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Bergdolt J, Hubert S, Schreiter J, Jenderny S, Beblo T, Driessen M, Steinhart I, Dehn LB. Predictors of return to work in people with major depression: Results from a supported employment program in Germany. J Affect Disord 2024; 364:1-8. [PMID: 39029690 DOI: 10.1016/j.jad.2024.07.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/26/2024] [Accepted: 07/14/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Depression is a common mental disorder and is associated with work disability. For the implementation of evidence-based interventions, such as Individual Placement and Support (IPS) for people with depression in Germany, the aim of this study was to investigate client variables that predict return to work. METHODS The sample consisted of 129 participants, initially treated in a psychiatric hospital due to major depression, who participated in IPS as part of a German clinical trial. Baseline demographic (age, sex, education, sickness absence days, employment status), psychiatric (symptom severity, comorbidity, general physical and mental health, disability), and neuropsychological (self-rated deficits, test performance) variables were included. Return to work within one year was predicted using separate and overall binary logistic regression analyses. RESULTS A total of 70 participants (56 %) returned to work within the one-year follow-up period. >100 days of sick leave in the year prior to study entry (vs. <100 days) and higher self-rated cognitive deficits were significantly associated with reduced odds of return to work within one year of IPS. LIMITATIONS The sample consisted of participants with a relatively good work history who were assigned to IPS by the treatment team, thus, the generalizability of the results is limited. CONCLUSIONS People with depression who participate in IPS interventions might benefit from specifically targeting perceived cognitive deficits. Factors associated with prolonged sick leave due to depression and their role in return to work with IPS need further investigation.
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Affiliation(s)
- Juliane Bergdolt
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL, Universität Bielefeld, Remterweg 69-71, 33617 Bielefeld, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany.
| | - Stella Hubert
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL, Universität Bielefeld, Remterweg 69-71, 33617 Bielefeld, Germany
| | - Julia Schreiter
- Institut für Sozialpsychiatrie Mecklenburg-Vorpommern e.V., Universität Greifswald, Greifswald, Germany
| | - Sarah Jenderny
- Institut für Sozialpsychiatrie Mecklenburg-Vorpommern e.V., Universität Greifswald, Greifswald, Germany
| | - Thomas Beblo
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL, Universität Bielefeld, Remterweg 69-71, 33617 Bielefeld, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany
| | - Martin Driessen
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL, Universität Bielefeld, Remterweg 69-71, 33617 Bielefeld, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany
| | - Ingmar Steinhart
- Institut für Sozialpsychiatrie Mecklenburg-Vorpommern e.V., Universität Greifswald, Greifswald, Germany
| | - Lorenz B Dehn
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL, Universität Bielefeld, Remterweg 69-71, 33617 Bielefeld, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany
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Tellone V, Markovic O, Strashimirova M, Sani G, Lenderking WR, Margolis MK, Fallone R, Quarchioni E, Cattaneo A, Comandini A. Impact of trazodone once-a-day on quality of life and functional recovery in adults with major depressive disorder: A prospective, observational study. Brain Behav 2024; 14:e3580. [PMID: 39034363 PMCID: PMC11260556 DOI: 10.1002/brb3.3580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/05/2024] [Accepted: 05/17/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Health-related quality of life (HRQL) is an important goal for patients with major depressive disorder (MDD), but whether antidepressants improve HRQL in these patients is unclear. Here, we describe the real-world effects of trazodone once-a-day (TzOAD) and selective serotonin reuptake inhibitor (SSRI) treatments on HRQL and functioning in adults with MDD. METHODS This 8-week prospective, observational, open-label, multicenter study was conducted in adults with moderate or severe MDD for whom TzOAD or SSRI were prescribed as monotherapy. The primary outcome was life enjoyment and satisfaction assessed via the patient-reported Quality-of-Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF) from baseline to week 8. Secondary outcomes included change in Q-LES-Q-SF from baseline to weeks 1 and 2; severity of depressive symptoms using the Montgomery Åsberg Depression Rating Scale (MADRS) and sleep disturbance via the PROMIS SF-SD 8b questionnaire at weeks 1, 2, and 8; and overall functioning via the Sheehan Disability Scale (SDS), hedonic capacity using the Snaith-Hamilton Pleasure Scale (SHAPS), and cognitive dysfunction using the Perceived Deficits Questionnaire (PDQ-5) at baseline and week 8. RESULTS The study included 208 adults with MDD (mean [SD] age = 50.2 [14.3] years; 68.6% female; 98.4% White). Life enjoyment and satisfaction improved from baseline to week 8 for both treatment groups: Q-LES-Q-SF mean (SD) scores were 27.5 (20.4) for the SSRI group and 39.0 (22.1) for the TzOAD group. Depressive symptoms and sleep disturbances also reduced from baseline to week 8: MADRS (SSRI, -15.7 [8.3]; TzOAD, -21.0 [9.8]); PROMIS SF-SD 8b (SSRI, -9.9 [12.6]; TzOAD, -22.0 [12.6]). Mean change scores in Q-LES-Q-SF, MADRS, and PROMIS SF-SD 8b improved as early as week 1 in both groups. Mean scores also improved from baseline to week 8 on SDS (SSRI, -9.2 [7.4]; TzOAD, -14.3 [7.5]), SHAPS (SSRI, -6.6 [4.3]; TzOAD, -8.3 [4.4]), and PDQ-5 (SSRI, -5.8 [4.5]; TzOAD, -7.7 [5.0]). CONCLUSIONS In adults with MDD who received TzOAD or SSRIs, overall and individual HQRL domains improved rapidly and in parallel with improvements in depressive symptoms, with a slightly greater improvement observed in the TzOAD group.
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Affiliation(s)
| | - Oto Markovic
- Clinline Services s.r.o.Stredoceský krajCzech Republic
| | | | - Gabriele Sani
- Department of Neuroscience, Section of PsychiatryUniversità Cattolica del Sacro CuoreRomeItaly
- Department of Neuroscience, Sensory Organs and Thorax, UOC Psichiatria Clinica e D'UrgenzaFondazione Policlinico Universitario A Gemelli IRCCSRomeItaly
| | | | | | | | - Elisa Quarchioni
- Pharmacometrics & Clinical SupplyAngelini Pharma S.p.A.RomeItaly
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Guimond S, Van Rheenen TE. Editorial: Progress in understanding cognitive dysfunction in severe psychiatric disorders. Prog Neuropsychopharmacol Biol Psychiatry 2024; 132:110989. [PMID: 38458345 DOI: 10.1016/j.pnpbp.2024.110989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024]
Affiliation(s)
- Synthia Guimond
- Department of Psychoeducation and Psychology, University of Quebec in Outaouais, Gatineau, Canada; The Royal's Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada.
| | - Tamsyn E Van Rheenen
- Department of Psychiatry, University of Melbourne, Melbourne, Australia; Centre for Mental Health and Brain Sciences, Swinburne University, Melbourne, Australia
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Wang G, Si T, Rieckmann A, Ma J, Christensen MC. Effectiveness of Vortioxetine in Working Patients with Major Depressive Disorder in China: A Subgroup Analysis of the RELIEVE China Study. Neuropsychiatr Dis Treat 2024; 20:1211-1223. [PMID: 38863483 PMCID: PMC11166150 DOI: 10.2147/ndt.s460408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/24/2024] [Indexed: 06/13/2024] Open
Abstract
Background Major depressive disorder (MDD) causes significant functional impairments that impact on all aspects of patients' daily lives, including their ability to work, work productivity, and social life. Purpose To assess the real-world effectiveness of the multimodal antidepressant vortioxetine in working patients with MDD in China. Patients and methods RELIEVE China was an observational, prospective cohort study. Patients (aged ≥18 years) with MDD initiating treatment with vortioxetine in routine clinical practice settings were followed for 24 weeks. In this subgroup analysis, functioning was assessed using the Sheehan Disability Scale (SDS) in patients in full- or part-time work or education at baseline who remained on treatment at all follow-up visits (n=424). Depressive, cognitive, and anxiety symptoms were also assessed. For all endpoints, mean change from baseline at weeks 8 and 24 was analyzed using mixed models for repeated measures. Results Clinically relevant and sustained improvements in patient functioning and measures of work productivity were observed over the 24 weeks of vortioxetine treatment. The adjusted mean (standard error) reduction in SDS total score from baseline was 5.4 (0.3) points at week 8 and 8.7 (0.3) points at week 24 (both P<0.001 vs baseline). Significant improvements were observed across all SDS domains and in levels of absenteeism and presenteeism (P<0.001 vs baseline for all endpoints at both time points). Significant improvements in depressive, cognitive, and anxiety symptoms were also observed over the study period (all P<0.001 vs baseline). The proportion of patients in remission (ie, 17-item Hamilton Depression Rating Scale score ≤7) after 24 weeks of vortioxetine treatment was 65.4%. Vortioxetine was well tolerated; nausea was the most common adverse event, reported by 18.6% of patients. Conclusion These findings support the effectiveness and tolerability of vortioxetine in working patients with MDD receiving treatment in routine clinical practice settings in China.
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Affiliation(s)
- Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People’s Republic of China
| | - Tianmei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, People’s Republic of China
| | | | - Jingdong Ma
- Medical Affairs, Lundbeck China, Beijing, People’s Republic of China
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Olivera-López C, Jiménez-Genchi A, Ortega-Robles D, Valencia-Flores M, Cansino S, Salvador-Cruz J. Polysomnographic parameters associated with cognitive function in patients with major depression and insomnia. CNS Spectr 2024; 29:197-205. [PMID: 38685584 DOI: 10.1017/s1092852924000257] [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] [Indexed: 05/02/2024]
Abstract
OBJECTIVE To examine whether objective sleep parameters are associated with cognitive function (CF) in patients with major depressive disorder (MDD) with chronic insomnia (CI) and whether the severity of these disorders is related to CF. METHOD Thirty patients with MDD with CI attending a tertiary care institution underwent two consecutive nights of polysomnographic (PSG) recording and a battery of neuropsychological tests, which included episodic memory, sustained attention, working memory, and executive function. The severity of MDD and CI was assessed by clinical scales. We examined the relationship between PSG parameters and CF, as well as whether the severity of the disorders is related to CF. RESULTS Linear regression analysis revealed that total sleep time (TST) was positively associated with higher learning and recall of episodic memory, as well as better attention. Slow-wave sleep (SWS) showed a positive association with better working memory. Furthermore, wake after sleep onset (WASO) was negatively associated with episodic memory and lower attention. No significant relationships were found between the severity of MDD or CI with CF. CONCLUSION Both sleep duration and depth are positively associated with several aspects of CF in patients with MDD with CI. Conversely, a lack of sleep maintenance is negatively related to CF in these patients. These findings could help identify modifiable therapeutic targets to reduce CF impairment.
