell identification test ≤15th centile or Sniffin' Sticks at or ≤10th centile corrected for age and sex), rapid-eye movement sleep behaviour disorder (RBD questionnaire >4), constipation (<1 daily spontaneous bowel motion) and depression (Leeds >6) were recorded in recent onset PD cases, and proposed non-motor screening criteria applied. RESULTS In 1,719 PD cases, mean age 68.6 years (SD 8.1), 65.5% male, mean disease duration 1.3 years (SD 0.9), 72.2% were hyposmic, 43.3% had RBD, 22.1% depression, and 21.5% constipation. 11.6% of cases had no key non-motor features, 38.8% one, 32.1% two, 15.5% three, and 2.0% all four. Increasing numbers of non-motor features were associated with younger age (p = 0.019), higher motor scores (p < 0.001), more postural instability gait difficulty (PIGD) (p < 0.001), greater cognitive impairment (p < 0.001) and higher total non-motor burden (p < 0.001). Cases with hyposmia alone were younger (p < 0.001), had less severe cognitive (p = 0.006) and other non-motor features (p < 0.001). All screening criteria selected younger patients (p = 0.001, p < 0.001), three of four greater overall non-motor burden (p = 0.005, p < 0.001), and inclusion of RBD more cognitive impairment (p = 0.003, p = 0.001) and PIGD (p = 0.004, p = 0.001). CONCLUSIONS Varying sensitivity levels, and age and phenotype selectivity, are found when different non-motor screening methods to detect prodromal PD are applied to an early clinical PD cohort.
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Affiliation(s)
- Diane M A Swallow
- Department of Neurology, Institute of Neurological Sciences, Glasgow, UK
| | - Michael A Lawton
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | - Naveed Malek
- Department of Neurology, Institute of Neurological Sciences, Glasgow, UK
| | - Callum R Smith
- Department of Neurology, Institute of Neurological Sciences, Glasgow, UK
| | - Nin P Bajaj
- Department of Neurology, Queen's Medical Centre, Nottingham, UK
| | - Roger A Barker
- Clinical Neurosciences, John van Geest Centre for Brain Repair, Cambridge, UK
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - David J Burn
- Institute of Neuroscience, University of Newcastle, UK
| | - Thomas Foltynie
- Sobell Department of Motor Neuroscience, UCL Institute of Neurology, London, UK
| | - John Hardy
- Reta Lila Weston Laboratories, Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Huw R Morris
- Department of Clinical Neuroscience, UCL Institute of Neurology, London, UK
| | - Nigel Williams
- Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Nicholas W Wood
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Donald G Grosset
- Department of Neurology, Institute of Neurological Sciences, Glasgow, UK
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24
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Abstract
BACKGROUND The sleep and cognitive dysfunction are common in major depressive disorders (MDDs). Recently, the 2-pore domain potassium channel twik-related K(+) channel 1 (TREK-1) has been identified to be closely related to the etiology of MDD. However, whether TREK-1 is involved in the regulation of sleep and cognition is still unknown. METHODS The present study tried to dissect the role of outwardly rectifying K+ channel-1 (ORK1) (TREK-1 homolog in Drosophila) in sleep and cognition in Drosophila. The mutant and over-expressed lines of ork1 were generated using Drosophila genetics. Sleep analysis and short-term memory experiments were used to test sleep time and short-term memory of the mutant and over-expressed ORK1 lines, respectively. RESULTS Our results showed that the learning index of ork1 mutant lines was increased compared with the wild type. However, ork1 mutant could obviously decrease sleep time in Drosophila. Contrary to the ork1 mutant lines, we also found that ORK1 over-expression could increase sleep time and decreased learning index in Drosophila. CONCLUSION Results from this study suggest that ORK1 might play an important role in the regulation of sleep time and short-term memory in Drosophila.