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Affiliation(s)
- Carlos Olivera-López
- Laboratory of Sleep Disorders, Faculty of Psychology, National Autonomous University of Mexico, Mexico City, Mexico
- Faculty of Higher Studies Zaragoza, National Autonomous University of Mexico, Mexico City, Mexico
| | - Alejandro Jiménez-Genchi
- Clinical Services Unit, Sleep Clinic, National Institute of Psychiatry "Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - David Ortega-Robles
- Clinical Services Unit, Sleep Clinic, National Institute of Psychiatry "Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - Matilde Valencia-Flores
- Laboratory of Sleep Disorders, Faculty of Psychology, National Autonomous University of Mexico, Mexico City, Mexico
| | - Selene Cansino
- Laboratory of NeuroCognition, Faculty of Psychology, National Autonomous University of Mexico, Mexico City, Mexico
| | - Judith Salvador-Cruz
- Faculty of Higher Studies Zaragoza, National Autonomous University of Mexico, Mexico City, Mexico
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Martin DM, Harvey AJ, Baune B, Berk M, Carter GL, Dong V, Glozier N, Glue P, Hood S, Hadzi-Pavlovic D, Hackett M, Mills N, Sarma S, Somogyi A, Rodgers A, Loo CK. Cognitive outcomes from the randomised, active-controlled Ketamine for Adult Depression Study (KADS). J Affect Disord 2024; 352:163-170. [PMID: 38378088 DOI: 10.1016/j.jad.2024.02.052] [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: 12/11/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Due to its rapid antidepressant effect, ketamine has recently been clinically translated for people with treatment-resistant depression. However, its cognitive profile remains unclear, particularly with repeated and higher doses. In the present study, we report the cognitive results from a recent large multicentre randomised controlled trial, the Ketamine for Adult Depression Study (KADS). METHODS In this randomised, double-blind, active-controlled, parallel group, multicentre phase 3 trial study we investigated potential cognitive changes following repeated treatment of subcutaneous racemic ketamine compared to an active comparator, midazolam, over 4 weeks, which involved two cohorts; Cohort 1 involved a fixed dose treatment protocol (0.5 mg/kg ketamine), Cohort 2 involved a dose escalation protocol (0.5-0.9 mg/kg) based on mood outcomes. Participants with treatment-resistant Major Depressive Disorder (MDD) were recruited from 7 mood disorder centres and were randomly assigned to receive ketamine (Cohort 1 n = 33; Cohort 2 n = 53) or midazolam (Cohort 1 n = 35; Cohort 2 n = 53) in a 1:1 ratio. Cognitive measurements were assessed at baseline and at the end of randomised treatment. RESULTS Results showed that in Cohort 1, there were no differences between ketamine and midazolam in cognitive outcomes. For Cohort 2, there was similarly no difference between conditions for cognitive outcomes. LIMITATIONS The study included two Cohorts with different dosing regimes. CONCLUSIONS The findings support the cognitive safety of repeated fixed and escalating doses at least in the short-term in people with treatment resistant MDD.
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Affiliation(s)
- Donel M Martin
- University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Sydney, NSW, Australia; The George Institute for Global Health, Sydney, NSW, Australia.
| | - Anna J Harvey
- University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Sydney, NSW, Australia
| | | | | | | | - Vanessa Dong
- University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Sydney, NSW, Australia
| | - Nick Glozier
- The University of Sydney, Sydney, NSW, Australia
| | - Paul Glue
- University of Otago, Dunedin, New Zealand
| | - Sean Hood
- University of Western Australia, Perth, WA, Australia
| | | | - Maree Hackett
- The George Institute for Global Health, Sydney, NSW, Australia
| | | | - Shanthi Sarma
- Bond University, Southport, QLD, Australia; Mental Health and Special Services, Gold Coast Health, QLD, Australia
| | | | - Anthony Rodgers
- The George Institute for Global Health, Sydney, NSW, Australia
| | - Colleen K Loo
- University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Sydney, NSW, Australia; The George Institute for Global Health, Sydney, NSW, Australia
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Bogie BJM, Noël C, Alftieh A, MacDonald J, Lei YT, Mongeon J, Mayaud C, Dans P, Guimond S. Verbal memory impairments in mood disorders and psychotic disorders: A systematic review of comparative studies. Prog Neuropsychopharmacol Biol Psychiatry 2024; 129:110891. [PMID: 37931773 DOI: 10.1016/j.pnpbp.2023.110891] [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: 06/20/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Mood and psychotic disorders are both associated with verbal memory impairments. Verbal memory represents an important treatment target for both disorders. However, whether the neurocognitive and neurophysiological profiles of verbal memory impairments differ between specific disorders within these two diagnostic categories and healthy controls remains unclear. The current systematic review synthesized findings from comparative studies which used behavioural and neuroimaging tasks to investigate verbal memory impairments between: (1) mood disorder, psychotic disorder, and healthy control groups; and (2) mood disorder without psychotic features, mood disorder with psychotic features, and healthy control groups. METHODS The search strategy combined terms related to three main concepts: 'mood disorders', 'psychotic disorders', and 'verbal memory'. Searches were executed in Embase, MEDLINE, PsycInfo, and PubMed databases. A total of 38 articles met the full eligibility criteria and were included in the final narrative synthesis. Findings were stratified by memory domain (overall composite score, verbal working memory, immediate recall, delayed recall, and recognition memory) and by illness phase (acute and non-acute). RESULTS Mood and psychotic disorders displayed consistent verbal memory impairments compared to healthy controls during the acute and non-acute phases. Few significant differences were identified in the literature between mood and psychotic disorders, and between mood disorders with and without psychotic features. Individuals with schizophrenia were found to have decreased immediate and delayed verbal recall performance compared to bipolar disorder groups during the acute phase. Major depressive disorder groups with psychotic features were also found to have decreased delayed verbal recall performance compared to those without psychosis during the acute phase. No consistent differences were identified between mood and psychotic disorders during the non-acute phase. Finally, preliminary evidence suggests there may be functional abnormalities in important frontal and temporal brain regions related to verbal memory difficulties in both mood and psychotic disorders. DISCUSSION The current findings have potential implications for the diagnosis and treatment of cognitive impairments in mood and psychotic disorders. Verbal recall memory may serve as a sensitive tool in the risk stratification of cognitive impairments for certain mood and psychotic disorders. Moreover, since no widespread differences between clinical groups were identified, the evidence supports providing targeted interventions for verbal memory, such as pharmacological and non-pharmacological interventions, through a trans-diagnostic approach in mood and psychotic disorders.
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Affiliation(s)
- Bryce J M Bogie
- MD/PhD Program, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; The Royal's Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Chelsea Noël
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada
| | - Ahmad Alftieh
- The Royal's Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Julia MacDonald
- The Royal's Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa, ON, Canada
| | - Ya Ting Lei
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Jamie Mongeon
- The Royal's Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Claire Mayaud
- Department of Psychology, University of Bordeaux, France
| | - Patrick Dans
- Temerty Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Synthia Guimond
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; The Royal's Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada; Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada; Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
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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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Wenzel J, Badde L, Haas SS, Bonivento C, Van Rheenen TE, Antonucci LA, Ruef A, Penzel N, Rosen M, Lichtenstein T, Lalousis PA, Paolini M, Stainton A, Dannlowski U, Romer G, Brambilla P, Wood SJ, Upthegrove R, Borgwardt S, Meisenzahl E, Salokangas RKR, Pantelis C, Lencer R, Bertolino A, Kambeitz J, Koutsouleris N, Dwyer DB, Kambeitz-Ilankovic L. Transdiagnostic subgroups of cognitive impairment in early affective and psychotic illness. Neuropsychopharmacology 2024; 49:573-583. [PMID: 37737273 PMCID: PMC10789737 DOI: 10.1038/s41386-023-01729-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/03/2023] [Accepted: 08/26/2023] [Indexed: 09/23/2023]
Abstract
Cognitively impaired and spared patient subgroups were identified in psychosis and depression, and in clinical high-risk for psychosis (CHR). Studies suggest differences in underlying brain structural and functional characteristics. It is unclear whether cognitive subgroups are transdiagnostic phenomena in early stages of psychotic and affective disorder which can be validated on the neural level. Patients with recent-onset psychosis (ROP; N = 140; female = 54), recent-onset depression (ROD; N = 130; female = 73), CHR (N = 128; female = 61) and healthy controls (HC; N = 270; female = 165) were recruited through the multi-site study PRONIA. The transdiagnostic sample and individual study groups were clustered into subgroups based on their performance in eight cognitive domains and characterized by gray matter volume (sMRI) and resting-state functional connectivity (rsFC) using support vector machine (SVM) classification. We identified an impaired subgroup (NROP = 79, NROD = 30, NCHR = 37) showing cognitive impairment in executive functioning, working memory, processing speed and verbal learning (all p < 0.001). A spared subgroup (NROP = 61, NROD = 100, NCHR = 91) performed comparable to HC. Single-disease subgroups indicated that cognitive impairment is stronger pronounced in impaired ROP compared to impaired ROD and CHR. Subgroups in ROP and ROD showed specific symptom- and functioning-patterns. rsFC showed superior accuracy compared to sMRI in differentiating transdiagnostic subgroups from HC (BACimpaired = 58.5%; BACspared = 61.7%, both: p < 0.01). Cognitive findings were validated in the PRONIA replication sample (N = 409). Individual cognitive subgroups in ROP, ROD and CHR are more informative than transdiagnostic subgroups as they map onto individual cognitive impairment and specific functioning- and symptom-patterns which show limited overlap in sMRI and rsFC. CLINICAL TRIAL REGISTRY NAME: German Clinical Trials Register (DRKS). Clinical trial registry URL: https://www.drks.de/drks_web/ . Clinical trial registry number: DRKS00005042.
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Affiliation(s)
- Julian Wenzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
| | - Luzie Badde
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Shalaila S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, NY, USA
| | | | - Tamsyn E Van Rheenen
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Melbourne, VIC, Australia
| | - Linda A Antonucci
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
- Department of Translational Biomedicine and Neuroscience - University of Bari Aldo Moro, Bari, Italy
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
| | - Nora Penzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- Department of Translational Biomedicine and Neuroscience - University of Bari Aldo Moro, Bari, Italy
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Theresa Lichtenstein
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Paris Alexandros Lalousis
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - Marco Paolini
- Department of Radiology, University Hospital, Ludwig-Maximilian University, Munich, Germany
| | - Alexandra Stainton
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Muenster, Münster, Germany
| | - Georg Romer
- Department of Child and Adolescent Psychiatry, University of Münster, Münster, Germany
| | - Paolo Brambilla
- Department of Neuosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Mental Health, University of Milan, Milan, Italy
| | - Stephen J Wood
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Rachel Upthegrove
- School of Psychology, University of Birmingham, Birmingham, UK
- Institute of Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Stefan Borgwardt
- Translational Psychiatry Unit (TPU), Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | | | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne & Western Health, Melbourne, VIC, Australia
| | - Rebekka Lencer
- Institute for Translational Psychiatry, University of Muenster, Münster, Germany
- Translational Psychiatry Unit (TPU), Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
| | - Alessandro Bertolino
- Department of Translational Biomedicine and Neuroscience - University of Bari Aldo Moro, Bari, Italy
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King's College London, London, UK
- Max Planck Institute for Psychiatry, Munich, Germany
| | - Dominic B Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
- Orygen, Melbourne, VIC, Australia
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- Faculty of Psychology and Educational Sciences, Department of Psychology, Ludwig-Maximilian University, Munich, Germany
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10
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Zhou W, Long F, Wang F, Zhou R. Subsyndromal depression leads to early under-activation and late over-activation during inhibitory control: an ERP study. Biol Psychol 2024; 186:108742. [PMID: 38191070 DOI: 10.1016/j.biopsycho.2024.108742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Abstract
Individuals with depressive disorders have deficits in inhibitory control and exhibit symptoms of impaired cognitive and emotional functioning. Individuals with subsyndromal depression are intermediate between the healthy group and clinically diagnosed patients with depressive disorders, and studying the characteristics of their inhibitory control functioning can help to investigate the mechanisms underlying the development of depressive disorders. Using two classical paradigms of inhibitory control, Flanker and Go/NoGo, the present study explored the differences in inhibitory control between individuals with subsyndromal depression and healthy individuals from the perspectives of both response inhibition and interference control. Behavioral results showed that both groups did not differ in response time and accuracy; in terms of event-related potentials, individuals with subsyndromal depression presented smaller N2 amplitudes as well as larger P3 amplitudes in the NoGo condition of the Go/NoGo paradigm; and smaller N2 amplitudes in the incongruent condition of the Flanker paradigm. Moreover, the depression-prone group showed lower theta power compared to the healthy group in the NoGo condition of the NoGo paradigm and the incongruent condition of the Flanker paradigm. The present study reveals that the depression-prone group may have a compensatory mechanism in the response inhibition, which is mainly manifested as early under-activation as well as late over-activation.
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Affiliation(s)
- Weiyi Zhou
- Department of Psychology, Nanjing University, Nanjing 210023, China
| | - Fangfang Long
- Department of Psychology, Nanjing University, Nanjing 210023, China; School of Psychology, Guizhou Normal University, Guiyang 550025, China
| | - Fang Wang
- Department of Psychology, Nanjing University, Nanjing 210023, China
| | - Renlai Zhou
- Department of Psychology, Nanjing University, Nanjing 210023, China; Department of Radiology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China; State Key Laboratory of Media Convergence Production Technology and Systems, Beijing, China.
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11
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Sánchez-Ortí JV, Correa-Ghisays P, Balanzá-Martínez V, Selva-Vera G, Vila-Francés J, Magdalena-Benedito R, San-Martin C, Victor VM, Escribano-Lopez I, Hernandez-Mijares A, Vivas-Lalinde J, Crespo-Facorro B, Tabarés-Seisdedos R. Inflammation and lipid metabolism as potential biomarkers of memory impairment across type 2 diabetes mellitus and severe mental disorders. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110817. [PMID: 37327846 DOI: 10.1016/j.pnpbp.2023.110817] [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: 03/10/2023] [Revised: 05/20/2023] [Accepted: 06/12/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Neurocognitive impairment is a transdiagnostic feature across several psychiatric and cardiometabolic conditions. The relationship between inflammatory and lipid metabolism biomarkers and memory performance is not fully understood. This study aimed to identify peripheral biomarkers suitable to signal memory decline from a transdiagnostic and longitudinal perspective. METHODS Peripheral blood biomarkers of inflammation, oxidative stress and lipid metabolism were assessed twice over a 1-year period in 165 individuals, including 30 with schizophrenia (SZ), 42 with bipolar disorder (BD), 35 with major depressive disorder (MDD), 30 with type 2 diabetes mellitus (T2DM), and 28 healthy controls (HCs). Participants were stratified by memory performance quartiles, taking as a reference their global memory score (GMS) at baseline, into categories of high memory (H; n = 40), medium to high memory (MH; n = 43), medium to low memory (ML; n = 38) and low memory (L; n = 44). Exploratory and confirmatory factorial analysis, mixed one-way analysis of covariance and discriminatory analyses were performed. RESULTS L group was significantly associated with higher levels of tumor necrosis factor-alpha (TNF-α) and lower levels of apolipoprotein A1 (Apo-A1) compared to those from the MH and H groups (p < 0.05; η2p = 0.06-0.09), with small to moderate effect sizes. Moreover, the combination of interleukin-6 (IL-6), TNF-α, c-reactive protein (CRP), Apo-A1 and Apo-B compounded the transdiagnostic model that best discriminated between groups with different degrees of memory impairment (χ2 = 11.9-49.3, p < 0.05-0.0001). CONCLUSIONS Inflammation and lipid metabolism seem to be associated with memory across T2DM and severe mental illnesses (SMI). A panel of biomarkers may be a useful approach to identify individuals at greater risk of neurocognitive impairment. These findings may have a potential translational utility for early intervention and advance precision medicine in these disorders.
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Affiliation(s)
- Joan Vicent Sánchez-Ortí
- INCLIVA - Health Research Institute, Valencia, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Patricia Correa-Ghisays
- INCLIVA - Health Research Institute, Valencia, Spain; Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Faculty of Psychology, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain.
| | - Vicent Balanzá-Martínez
- INCLIVA - Health Research Institute, Valencia, Spain; Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain; Mental Health Unit of Catarroja, Valencia, Spain.
| | - Gabriel Selva-Vera
- INCLIVA - Health Research Institute, Valencia, Spain; Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Joan Vila-Francés
- IDAL - Intelligent Data Analysis Laboratory, University of Valencia, Valencia, Spain
| | | | - Constanza San-Martin
- Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Víctor M Victor
- Service of Endocrinology and Nutrition, University Hospital Dr. Peset, Spain; Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain; Department of Physiology, University of Valencia, Valencia, Spain
| | | | | | | | - Benedicto Crespo-Facorro
- Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; Department of Psychiatry, Faculty of Medicine, University of Sevilla, HU Virgen del Rocío IBIS, Spain
| | - Rafael Tabarés-Seisdedos
- INCLIVA - Health Research Institute, Valencia, Spain; Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
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12
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Guerrera CS, Platania GA, Boccaccio FM, Sarti P, Varrasi S, Colliva C, Grasso M, De Vivo S, Cavallaro D, Tascedda F, Pirrone C, Drago F, Di Nuovo S, Blom JMC, Caraci F, Castellano S. The dynamic interaction between symptoms and pharmacological treatment in patients with major depressive disorder: the role of network intervention analysis. BMC Psychiatry 2023; 23:885. [PMID: 38017462 PMCID: PMC10683186 DOI: 10.1186/s12888-023-05300-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/23/2023] [Indexed: 11/30/2023] Open
Abstract
INTRODUCTION The Major Depressive Disorder (MDD) is a mental health disorder that affects millions of people worldwide. It is characterized by persistent feelings of sadness, hopelessness, and a loss of interest in activities that were once enjoyable. MDD is a major public health concern and is the leading cause of disability, morbidity, institutionalization, and excess mortality, conferring high suicide risk. Pharmacological treatment with Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin Noradrenaline Reuptake Inhibitors (SNRIs) is often the first choice for their efficacy and tolerability profile. However, a significant percentage of depressive individuals do not achieve remission even after an adequate trial of pharmacotherapy, a condition known as treatment-resistant depression (TRD). METHODS To better understand the complexity of clinical phenotypes in MDD we propose Network Intervention Analysis (NIA) that can help health psychology in the detection of risky behaviors, in the primary and/or secondary prevention, as well as to monitor the treatment and verify its effectiveness. The paper aims to identify the interaction and changes in network nodes and connections of 14 continuous variables with nodes identified as "Treatment" in a cohort of MDD patients recruited for their recent history of partial response to antidepressant drugs. The study analyzed the network of MDD patients at baseline and after 12 weeks of drug treatment. RESULTS At baseline, the network showed separate dimensions for cognitive and psychosocial-affective symptoms, with cognitive symptoms strongly affecting psychosocial functioning. The MoCA tool was identified as a potential psychometric tool for evaluating cognitive deficits and monitoring treatment response. After drug treatment, the network showed less interconnection between nodes, indicating greater stability, with antidepressants taking a central role in driving the network. Affective symptoms improved at follow-up, with the highest predictability for HDRS and BDI-II nodes being connected to the Antidepressants node. CONCLUSION NIA allows us to understand not only what symptoms enhance after pharmacological treatment, but especially the role it plays within the network and with which nodes it has stronger connections.
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Affiliation(s)
- Claudia Savia Guerrera
- Department of Educational Sciences, University of Catania, Catania, Italy
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | | | | | - Pierfrancesco Sarti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Simone Varrasi
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Chiara Colliva
- Azienda Unità Sanitaria Locale Di Modena, Distretto Di Carpi, Carpi, Italy
| | - Margherita Grasso
- Unit of Neuropharmacology and Translation Neurosciences, Oasi Research Institute - IRCCS, Troina, Italy
| | | | | | - Fabio Tascedda
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Concetta Pirrone
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Santo Di Nuovo
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Johanna M C Blom
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
- Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy.
| | - Filippo Caraci
- Unit of Neuropharmacology and Translation Neurosciences, Oasi Research Institute - IRCCS, Troina, Italy
- Department of Drug and Health Sciences, University of Catania, Catania, Italy
| | - Sabrina Castellano
- Department of Educational Sciences, University of Catania, Catania, Italy
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13
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Vicent-Gil M, Trujols J, Serra-Blasco M, Navarra-Ventura G, Puigdemont D, Alemany C, Crivillés S, de Diego-Adeliño J, Cardoner N, Portella MJ. If you feel you can't, you won't: the role of subjective and objective cognitive competence on psychosocial functioning in depression. Eur Psychiatry 2023; 66:e83. [PMID: 37855104 PMCID: PMC10755570 DOI: 10.1192/j.eurpsy.2023.2454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/27/2023] [Accepted: 08/21/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The purpose of this exploratory study is to examine the role of sociodemographic, clinical, and cognitive - both objective and subjective - factors in overall and in specific domains of psychosocial functioning, in patients with depression at different clinical states of the disease (remitted and non-remitted). METHODS A sample of 325 patients with major depressive disorder, 117 in remission and 208 in non-remission, were assessed with a semi-structured interview collecting sociodemographic, clinical, cognitive (with neuropsychological tests and the Perceived Deficit Questionnaire), and functional (Functioning Assessment Short Test) characteristics. Backward regression models were conducted to determine associations of global and specific areas of functioning with independent factors, for both clinical states. RESULTS Residual depressive symptomatology and self-appraisal of executive competence were significantly associated with psychosocial functioning in remitted patients, in overall and some subdomains of functioning, particularly cognitive and interpersonal areas. While depressive symptoms, executive deficits and self-appraisal of executive function were significantly related to functional outcomes in non-remitted patients, both in overall functioning and in most of subdomains. DISCUSSION This study evidences the strong association of one's appraisal of executive competence with psychosocial functioning, together with depressive symptoms, both in remitted and non-remitted patients with depression. Therefore, to achieve full recovery, clinical management of patients should tackle not only the relief of core depressive symptoms, but also the cognitive ones, both those that are objectified with neuropsychological tests and those that are reported by the patients themselves.
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Affiliation(s)
- Muriel Vicent-Gil
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Joan Trujols
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Maria Serra-Blasco
- eHealth ICOnnecta’t Program and Psycho-Oncology Service, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Spain
| | - Guillem Navarra-Ventura
- Institut d’Investigació Sanitària Illes Balears (IdISBa), Hospital Universitari Son Espases, Palma, Spain
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS), Universitat de les Illes Balears, Palma, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III (CIBERES-ISCIII), Madrid, Spain
| | - Dolors Puigdemont
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Carlo Alemany
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Sara Crivillés
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Javier de Diego-Adeliño
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Narcís Cardoner
- Department of Psychiatry and Legal Medicine, Institute of Neuroscience, Universitat Autònoma de Barcelona (UAB)
| | - Maria J. Portella
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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14
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Beblo T, Bergdolt J, Kilian M, Toepper M, Moritz S, Driessen M, Dehn L. Do depressed patients really over-report cognitive impairment? J Affect Disord 2023; 338:466-471. [PMID: 37385388 DOI: 10.1016/j.jad.2023.06.055] [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: 03/15/2023] [Revised: 06/07/2023] [Accepted: 06/26/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Depressed patients report more severe cognitive impairment than is detectable by neuropsychological tests because they may underestimate their cognitive performance. Alternatively, it is possible that cognitive impairment primarily occurs under everyday life conditions as referred to in most questionnaires. The aim of the present study is to investigate the validity of self-reports in patients with major depression in order to better understand the pronounced impairment in self-reports. METHODS We investigated 58 patients with major depression and 28 heathy control participants. We administered the "Screen for Cognitive Impairment in Psychiatry" (SCIP) to assess cognitive performance, the "Questionnaire for Cognitive Complaints" (FLei), and the newly developed scale for "Self-Perception of Cognitive Performance in everyday life and test settings" to ask for the self-assessed cognitive performance in everyday life and in a test situation more specifically. RESULTS Depressed patients showed an inferior test performance and reported much more general everyday life related cognitive problems compared to healthy participants. When asked more specifically for their cognitive performance in the test-situation compared to others and compared to everyday life, they did not report more test-related and everyday life related impairment than healthy participants did. LIMITATIONS Results might be influenced by comorbidity. CONCLUSIONS These results have implications for the assessment of subjective cognitive performance of depressed patients and shed light on the negative effects of general versus more specific recall of autobiographical information.