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25
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Huang M, Lu S, Yu L, Li L, Zhang P, Hu J, Zhou W, Hu S, Wei N, Huang J, Weng J, Xu Y. Altered fractional amplitude of low frequency fluctuation associated with cognitive dysfunction in first-episode drug-naïve major depressive disorder patients. BMC Psychiatry 2017; 17:11. [PMID: 28077120 PMCID: PMC5225658 DOI: 10.1186/s12888-016-1190-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 12/31/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Previous studies have demonstrated that abnormities of both resting-state brain activity and cognitive dysfunction are frequently observed in patients with major depressive disorder (MDD). However, the underlying relationship between these two aspects is less investigated. In this context, the aim of the present study was to investigate the association between cognitive dysfunction and altered resting-state brain function in first-episode drug-naïve MDD patients. METHODS Twenty-five drug-naïve MDD patients and twenty-six age-, sex-, and education-matched normal controls were recruited in this study. Cognitive function was evaluated by using a series of validated test procedures. The resting-state functional magnetic resonance imaging data were obtained on a Philips 3.0 Tesla scanner and analysed using the fractional amplitude of low frequency fluctuation (fALFF) method. Correlations of fALFF values with cognitive dysfunction were further analysed. RESULTS Compared with healthy controls, MDD patients showed significantly fewer completed categories in the Wisconsin Card Sorting Test (WCST) and decreased scores in the first and second subtests of the Continuous Performance Test (CPT). However, the two groups did not differ in their performance on the Stroop Colour Word Test and Trail-making Test. MDD patients exhibited significantly decreased fALFF values in the left superior frontal gyrus (SFG), left middle frontal gyrus, and left inferior frontal gyrus, as well as increased fALFF values in the left inferior temporal gyrus (ITG), bilateral parahippocampal gyrus, and the right caudate. Finally, the correlation analyses revealed that fALFF values in the left SFG and left ITG were associated with the number of WSCT completed categories and scores on the second subtest of the CPT in MDD, respectively. CONCLUSIONS The present findings suggest that there is little evidence of an association between regional abnormalities in resting-state brain function and cognitive deficits in MDD.
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Affiliation(s)
- Manli Huang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder’s Management of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003 Zhejiang China
| | - Shaojia Lu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder’s Management of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003 Zhejiang China
| | - Liang Yu
- Department of Anesthesiology and Pain, Hang Zhou First People’s Hospital, Hangzhou, Zhejiang China
| | - Lingjiang Li
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Key Laboratory of Psychiatry and Mental Health of Hunan Province, National Technology Institute of Psychiatry and Mental Health, Changsha, Hunan China
| | - Peng Zhang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder’s Management of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003 Zhejiang China ,Mental Health Centre, Xiaoshan Hospital of Zhejiang Province, Hangzhou, Zhejiang China
| | - Jianbo Hu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder’s Management of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003 Zhejiang China
| | - Weihua Zhou
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder’s Management of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003 Zhejiang China
| | - Shaohua Hu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder’s Management of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003 Zhejiang China
| | - Ning Wei
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder’s Management of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003 Zhejiang China
| | - Jinwen Huang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder’s Management of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003 Zhejiang China
| | - Jian Weng
- Bio-X Lab, Department of Physics, Zhejiang University, Hangzhou, Zhejiang China
| | - Yi Xu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003, Zhejiang, China.
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Overgeneral autobiographical memory at baseline predicts depressive symptoms at follow-up in patients with first-episode depression. Psychiatry Res 2016; 243:123-7. [PMID: 27392229 DOI: 10.1016/j.psychres.2016.06.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 06/19/2016] [Accepted: 06/19/2016] [Indexed: 11/20/2022]
Abstract
Previous studies have shown that overgeneral autobiographical memory (OGM) is a characteristic of depression. However, there are no studies to explore the association between baseline OGM and depressive symptoms at follow-up in patients with first-episode depression (FE). This study investigated whether baseline OGM predicts depressive symptoms at follow-up in patients with FE. We recruited 125 patients with FE. The participants were divided into remitted group and non-remitted group according to the severity of their depression at 12 months follow-up. The measures consisted of the 17-item Hamilton Depression Rating Scale, Ruminative Response Scale, and Autobiographical Memory Test. Hierarchical linear regression analyses and bootstrap mediation analyses were conducted. The results showed that non-remitted patients had more OGM at baseline. Baseline OGM predicted depressive symptoms at follow-up in patients with FE. Rumination mediated the relationship between baseline OGM and depressive symptoms at follow-up. Our findings highlight OGM as a vulnerability factor involved in the maintenance of depression in patients with FE.
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