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Affiliation(s)
- Thomas Beblo
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bethel, University Hospital OWL, Remterweg 69-71, 33617 Bielefeld, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany.
| | - Juliane Bergdolt
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bethel, University Hospital OWL, Remterweg 69-71, 33617 Bielefeld, Germany
| | - Mia Kilian
- Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany
| | - Max Toepper
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bethel, University Hospital OWL, Remterweg 69-71, 33617 Bielefeld, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Driessen
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bethel, University Hospital OWL, Remterweg 69-71, 33617 Bielefeld, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany
| | - Lorenz Dehn
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bethel, University Hospital OWL, Remterweg 69-71, 33617 Bielefeld, Germany
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15
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Chokka P, Bender A, Brennan S, Ahmed G, Corbière M, Dozois DJA, Habert J, Harrison J, Katzman MA, McIntyre RS, Liu YS, Nieuwenhuijsen K, Dewa CS. Practical pathway for the management of depression in the workplace: a Canadian perspective. Front Psychiatry 2023; 14:1207653. [PMID: 37732077 PMCID: PMC10508062 DOI: 10.3389/fpsyt.2023.1207653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/09/2023] [Indexed: 09/22/2023] Open
Abstract
Major depressive disorder (MDD) and other mental health issues pose a substantial burden on the workforce. Approximately half a million Canadians will not be at work in any week because of a mental health disorder, and more than twice that number will work at a reduced level of productivity (presenteeism). Although it is important to determine whether work plays a role in a mental health condition, at initial presentation, patients should be diagnosed and treated per appropriate clinical guidelines. However, it is also important for patient care to determine the various causes or triggers including work-related factors. Clearly identifying the stressors associated with the mental health disorder can help clinicians to assess functional limitations, develop an appropriate care plan, and interact more effectively with worker's compensation and disability programs, as well as employers. There is currently no widely accepted tool to definitively identify MDD as work-related, but the presence of certain patient and work characteristics may help. This paper seeks to review the evidence specific to depression in the workplace, and provide practical tips to help clinicians to identify and treat work-related MDD, as well as navigate disability issues.
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Affiliation(s)
- Pratap Chokka
- Department of Psychiatry, University of Alberta, Grey Nuns Hospital, Edmonton, AB, Canada
| | - Ash Bender
- Work, Stress and Health Program, The Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Stefan Brennan
- Department of Psychiatry, University of Saskatchewan, Royal University Hospital, Saskatoon, SK, Canada
| | - Ghalib Ahmed
- Department of Family Medicine and Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Marc Corbière
- Department of Education, Career Counselling, Université du Québec à Montréal, Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - David J. A. Dozois
- Department of Psychology, University of Western Ontario, London, ON, Canada
| | - Jeff Habert
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - John Harrison
- Metis Cognition Ltd., Kilmington, United Kingdom; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, United Kingdom; Alzheimercentrum, AUmc, Amsterdam, Netherlands
| | - Martin A. Katzman
- START Clinic for the Mood and Anxiety Disorders, Toronto, ON, Canada; Department of Psychiatry, Northern Ontario School of Medicine, and Department of Psychology, Lakehead University, Thunder Bay, ON, Canada
| | - Roger S. McIntyre
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Yang S. Liu
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Karen Nieuwenhuijsen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Carolyn S. Dewa
- Department of Psychiatry and Behavioural Sciences, University of California, Davis, Davis, CA, United States
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16
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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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Gryksa K, Schmidtner AK, Masís-Calvo M, Rodríguez-Villagra OA, Havasi A, Wirobski G, Maloumby R, Jägle H, Bosch OJ, Slattery DA, Neumann ID. Selective breeding of rats for high (HAB) and low (LAB) anxiety-related behaviour: A unique model for comorbid depression and social dysfunctions. Neurosci Biobehav Rev 2023; 152:105292. [PMID: 37353047 DOI: 10.1016/j.neubiorev.2023.105292] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 06/25/2023]
Abstract
Animal models of selective breeding for extremes in emotionality are a strong experimental approach to model psychopathologies. They became indispensable in order to increase our understanding of neurobiological, genetic, epigenetic, hormonal, and environmental mechanisms contributing to anxiety disorders and their association with depressive symptoms or social deficits. In the present review, we extensively discuss Wistar rats selectively bred for high (HAB) and low (LAB) anxiety-related behaviour on the elevated plus-maze. After 30 years of breeding, we can confirm the prominent differences between HAB and LAB rats in trait anxiety, which are accompanied by consistent differences in depressive-like, social and cognitive behaviours. We can further confirm a single nucleotide polymorphism in the vasopressin promotor of HAB rats causative for neuropeptide overexpression, and show that low (or high) anxiety and fear levels are unlikely due to visual dysfunctions. Thus, HAB and LAB rats continue to exist as a reliable tool to study the multiple facets underlying the pathology of high trait anxiety and its comorbidity with depression-like behaviour and social dysfunctions.
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Affiliation(s)
- Katharina Gryksa
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Universitaetsstr. 31, 93053 Regensburg, Germany.
| | - Anna K Schmidtner
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Universitaetsstr. 31, 93053 Regensburg, Germany.
| | - Marianella Masís-Calvo
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Universitaetsstr. 31, 93053 Regensburg, Germany.
| | - Odir A Rodríguez-Villagra
- Centro de Investigación en Neurosciencias, Universidad de Costa Rica, San Pedro, San José, Costa Rica.
| | - Andrea Havasi
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Universitaetsstr. 31, 93053 Regensburg, Germany.
| | - Gwendolyn Wirobski
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Universitaetsstr. 31, 93053 Regensburg, Germany.
| | - Rodrigue Maloumby
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Universitaetsstr. 31, 93053 Regensburg, Germany.
| | - Herbert Jägle
- Department of Ophthalmology, University Hospital of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany.
| | - Oliver J Bosch
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Universitaetsstr. 31, 93053 Regensburg, Germany.
| | - David A Slattery
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Heinrich-Hoffmann-Straße 10, 60528 Frankfurt am Main, Germany.
| | - Inga D Neumann
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Universitaetsstr. 31, 93053 Regensburg, Germany.
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LoTemplio S, Bettmann JE, Scott E, Blumenthal E. Do Mental Health Changes in Nature Co-occur with Changes in Heartrate Variability and Executive Functioning? A Systematic Review. Curr Environ Health Rep 2023; 10:278-290. [PMID: 37516682 DOI: 10.1007/s40572-023-00407-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 07/31/2023]
Abstract
PURPOSE OF REVIEW Given the global burden of mental health issues, new solutions are needed to promote mental health. Nature exposure represents a promising option to promote mental health, but the mechanisms are poorly understood. Recent frameworks have argued that changes in mental health in nature are caused by activity changes in the vagus nerve, which connects the heart and the brain, and that these changes also improve executive functioning (EF) abilities. This suggests that changes in mental health symptomology in nature should be accompanied by changes in vagus nerve activity, as well as changes in executive functioning. Yet, little work has systematically examined co-variation of these outcomes in empirical studies. The present manuscript systematically examines whether changes in mental health in nature are accompanied by changes in vagus nerve activity (approximated by heartrate variability) and changes in executive functioning. RECENT FINDINGS There is compelling evidence that spending time in nature can increase heartrate variability, improve mental health, and improve executive functioning. However, despite strong theoretical claims that these three outcomes should be linked after spending time in nature settings, few studies directly examine such co-occurrence. The study systematically examines whether studies that considered both mental health and executive functioning (n = 6) showed co-occurring effects in response to nature exposure. Similarly, the study also considers if studies examining mental health and heartrate variability (n = 6) showed similarly directional effects following nature exposure. This systematic review concludes with discussion about the limited number of studies (n =1) that include all three measures. We find mixed results of co-occurrence with these variables, suggesting that the relationship between these three constructs in nature may be more nuanced than current theory suggests. Perhaps more importantly, our results demonstrate that there is very little existing work linking changes in mental health to changes in EF and vagal tone. We conclude with justification for why it may be beneficial for researchers to include all three metrics as well as guidance on how to do so.
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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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20
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Francis AM, Bissonnette JN, Hull KM, Leckey J, Pimer L, Lawrence MA, Berrigan LI, Fisher DJ. Measuring the attention networks and quantitative-electroencephalography correlates of attention in depression. Psychiatry Res Neuroimaging 2023; 333:111661. [PMID: 37331318 DOI: 10.1016/j.pscychresns.2023.111661] [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: 11/08/2022] [Revised: 03/06/2023] [Accepted: 05/22/2023] [Indexed: 06/20/2023]
Abstract
Given the association between major depressive disorder (MDD) and cortical inefficiency related to executive control, specifically in the sense that individuals with MDD may recruit more cognitive resources to complete tasks at the same capacity as those without MDD, the current study was interested in examining the attention networks and executive functioning of those with MDD. Past research has used the Attention Network Test (ANT) to measure changes of attention in clinical vs. healthy populations; however, theoretical concerns have been raised regarding the task. The Combined Attention Systems Task (CAST) was developed to address these concerns and was used in our study in combination with quantitative-electroencephalography (QEEG) to assess both behavioural and neurophysiological changes in participants with MDD (n = 18) compared to healthy controls (HCs; n = 22). We found no behavioural differences between MDD and HC groups suggesting individuals with MDD in our sample were not experiencing the executive functioning deficits previously reported in the literature. Neurophysiological measures of attention revealed that MDD participants had greater theta and alpha1 activity relative to HCs, suggesting that although individuals with MDD do not show deficits in behavioural attention, they exhibit altered neural processing which underlies cognitive function.
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Affiliation(s)
- Ashley M Francis
- Department of Psychology, Saint Mary's University, Halifax, NS, Canada; Department of Psychology, St. Francis Xavier University, Antigonish, Nova Scotia, Canada; Department of Psychiatry, Dalhousie University, Nova Scotia, Canada
| | - Jenna N Bissonnette
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada; Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Krista M Hull
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
| | - Jennifer Leckey
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
| | - Laura Pimer
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada; Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
| | - Michael A Lawrence
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Lindsay I Berrigan
- Department of Psychology, St. Francis Xavier University, Antigonish, Nova Scotia, Canada; Department of Psychiatry, Dalhousie University, Nova Scotia, Canada
| | - Derek J Fisher
- Department of Psychology, Saint Mary's University, Halifax, NS, Canada; Department of Psychiatry, Dalhousie University, Nova Scotia, Canada; Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada; Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada.
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21
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Vancappel A, Dansou Y, Godin O, Haffen E, Yrondi A, Stephan F, Richieri RM, Molière F, Holtzmann J, Horn M, Allauze E, Genty JB, Bouvard A, Dorey JM, Hennion V, Camus V, Fond G, Peran B, Walter M, Anguill L, Scotto D'apolina C, Vilà E, Fredembach B, Petrucci J, Rey R, Nguon AS, Etain B, Carminati M, Courtet P, Vaiva G, Llorca PM, Leboyer M, Aouizerate B, Bennabi D, El Hage W. Evolution of Cognitive Impairments in Treatment-Resistant Depression: Results from the Longitudinal French Centers of Expertise for Treatment-Resistant Depression (FACE-DR) Cohort. Brain Sci 2023; 13:1120. [PMID: 37509050 PMCID: PMC10377578 DOI: 10.3390/brainsci13071120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/10/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
Previous studies set out profound cognitive impairments in subjects with treatment-resistant depression (TRD). However, little is known about the course of such alterations depending on levels of improvement in those patients followed longitudinally. The main objective of this study was to describe the course of cognitive impairments in responder versus non-responder TRD patients at one-year follow-up. The second aim was to evaluate the predictive aspect of cognitive impairments to treatment resistance in patients suffering from TRD. We included 131 patients from a longitudinal cohort (FACE-DR) of the French Network of Expert TRD Centers. They undertook comprehensive sociodemographic, clinical, global functioning, and neuropsychological testing (TMT, Baddeley task, verbal fluencies, WAIS-4 subtests, D2 and RLRI-16) at baseline (V0) and one-year follow-up (V1). Most patients (n = 83; 63.36%) did not respond (47 women, 49.47 ± 12.64 years old), while one-third of patients responded (n = 48, 30 women, 54.06 ± 12.03 years old). We compared the cognitive performances of participants to average theoretical performances in the general population. In addition, we compared the cognitive performances of patients between V1 and V0 and responder versus non-responder patients at V1. We observed cognitive impairments during the episode and after a therapeutic response. Overall, each of them tended to show an increase in their cognitive scores. Improvement was more prominent in responders at V1 compared to their non-responder counterparts. They experienced a more marked improvement in code, digit span, arithmetic, similarities, and D2 tasks. Patients suffering from TRD have significant cognitive impairments that persist but alleviate after therapeutic response. Cognitive remediation should be proposed after therapeutic response to improve efficiency and increase the daily functioning.
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Affiliation(s)
- Alexis Vancappel
- Fondation FondaMental, 94000 Créteil, France
- CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France
- EE 1901 Qualipsy, Université de Tours, 37000 Tours, France
| | | | - Ophelia Godin
- Fondation FondaMental, 94000 Créteil, France
- INSERM U955, Équipe de Psychiatrie Translationnelle, Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, 94000 Créteil, France
| | - Emmanuel Haffen
- Fondation FondaMental, 94000 Créteil, France
- Department of Clinical Psychiatry, CIC-1431 INSERM, CHU de Besançon, UR481 Neurosciences and Cognition, University of Franche-Comté, 25000 Besançon, France
| | - Antoine Yrondi
- Fondation FondaMental, 94000 Créteil, France
- Service de Psychiatrie et de Psychologie Médicale de l'adulte, CHU de Toulouse, Hôpital Purpan, Université Paul Sabatier Toulouse 3, 31062 Toulouse, France
| | - Florian Stephan
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale, 29200 Brest, France
| | - Raphaelle Marie Richieri
- Fondation FondaMental, 94000 Créteil, France
- Equipe Imothep, Institut Fresnel, UMR 7249, Aix-Marseille Université, CNRS, Ecole Centrale Marseille, 13284 Marseille, France
| | - Fanny Molière
- Fondation FondaMental, 94000 Créteil, France
- Department of Emergency Psychiatry and Post Acute Care, Hôpital Lapeyronie, CHU Montpellier, 34000 Montpellier, France
| | - Jérôme Holtzmann
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie, CHU Grenoble Alpes, University Grenoble Alpes, 38400 Grenoble, France
| | | | | | | | - Alex Bouvard
- Fondation FondaMental, 94000 Créteil, France
- Centre de Référence Régional des Pathologies Anxieuses et de la Dépression, Centre Expert Dépression Résistante, Pôle de Psychiatrie Générale et Universitaire, CH Charles Perrens, 33076 Bordeaux, France
- Laboratoire Nutrition et Neurobiologie Intégrée (UMR INRAE 1286), Université de Bordeaux, 33076 Bordeaux, France
| | | | - Vincent Hennion
- Fondation FondaMental, 94000 Créteil, France
- INSERM UMR-S 1144 Optimisation Thérapeutique en Neurospsychopharmacologie, Département de Psychiatrie et de Médecine Addictologique, OTeN, Hôpitaux Lariboisière-Fernand Widal, GHU APHP Nord_Université Paris Cité, 75006 Paris, France
| | - Vincent Camus
- Fondation FondaMental, 94000 Créteil, France
- CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France
| | - Guillaume Fond
- Fondation FondaMental, 94000 Créteil, France
- Clinical Research Unit, Academic Hospitals of Marseille (APHM), School of Medicine-La Timone Medical Campus, EA 3279, Department of Epidemiology and Health Economics, Aix-Marseille University, 13284 Marseille, France
| | - Barbara Peran
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale, 29200 Brest, France
| | - Michel Walter
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale, 29200 Brest, France
| | - Loic Anguill
- Fondation FondaMental, 94000 Créteil, France
- Service de Psychiatrie et de Psychologie Médicale de l'adulte, CHU de Toulouse, Hôpital Purpan, Université Paul Sabatier Toulouse 3, 31062 Toulouse, France
| | - Charlotte Scotto D'apolina
- Fondation FondaMental, 94000 Créteil, France
- Service de Psychiatrie et de Psychologie Médicale de l'adulte, CHU de Toulouse, Hôpital Purpan, Université Paul Sabatier Toulouse 3, 31062 Toulouse, France
| | - Estelle Vilà
- Fondation FondaMental, 94000 Créteil, France
- Centre de Référence Régional des Pathologies Anxieuses et de la Dépression, Centre Expert Dépression Résistante, Pôle de Psychiatrie Générale et Universitaire, CH Charles Perrens, 33076 Bordeaux, France
- Laboratoire Nutrition et Neurobiologie Intégrée (UMR INRAE 1286), Université de Bordeaux, 33076 Bordeaux, France
| | - Benjamin Fredembach
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie, CHU Grenoble Alpes, University Grenoble Alpes, 38400 Grenoble, France
| | | | - Romain Rey
- Fondation FondaMental, 94000 Créteil, France
| | - Anne Sophie Nguon
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie, CHU Grenoble Alpes, University Grenoble Alpes, 38400 Grenoble, France
| | - Bruno Etain
- Fondation FondaMental, 94000 Créteil, France
- INSERM UMR-S 1144 Optimisation Thérapeutique en Neurospsychopharmacologie, Département de Psychiatrie et de Médecine Addictologique, OTeN, Hôpitaux Lariboisière-Fernand Widal, GHU APHP Nord_Université Paris Cité, 75006 Paris, France
| | - Mathilde Carminati
- Fondation FondaMental, 94000 Créteil, France
- INSERM UMR-S 1144 Optimisation Thérapeutique en Neurospsychopharmacologie, Département de Psychiatrie et de Médecine Addictologique, OTeN, Hôpitaux Lariboisière-Fernand Widal, GHU APHP Nord_Université Paris Cité, 75006 Paris, France
| | - Philippe Courtet
- Fondation FondaMental, 94000 Créteil, France
- Department of Emergency Psychiatry and Post Acute Care, Hôpital Lapeyronie, CHU Montpellier, 34000 Montpellier, France
| | - Guillaume Vaiva
- Fondation FondaMental, 94000 Créteil, France
- Inserm-U1172-LilNCog-Lille Neuroscience & Cognition, Centre National de Ressources & Résilience pour les Psychotraumatismes (Cn2r Lille Paris), Université de Lille (CHU Lille), 59000 Lille, France
| | | | | | - Bruno Aouizerate
- Fondation FondaMental, 94000 Créteil, France
- Centre de Référence Régional des Pathologies Anxieuses et de la Dépression, Centre Expert Dépression Résistante, Pôle de Psychiatrie Générale et Universitaire, CH Charles Perrens, 33076 Bordeaux, France
- Laboratoire Nutrition et Neurobiologie Intégrée (UMR INRAE 1286), Université de Bordeaux, 33076 Bordeaux, France
| | - Djamila Bennabi
- Fondation FondaMental, 94000 Créteil, France
- Department of Clinical Psychiatry, CIC-1431 INSERM, CHU de Besançon, UR481 Neurosciences and Cognition, University of Franche-Comté, 25000 Besançon, France
| | - Wissam El Hage
- Fondation FondaMental, 94000 Créteil, France
- CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France
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22
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Yitzhak N, Shimony O, Oved N, Bonne O, Nahum M. Less inhibited and more depressed? The puzzling association between mood, inhibitory control and depressive symptoms. Compr Psychiatry 2023; 124:152386. [PMID: 37075621 DOI: 10.1016/j.comppsych.2023.152386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 02/07/2023] [Accepted: 04/04/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Inhibitory control (IC) deficits have been proposed as a potential risk factor for depression. However, little is known about the intra-individual daily fluctuations in IC, and its relationship to mood and depressive symptoms. Here, we examined the everyday association between IC and mood, in typical adults with various levels of depressive symptoms. METHODS Participants (N = 106) reported their depressive symptoms and completed a Go-NoGo (GNG) task measuring IC at baseline. Then, they completed a 5-day ecological-momentary-assessment (EMA) protocol, in which they reported their current mood and performed a shortened GNG task twice/day using a mobile app. Depressive symptoms were measured again following the EMA. Hierarchical-linear-modeling (HLM) was applied to examine the association between momentary IC and mood, with post-EMA depressive symptoms as a moderator. RESULTS Individuals with elevated depressive symptoms demonstrated worse and more variable IC performance over the EMA. In addition, post-EMA depressive symptoms moderated the association between momentary IC and daily mood, such that reduced IC was associated with more negative mood only for those with lower, but not higher, symptoms. LIMITATIONS Future investigations should examine the validity of these outcomes in clinical samples, including patients with Major Depressive Disorder. CONCLUSIONS Variable, rather than mere reduced, IC, is related to depressive symptoms. Moreover, the role of IC in modulating mood may differ in non-depressed individuals and individuals with sub-clinical depression. These findings contribute to our understanding of IC and mood in real life and help account for some of the discrepant findings related to cognitive control models of depression.
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Affiliation(s)
- Neta Yitzhak
- School of Occupational Therapy, Faculty of Medicine, The Hebrew University, Jerusalem, Israel.
| | - Orly Shimony
- School of Occupational Therapy, Faculty of Medicine, The Hebrew University, Jerusalem, Israel
| | - Nisiel Oved
- School of Occupational Therapy, Faculty of Medicine, The Hebrew University, Jerusalem, Israel
| | - Omer Bonne
- Department of Psychiatry, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, The Hebrew University, Jerusalem, Israel
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23
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Cullen B, Gameroff MJ, Ward J, Bailey MES, Lyall DM, Lyall LM, MacSweeney N, Murphy E, Sangha N, Shen X, Strawbridge RJ, van Dijk MT, Zhu X, Smith DJ, Talati A, Whalley HC, Cavanagh J, Weissman MM. Cognitive Function in People With Familial Risk of Depression. JAMA Psychiatry 2023; 80:610-620. [PMID: 37074691 PMCID: PMC10116387 DOI: 10.1001/jamapsychiatry.2023.0716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/16/2023] [Indexed: 04/20/2023]
Abstract
Importance Cognitive impairment in depression is poorly understood. Family history of depression is a potentially useful risk marker for cognitive impairment, facilitating early identification and targeted intervention in those at highest risk, even if they do not themselves have depression. Several research cohorts have emerged recently that enable findings to be compared according to varying depths of family history phenotyping, in some cases also with genetic data, across the life span. Objective To investigate associations between familial risk of depression and cognitive performance in 4 independent cohorts with varied depth of assessment, using both family history and genetic risk measures. Design, Setting, and Participants This study used data from the Three Generations at High and Low Risk of Depression Followed Longitudinally (TGS) family study (data collected from 1982 to 2015) and 3 large population cohorts, including the Adolescent Brain Cognitive Development (ABCD) study (data collected from 2016 to 2021), National Longitudinal Study of Adolescent to Adult Health (Add Health; data collected from 1994 to 2018), and UK Biobank (data collected from 2006 to 2022). Children and adults with or without familial risk of depression were included. Cross-sectional analyses were conducted from March to June 2022. Exposures Family history (across 1 or 2 prior generations) and polygenic risk of depression. Main Outcomes and Measures Neurocognitive tests at follow-up. Regression models were adjusted for confounders and corrected for multiple comparisons. Results A total of 57 308 participants were studied, including 87 from TGS (42 [48%] female; mean [SD] age, 19.7 [6.6] years), 10 258 from ABCD (4899 [48%] female; mean [SD] age, 12.0 [0.7] years), 1064 from Add Health (584 [49%] female; mean [SD] age, 37.8 [1.9] years), and 45 899 from UK Biobank (23 605 [51%] female; mean [SD] age, 64.0 [7.7] years). In the younger cohorts (TGS, ABCD, and Add Health), family history of depression was primarily associated with lower performance in the memory domain, and there were indications that this may be partly associated with educational and socioeconomic factors. In the older UK Biobank cohort, there were associations with processing speed, attention, and executive function, with little evidence of education or socioeconomic influences. These associations were evident even in participants who had never been depressed themselves. Effect sizes between familial risk of depression and neurocognitive test performance were largest in TGS; the largest standardized mean differences in primary analyses were -0.55 (95% CI, -1.49 to 0.38) in TGS, -0.09 (95% CI, -0.15 to -0.03) in ABCD, -0.16 (95% CI, -0.31 to -0.01) in Add Health, and -0.10 (95% CI, -0.13 to -0.06) in UK Biobank. Results were generally similar in the polygenic risk score analyses. In UK Biobank, several tasks showed statistically significant associations in the polygenic risk score analysis that were not evident in the family history models. Conclusions and Relevance In this study, whether assessed by family history or genetic data, depression in prior generations was associated with lower cognitive performance in offspring. There are opportunities to generate hypotheses about how this arises through genetic and environmental determinants, moderators of brain development and brain aging, and potentially modifiable social and lifestyle factors across the life span.
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Affiliation(s)
- Breda Cullen
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Marc J. Gameroff
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York
| | - Joey Ward
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Mark E. S. Bailey
- School of Molecular Biosciences, University of Glasgow, Glasgow, United Kingdom
| | - Donald M. Lyall
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Laura M. Lyall
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Niamh MacSweeney
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Eleanor Murphy
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York
| | - Natasha Sangha
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Xueyi Shen
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Rona J. Strawbridge
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
| | - Milenna T. van Dijk
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York
| | - Xingxing Zhu
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Daniel J. Smith
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Ardesheer Talati
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York
| | - Heather C. Whalley
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Jonathan Cavanagh
- School of Infection and Immunity, University of Glasgow, Glasgow, United Kingdom
| | - Myrna M. Weissman
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York
- Mailman School of Public Health, Columbia University, New York, New York
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Liu J, Chen Y, Xie X, Liu B, Ju Y, Wang M, Dong Q, Lu X, Sun J, Zhang L, Guo H, Zhao F, Li W, Zhang L, Li Z, Liao M, Li L, Zhang Y. The percentage of cognitive impairment in patients with major depressive disorder over the course of the depression: A longitudinal study. J Affect Disord 2023; 329:511-518. [PMID: 36863474 DOI: 10.1016/j.jad.2023.02.133] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/15/2023] [Accepted: 02/23/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND Cognitive impairments (CI) are prevalent and persistent in patients with major depressive disorder (MDD). There is a lack of longitudinal studies exploring the changes of the percentage of CI among MDD patients before and after a long-term antidepressant treatment and the risk factors that predict the residual CI. METHODS A neurocognitive battery was performed to assess four domains of cognitive function, including executive function, processing speed, attention, and memory. CI was set as cognitive performance scoring 1.5 SDs lower than the mean scores of healthy controls (HCs). Logistic regression models were conducted to examine the risk factors for the after-treatment residual CI. RESULTS Over 50 % of patients showed at least one kind of CI. After the antidepressant treatment, the overall cognitive performance among remitted MDD patients was identical to HCs, however, there were still 24 % of the remitted MDD patients had at least one type of CI, especially in executive function and attention. Additionally, the percentage of CI among non-remitted MDD patients was still significantly different from HCs. Our regression analysis further identified that except for the non-remission of MDD, CI at baseline could also predict the residual CI in MDD patients. LIMITATIONS A relatively high drop-out rate at follow-ups. CONCLUSIONS Cognitive impairment in executive function and attention is persistent even in remitted patients with MDD, and baseline cognitive performance can predict the post-treatment cognitive performance. Our findings emphasize the integral role of early cognitive intervention in MDD treatment.
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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 410011, Hunan, China
| | - Yanjun Chen
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xinyu Xie
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Bangshan Liu
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Yumeng Ju
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Mi Wang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Qiangli Dong
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xiaowen Lu
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jinrong Sun
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Liang Zhang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, 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
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Li Zhang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Zexuan Li
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Mei Liao
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Lingjiang Li
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Yan Zhang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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25
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Gerber M, Cody R, Beck J, Brand S, Donath L, Eckert A, Faude O, Hatzinger M, Imboden C, Kreppke JN, Lang UE, Mans S, Mikoteit T, Oswald A, Schweinfurth-Keck N, Zahner L, Ludyga S. Differences in Selective Attention and Inhibitory Control in Patients with Major Depressive Disorder and Healthy Controls Who Do Not Engage in Sufficient Physical Activity. J Clin Med 2023; 12:jcm12103370. [PMID: 37240475 DOI: 10.3390/jcm12103370] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Patients with major depressive disorder (MDD) are characterized by neurocognitive impairments and show deficits in various cognitive performance indicators, including executive function. We examined whether sustained attention and inhibitory control differ between patients with MDD and healthy controls, and whether differences exist between patients with mild, moderate, and severe depression. METHODS Clinical in-patients (N = 212) aged 18-65 years with a current diagnosis of MDD and 128 healthy controls were recruited. Depression severity was assessed using the Beck Depression Inventory, and sustained attention and inhibitory control were assessed using the oddball and flanker tasks. The use of these tasks promises insights into executive function in depressive patients that are not biased by verbal skills. Group differences were tested via analyses of covariance. RESULTS Patients with MDD showed slower reaction times in both the oddball and flanker task, independent of the executive demands of the trial types. Younger participants achieved shorter reaction times in both inhibitory control tasks. After correcting for age, education, smoking, BMI, and nationality, only differences in reaction times in the oddball task were statistically significant. In contrast, reaction times were not sensitive to the symptom severity of depression. CONCLUSION Our results corroborate deficits in basic information processing and specific impairments in higher-order cognitive processes in MDD patients. As difficulties in executive function underlie problems in planning, initiating, and completing goal-directed activities, they may jeopardize in-patient treatment and contribute to the recurrent nature of depression.
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Affiliation(s)
- Markus Gerber
- Department for Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Robyn Cody
- Department for Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Johannes Beck
- Psychiatric Clinic Sonnenhalde, 4125 Riehen, Switzerland
| | - Serge Brand
- Department for Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
- Adult Psychiatric Clinics (UPKE), University of Basel, 4002 Basel, Switzerland
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran 1419733141, Iran
| | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University Cologne, 50933 Cologne, Germany
| | - Anne Eckert
- Adult Psychiatric Clinics (UPKE), University of Basel, 4002 Basel, Switzerland
| | - Oliver Faude
- Department for Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Martin Hatzinger
- Psychiatric Services Solothurn, University of Basel, 4503 Solothurn, Switzerland
| | | | - Jan-Niklas Kreppke
- Department for Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Undine E Lang
- Adult Psychiatric Clinics (UPKE), University of Basel, 4002 Basel, Switzerland
| | - Sarah Mans
- Private Clinic Wyss, 3053 Münchenbuchsee, Switzerland
| | - Thorsten Mikoteit
- Psychiatric Services Solothurn, University of Basel, 4503 Solothurn, Switzerland
| | - Anja Oswald
- Psychiatric Clinic Sonnenhalde, 4125 Riehen, Switzerland
| | | | - Lukas Zahner
- Department for Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Sebastian Ludyga
- Department for Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
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26
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Moritz S, Xie J, Penney D, Bihl L, Hlubek N, Elmers J, Beblo T, Hottenrott B. The magnitude of neurocognitive impairment is overestimated in depression: the role of motivation, debilitating momentary influences, and the overreliance on mean differences. Psychol Med 2023; 53:2820-2830. [PMID: 35022092 PMCID: PMC10235659 DOI: 10.1017/s0033291721004785] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 10/11/2021] [Accepted: 11/01/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Meta-analyses agree that depression is characterized by neurocognitive dysfunctions relative to nonclinical controls. These deficits allegedly stem from impairments in functionally corresponding brain areas. Increasingly, studies suggest that some performance deficits are in part caused by negative task-taking attitudes such as poor motivation or the presence of distracting symptoms. A pilot study confirmed that these factors mediate neurocognitive deficits in depression. The validity of these results is however questionable given they were based solely on self-report measures. The present study addresses this caveat by having examiners assess influences during a neurocognitive examination, which were concurrently tested for their predictive value on performance. METHODS Thirty-three patients with depression and 36 healthy controls were assessed on a battery of neurocognitive tests. The examiner completed the Impact on Performance Scale, a questionnaire evaluating mediating influences that may impact performance. RESULTS On average, patients performed worse than controls at a large effect size. When the total score of the Impact on Performance Scale was accounted for by mediation analysis and analyses of covariance, group differences were reduced to a medium effect size. A total of 30% of patients showed impairments of at least one standard deviation below the mean. CONCLUSIONS This study confirms that neurocognitive impairment in depression is likely overestimated; future studies should consider fair test-taking conditions. We advise researchers to report percentages of patients showing performance deficits rather than relying solely on overall group differences. This prevents fostering the impression that the majority of patients exert deficits, when in fact deficits are only true for a subgroup.
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Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jingyuan Xie
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Danielle Penney
- Centre Intégré Universitaire de Santé et de Services Sociaux de l'Ouest-de-l’Île-de-Montréal, Douglas Mental Health University Institute, Montreal, Canada
| | - Lisa Bihl
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Niklas Hlubek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Elmers
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Protestant Hospital Bethel, Bielefeld, Germany
| | - Birgit Hottenrott
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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27
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Pearson O, Uglik-Marucha N, Miskowiak KW, Cairney SA, Rosenzweig I, Young AH, Stokes PRA. The relationship between sleep disturbance and cognitive impairment in mood disorders: A systematic review. J Affect Disord 2023; 327:207-216. [PMID: 36739007 DOI: 10.1016/j.jad.2023.01.114] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cognitive impairment experienced by people with bipolar disorders (BD) or major depressive disorder (MDD) is associated with impaired psychosocial function and poorer quality of life. Sleep disturbance is another core symptom of mood disorders which may be associated with, and perhaps worsen, cognitive impairments. The aim of this systematic review was to critically assess the relationship between sleep disturbance and cognitive impairment in mood disorders. METHODS In this systematic review, relevant studies were identified using electronic database searches of PsychINFO, MEDLINE, Embase and Web of Science. FINDINGS Fourteen studies were included; eight investigated people with BD, five investigated people with MDD, and one included both people with MDD and people with BD. One study was an intervention for sleep disturbance and the remaining thirteen studies used either a longitudinal or cross-sectional observational design. Ten studies reported a significant association between subjectively measured sleep disturbance and cognitive impairment in people with MDD or BD after adjusting for demographic and clinical covariates, whereas no such association was found in healthy participants. Two studies reported a significant association between objectively measured (actigraphy or polysomnography) sleep abnormalities and cognitive impairment in mood disorders. One study of cognitive behavioural therapy for insomnia modified for BD (CBTI-BD) found an association between improvements in sleep and cognitive performance in BD. INTERPRETATION There is preliminary evidence to suggest a significant association between sleep disturbance and cognitive impairment in mood disorders. These findings highlight the need for further research of sleep disturbances and cognitive impairment in people with mood disorders.
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Affiliation(s)
- Oliver Pearson
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF London, United Kingdom; Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry & Psychology and Neuroscience, King's College London, United Kingdom.
| | - Nora Uglik-Marucha
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF London, United Kingdom
| | - Kamilla W Miskowiak
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Scott A Cairney
- Department of Psychology, University of York, York YO10 5DD, United Kingdom; York Biomedical Research Institute, University of York, York YO10 5DD, United Kingdom
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, IoPPN, KCL, United Kingdom; Sleep Disorders Centre, Guy's and St Thomas' Hospital, GSTT NHS, London, United Kingdom
| | - Allan H Young
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry & Psychology and Neuroscience, King's College London, United Kingdom; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, United Kingdom
| | - Paul R A Stokes
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry & Psychology and Neuroscience, King's College London, United Kingdom; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, United Kingdom
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28
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Wood-Ross C, Tran T, Milanovic M, Jokic R, Milev R, Bowie CR. Neurocognition and Depressive Symptoms have Unique Pathways to Predicting Different Domains of Functioning in Major Depressive Disorder. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:241-248. [PMID: 36411975 PMCID: PMC10037745 DOI: 10.1177/07067437221133375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Research has established the independent relationships between depressive symptoms to cognition and functioning in depression; however, little is known about the role of mediators in this relationship. We explored the role of neurocognitive abilities, depressive symptom severity, dysfunctional attitudes, and functional capacity in predicting two dimensions of daily functioning in individuals with major depressive disorder (MDD). METHODS One hundred and twenty-four participants (mean age = 46.26, SD = 12.27; 56% female) with a diagnosis of MDD were assessed on a standard neurocognitive battery, self-reported depressive symptoms, dysfunctional attitudes, and clinician-rated functional impairment. They completed a performance-based assessment of functional competence. RESULTS Confirmatory path analyses were used to model the independent and mediated effects of variables on two domains of functioning: social (relationships and social engagement) and productive (household and community activities). Cognition and depressive symptoms both predicted productive functioning, and dysfunctional attitudes mediated each of these relationships. Functional competence was a significant mediator in the relationship between neurocognition and productive functioning. Depressive symptoms and cognition were direct predictors of social functioning with no significant mediators. CONCLUSIONS There are divergent pathways to different dimensions of daily functioning in MDD. Measurement implications include the consideration of multiple levels of predicting productive activities and more direct relationships with social outcomes. Treatments that directly target depressive symptoms and cognition might not generalize to improvements in everyday functioning if additional pathways to functioning are not addressed.
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Affiliation(s)
| | - Tanya Tran
- Department of Psychology, Queen's University, Ontario, Canada
| | | | - Ruzica Jokic
- Department of Psychology, Queen's University, Ontario, Canada
- Centre for Neuroscience Studies, Queen's University, Ontario, Canada
| | - Roumen Milev
- Department of Psychology, Queen's University, Ontario, Canada
- Centre for Neuroscience Studies, Queen's University, Ontario, Canada
- Providence Care, Kingston, Ontario, Canada
| | - Christopher R Bowie
- Department of Psychology, Queen's University, Ontario, Canada
- Centre for Addictions and Mental Health, Ontario, Canada
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29
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Cheng CM, Jeng JS. Psychiatric rehabilitation and cognitive deficit for treatment-resistant depression. PROGRESS IN BRAIN RESEARCH 2023; 281:91-113. [PMID: 37806718 DOI: 10.1016/bs.pbr.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
Patients with TRD often experience persistent impairment of affective, psychosocial, and cognitive function, which impedes their recovery. The continuation of pharmacotherapy for patients with TRD remains the cornerstone of functional recovery. Cognitive dysfunction is prevalent in patients with MDD and may make patients' depressive symptoms and psychosocial functioning worse, even in the remitted stage of illness. Deficits can manifest not only in specific cognitive domains but also in global cognitive function, which may reflect underlying persistent pathophysiological changes. Compared with nontreatment-resistant patients with MDD, patients with TRD exhibit greater subjective and objective cognitive impairment, which possibly contributes to a greater adverse impact on daily functioning. Cognitive and psychosocial remission should be a goal in treating MDD. How to appropriately and individualized perform pharmacological intervention, psychotherapy, neuromodulation, cognitive remediation or other rehabilitation treatment programs is a critical step to achieve our goal. Integrating multiple interventions that engage multiple physiological systems with a multidisciplinary team warrants increased attention, and personalized therapeutic programs may facilitate the complete restoration of patients' everyday functioning.
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Affiliation(s)
- Chih-Ming Cheng
- Attending Psychiatrist, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Lecturer, Division of Psychiatry, College of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.
| | - Jia-Shyun Jeng
- Attending Psychiatrist, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
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30
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Ongeri L, Theuri C, Nyawira M, Penninx BWJH, Tijdink JK, Kariuki SM, Newton CRJC. Risk of suicidality in mental and neurological disorders in low and middle-income countries: A systematic review and meta-analysis. Compr Psychiatry 2023; 123:152382. [PMID: 36905857 DOI: 10.1016/j.comppsych.2023.152382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 02/07/2023] [Accepted: 02/28/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Both fatal and nonfatal suicidal behaviours are important complications of mental, neurological, and substance use disorders (MNSDs) worldwide. We aimed at quantifying the association of suicidal behaviour with MNSDs in Low and Middle Income Countries (LMICs) where varying environmental and socio-cultural factors may impact outcome. METHODS We conducted a systematic review and meta-analysis to report the associations between MNSDs and suicidality in LMICs and the study-level factors of these associations. We searched the following electronic databases: PUBMED, PsycINFO, MEDLINE, CINAHL, World Cat, and Cochrane library for studies on suicide risk in MNSDs, with a comparison/control group of persons without MNSDs, published from January 1, 1995 to September 3, 2020. Median estimates were calculated for relative risks for suicide behaviour and MNSDs, and when appropriate, these were pooled using random effects metanalytic model. This study was registered with PROSPERO, CRD42020178772. RESULTS The search identified 73 eligible studies: 28 were used for quantitative synthesis of estimates and 45 for description of risk factors. Studies included came from low and upper middle-income countries with a majority of these from Asia and South America and none from a low-income country. The sample size was 13,759 for MNSD cases and 11,792 hospital or community controls without MNSD. The most common MNSD exposure for suicidal behaviour was depressive disorders (47 studies (64%)), followed by schizophrenia spectrum, and other psychotic disorders (28 studies (38%)). Pooled estimates from the meta-analysis were statistically significant for suicidal behaviour with any MNSDs (odds ratios (OR) = 1∙98 (95%CI = 1∙80-2∙16))) and depressive disorder (OR = 3∙26 (95%CI = 2∙88-3∙63))), with both remaining significant after inclusion of high-quality studies only. Meta-regression identified only hospital-based studies (ratio of OR = 2∙85, CI:1∙24-6∙55) and sample size (OR = 1∙00, CI:0∙99-1∙00) as possible sources of variability in estimates. Risk for suicidal behaviour in MNSDs was increased by demographic factors (e.g., male sex, and unemployment), family history, psychosocial context and physical illness. INTERPRETATION There is an association between suicidal behaviour and MNSDs in LMICs, the association is greater for depressive disorder in LMICs than what has been reported in High Income Countries (HICs). There is urgent need to improve access for MNSDs care in LMICs. FUNDING None.
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Affiliation(s)
- Linnet Ongeri
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya.
| | - Cyrus Theuri
- Neuroscience Unit, Kenya Medical Research Institute-Wellcome Trust Research Program, Kilifi, Kenya
| | - Miriam Nyawira
- Neuroscience Unit, Kenya Medical Research Institute-Wellcome Trust Research Program, Kilifi, Kenya
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Joeri K Tijdink
- Department of Ethics, Law and Humanities, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Symon M Kariuki
- Neuroscience Unit, Kenya Medical Research Institute-Wellcome Trust Research Program, Kilifi, Kenya; Department of Public Health, Pwani University, Kilifi, Kenya
| | - Charles R J C Newton
- Neuroscience Unit, Kenya Medical Research Institute-Wellcome Trust Research Program, Kilifi, Kenya; Department of Psychiatry, University of Oxford, United Kingdom
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31
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Platania GA, Savia Guerrera C, Sarti P, Varrasi S, Pirrone C, Popovic D, Ventimiglia A, De Vivo S, Cantarella RA, Tascedda F, Drago F, Di Nuovo S, Colliva C, Caraci F, Castellano S, Blom JMC. Predictors of functional outcome in patients with major depression and bipolar disorder: A dynamic network approach to identify distinct patterns of interacting symptoms. PLoS One 2023; 18:e0276822. [PMID: 36791083 PMCID: PMC9931103 DOI: 10.1371/journal.pone.0276822] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 10/13/2022] [Indexed: 02/16/2023] Open
Abstract
The purpose of this study is to use a dynamic network approach as an innovative way to identify distinct patterns of interacting symptoms in patients with Major Depressive Disorder (MDD) and patients with Bipolar Type I Disorder (BD). More precisely, the hypothesis will be testing that the phenotype of patients is driven by disease specific connectivity and interdependencies among various domains of functioning even in the presence of underlying common mechanisms. In a prospective observational cohort study, hundred-forty-three patients were recruited at the Psychiatric Clinic "Villa dei Gerani" (Catania, Italy), 87 patients with MDD and 56 with BD with a depressive episode. Two nested sub-groups were treated for a twelve-week period, which allowed us to explore differences in the pattern of symptom distribution (central vs. peripheral) and their connectedness (strong vs weak) before (T0) and after (T1) treatment. All patients underwent a complete neuropsychological evaluation at baseline (T0) and at T1. A network structure was computed for MDD and BD patients at T0 and T1 from a covariance matrix of 17 items belonging to three domains-neurocognitive, psychosocial, and mood-related (affective) to identify what symptoms were driving the networks. Clinically relevant differences were observed between MDD and BD, at T0 and after 12 weeks of pharmacological treatment. At time T0, MDD patients displayed an affective domain strongly connected with the nodes of psychosocial functioning, while direct connectivity of the affective domain with the neurocognitive cluster was absent. The network of patients with BD, in contrast, revealed a cluster of highly interconnected psychosocial nodes but was guided by neurocognitive functions. The nodes related to the affective domain in MDD are less connected and placed in the periphery of the networks, whereas in BD they are more connected with psychosocial and neurocognitive nodes. Noteworthy is that, from T0 to T1 the "Betweenness" centrality measure was lower in both disorders which means that fewer "shortest paths" between nodes pass through the affective domain. Moreover, fewer edges were connected directly with the nodes in this domain. In MDD patients, pharmacological treatment primarily affected executive functions which seem to improve with treatment. In contrast, in patients with BD, treatment resulted in improvement of overall connectivity and centrality of the affective domain, which seems then to affect and direct the overall network. Though different network structures were observed for MDD and BD patients, data suggest that treatment should include tailored cognitive therapy, because improvement in this central domain appeared to be fundamental for better outcomes in other domains. In sum, the advantage of network analysis is that it helps to predict the trajectory of future phenotype related disease manifestations. In turn, this allows new insights in how to balance therapeutic interventions, involving different fields of function and combining pharmacological and non-pharmacological treatment modalities.
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Affiliation(s)
| | - Claudia Savia Guerrera
- Department of Educational Sciences, University of Catania, Catania, Italy
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Pierfrancesco Sarti
- Department of Biomedical, Metabolic and Neural Sciences—University of Modena and Reggio Emilia, Modena (MO), Italy
| | - Simone Varrasi
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Concetta Pirrone
- Department of Educational Sciences, University of Catania, Catania, Italy
| | | | - Andrea Ventimiglia
- Department of Educational Sciences, University of Catania, Catania, Italy
| | | | | | - Fabio Tascedda
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Santo Di Nuovo
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Chiara Colliva
- Azienda Unità Sanitaria Locale di Modena, Distretto di Carpi, Modena, Italy
| | - Filippo Caraci
- Department of Drug and Health Sciences, University of Catania, Catania, Italy
- Oasi Research Institute—IRCCS, Troina, Italy
- * E-mail: (FC); (JMCB)
| | - Sabrina Castellano
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Johanna M. C. Blom
- Department of Biomedical, Metabolic and Neural Sciences—University of Modena and Reggio Emilia, Modena (MO), Italy
- Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
- * E-mail: (FC); (JMCB)
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Crocker LD, Sullan MJ, Jurick SM, Thomas KR, Davey DK, Hoffman SN, Twamley EW, Jak AJ. Baseline executive functioning moderates treatment-related changes in quality of life in veterans with posttraumatic stress disorder and comorbid traumatic brain injury. J Trauma Stress 2023; 36:94-105. [PMID: 36204974 DOI: 10.1002/jts.22883] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 08/09/2022] [Accepted: 08/22/2022] [Indexed: 11/08/2022]
Abstract
Posttraumatic stress disorder (PTSD) treatment has been associated with improvement in quality of life (QOL); however, little is known about factors that moderate treatment-related changes in QOL, particularly cognitive factors. Executive functioning (EF) is important for success across all aspects of everyday life and predicts better psychological and physical health. EF is important to QOL, but more work is needed to better understand the association between EF and QOL improvements following interventions. We hypothesized that poorer baseline EF would be associated with less improvement in overall life satisfaction and satisfaction with health following PTSD treatment. U.S. veterans who served after the September 11, 2001 terrorist attacks (post 9-11; N = 80) with PTSD and a history of mild-to-moderate traumatic brain injury were randomized to standard cognitive processing therapy (CPT) or CPT combined with cognitive rehabilitation (SMART-CPT). Multilevel modeling was used to examine whether baseline EF performance was associated with changes in QOL scores from pretreatment to follow-up across both groups. Results indicated that poorer baseline performance on EF tests of working memory and inhibition were associated with less treatment-related improvements in general life satisfaction and satisfaction with health, rs = .26-.36. Treatment condition did not moderate any results. Future research should examine whether implementing EF-focused techniques before and/or concurrently with CPT for individuals with poorer baseline working memory and inhibition enhances QOL treatment gains, particularly in terms of general life and health-related satisfaction.
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Affiliation(s)
- Laura D Crocker
- Research Service, VA San Diego Healthcare System, San Diego, California, USA
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California, USA
| | - Molly J Sullan
- Psychology Service, VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Sarah M Jurick
- Research Service, VA San Diego Healthcare System, San Diego, California, USA
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Kelsey R Thomas
- Research Service, VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Delaney K Davey
- Research Service, VA San Diego Healthcare System, San Diego, California, USA
| | - Samantha N Hoffman
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Elizabeth W Twamley
- Research Service, VA San Diego Healthcare System, San Diego, California, USA
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Amy J Jak
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California, USA
- Psychology Service, VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
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Lan X, Wu F, Wang C, Wu K, Fang Z, Lao G, Zhang B, Ning Y, Zhou Y. Sex differences in the association of plasma cytokines and neurocognition in first-episode major depressive disorder. J Affect Disord 2023; 322:258-266. [PMID: 36370912 DOI: 10.1016/j.jad.2022.11.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/08/2022] [Accepted: 11/06/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Peripheral cytokines were found to be involved in the pathophysiology of neurocognition in individuals with major depressive disorder (MDD). However, whether there are sex differences in this association between cytokines and cognition in MDD remains unknown. Our aim is to examine sex differences in the relationship between plasma cytokines and cognition in MDD. METHOD One hundred and twenty-seven first episode drug naïve patients with MDD and sixty healthy controls (HCs) were recruited for present study. The MATRICS Consensus Cognitive Battery was administered to measure the cognition. Plasma concentrations of nineteen cytokines were measured using high sensitivity multiplex bead-based assays. RESULTS Both female and male patients with MDD had significant cognitive impairment in verbal learning and visual learning and had higher levels of a range of cytokines than HCs (all p < 0.05). Female patients performed worse in trail making (F = 4.442, p = 0.018) and had higher concentration of interleukin (IL)-4 (F = 7.775, p = 0.006) than males. In female MDD, a significant positive association between category frequency and level of IL-4 was observed (B = 8.040, p = 0.031). However, this association was not present in male MDD or HCs (p > 0.05). LIMITATION Present study used a cross-sectional design. CONCLUSION Female MDD patients had worse trail making performance and higher level of IL-4 than males. The elevated IL-4 in female MDD was positively associated with category fluency, suggesting that IL-4 may be involved in the pathophysiology related to specific cognitive domain in female MDD patients.
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Affiliation(s)
- Xiaofeng Lan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Fengchun Wu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Chengyu Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Kai Wu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China; Department of Biomedical Engineering, School of Material Science and Engineering, South China University of Technology, Guangzhou, China
| | - Ziyan Fang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Guohui Lao
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Bin Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.
| | - Yanling Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.
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Cognitive rehabilitation for improving cognitive functions and reducing the severity of depressive symptoms in adult patients with Major Depressive Disorder: a systematic review and meta-analysis of randomized controlled clinical trials. BMC Psychiatry 2023; 23:77. [PMID: 36707847 PMCID: PMC9883940 DOI: 10.1186/s12888-023-04554-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 01/17/2023] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Nearly 40% of patients with Major Depressive Disorder (MDD) have been found to experience cognitive impairment in at least one domain. Cognitive impairment associated with MDD is disproportionately represented in patients that have not fully returned to psychosocial functioning. As awareness regarding cognitive dysfunction in MDD patients grows, so does the interest in developing newer treatments that specifically address these deficits. METHOD In the present study, we conduct a systematic review of controlled randomized clinical trials that used cognitive training and remediation interventions for improving cognitive functions and reducing symptom severity in adult patients with MDD. We selected studies published before March 2022 using search databases including PubMed, ScienceDirect, Scopus, and Google scholar. For conducting the meta-analysis, standard differences in means with the random effect model and with a 95% confidence interval of change in outcome measures from baseline to post-intervention between the cognitive rehabilitation and the control groups were calculated. RESULTS The database search resulted in identifying 756 studies of interest, which ultimately 15 studies with 410 participants in the cognitive rehabilitation group and 339 participants in the control group were included. The meta-analysis of the data extracted from these studies, shows a moderate and significant effect on the executive function (d = 0.59 (95% CI, 0.25 to 0.93) p-value = 0.001, I2 = 15.2%), verbal learning (d = 0.45 (95% CI, 0.12 to 0.78) p-value = 0.007, I2 = 0.00%), and working memory (d = 0.41 (95% CI, 0.18 to 0.64) p-value < 0.001, I2 = 33%) of MDD patients. Although, there were no significant difference between intervention and control group in attention (d = 0.32 (95% CI, -0.01 to 0.66) p-value = 0.058, I2 = 0.00%) or depressive symptoms. CONCLUSION This systematic review and meta-analysis indicate that cognitive rehabilitation is an effective intervention for the executive function, verbal learning, and working memory of MDD patients. Due to the importance of these neuropsychological deficits in day-to-day life and the core symptoms of MDD, cognitive rehabilitation should be considered an important part of treating MDD. Further research in this area and concentrated on these particular deficits is warranted.
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Soumet-Leman C, Rotge JY, Delavaud P, Amoura Z, Cohen-Aubart F, Haroche J. Psychiatric disorders, personality and neuropsychological alterations in Erdheim-Chester disease. Orphanet J Rare Dis 2023; 18:9. [PMID: 36631837 PMCID: PMC9832607 DOI: 10.1186/s13023-022-02609-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 12/29/2022] [Indexed: 01/13/2023] Open
Abstract
Although neurological manifestations and changes in brain volumes have been described in Erdheim-Chester disease (ECD), it remains unknown whether ECD may be associated with psychiatric symptoms and cognitive dysfunctions. We assessed the presence of psychiatric disorders, changes in temperaments and characters, and neuropsychological performances in 32 ECD patients (mean age = 59) younger than 70, not treated with interferon alpha during the last 6 months, and without other serious illnesses. ECD patients exhibited high level of past depressive disorder (80%) and anxiety disorder, especially agoraphobia (29%). They revealed personality changes, especially with high agreeableness (t = 3.18, p < 0.005) and high conscientiousness (t = 3.81, p < 0.001). Neuropsychological assessments showed impairments in attention (GZ: t = 16.12, p < 0.0001, KL: t = 37.01, p < 0.0001) and episodic memory performances (STIR: t = - 3.01, p = 0.006, LTFR: t = - 2.87, p = 0.008, LTIR: t = - 3.63, p = 0.001). Executive functions, such as flexibility, inhibitory control, were unimpaired. Although it remains to be clarified whether these psychiatric symptoms and cognitive impairments may impact the daily functioning and the quality of life, the present study highlights the need to consider cognitive and emotional states in ECD management.
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Affiliation(s)
- Charlotte Soumet-Leman
- ICP (EA7403), équipe VCR, Paris, France. .,Université de Lorraine, APEMAC, équipe EPSAM, Metz, France. .,Department of Adult Psychiatry, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.
| | - Jean-Yves Rotge
- grid.411439.a0000 0001 2150 9058Department of Adult Psychiatry, Pitié-Salpêtrière Hospital, AP-HP, Paris, France ,grid.411439.a0000 0001 2150 9058Inserm U 1127, CNRS UMR 7225, Brain and Spine Institute (Institut du Cerveau et de la Moelle Epinière), ICM, Paris, France ,grid.462844.80000 0001 2308 1657Sorbonne Université, Paris, France
| | - Pauline Delavaud
- grid.411439.a0000 0001 2150 9058Department of Adult Psychiatry, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Zahir Amoura
- grid.462844.80000 0001 2308 1657Sorbonne Université, Paris, France ,grid.462844.80000 0001 2308 1657Internal Medicine Department 2, Pitié-Salpêtrière Hospital, French National Centre for Histiocytoses, AP-HP, Sorbonne Université, Paris, France
| | - Fleur Cohen-Aubart
- grid.462844.80000 0001 2308 1657Sorbonne Université, Paris, France ,grid.462844.80000 0001 2308 1657Internal Medicine Department 2, Pitié-Salpêtrière Hospital, French National Centre for Histiocytoses, AP-HP, Sorbonne Université, Paris, France
| | - Julien Haroche
- grid.462844.80000 0001 2308 1657Sorbonne Université, Paris, France ,grid.462844.80000 0001 2308 1657Internal Medicine Department 2, Pitié-Salpêtrière Hospital, French National Centre for Histiocytoses, AP-HP, Sorbonne Université, Paris, France
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Reinhard MJ, Allen N, Crock LE, McCarron KK, Veltkamp GM, Brewster RC. Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Clinical Normative Data for Gulf War Veterans. J Occup Environ Med 2022; 64:e799-e804. [PMID: 36190917 PMCID: PMC9729373 DOI: 10.1097/jom.0000000000002706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Heterogenous test batteries and methods applied in neurocognitive research on Gulf War Veterans (GWVs) limit the translation of findings to clinical practice. A clinical data set is necessary. METHODS Neurocognitive screening data from treatment-seeking GWVs were collected from multiple sites and compiled, informed by consideration of performance validity. RESULTS Repeatable Battery for the Assessment of Neuropsychological Status scores revealed the cognitive profile for GWVs (n = 189) as poorer across multiple domains when compared with similarly educated, nonveteran peers. However, mean scores generally remained within normal clinical limits. Data tables are presented to establish a comparison group for use in clinical care. CONCLUSIONS When assessing cognitive symptoms in GWVs, attention to education level and interpretation of subtle deficits is warranted. Current results highlight the importance of nuanced translation of neurocognitive research findings into clinical practice with GWVs.
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Affiliation(s)
- Mathew J. Reinhard
- War Related Illness and Injury Study Center at the
Washington DC VA Medical Center (WRIISC-DC), Washington, DC, United States of
America
| | - Nathaniel Allen
- War Related Illness and Injury Study Center at the
Washington DC VA Medical Center (WRIISC-DC), Washington, DC, United States of
America
| | - Lucas E. Crock
- War Related Illness and Injury Study Center at the
Washington DC VA Medical Center (WRIISC-DC), Washington, DC, United States of
America
| | - Kelly K. McCarron
- War Related Illness and Injury Study Center at the VA New
Jersey Healthcare System (WRIISC-NJ), East Orange, NJ, United States of America. The
work for this article was conducted during my work as an employee of the Department
of Veterans Affairs
| | - Gladys M. Veltkamp
- War Related Illness and Injury Study Center at the VA Palo
Alto Health Care System (WRIISC-CA), Palo Alto, CA, United States of America
| | - Ryan C. Brewster
- War Related Illness and Injury Study Center at the
Washington DC VA Medical Center (WRIISC-DC), Washington, DC, United States of
America
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Barlati S, Lisoni J, Nibbio G, Baldacci G, Cicale A, Ferrarin LC, Italia M, Zucchetti A, Deste G, Vita A. Current Evidence and Theories in Understanding the Relationship between Cognition and Depression in Childhood and Adolescence: A Narrative Review. Diagnostics (Basel) 2022; 12:diagnostics12102525. [PMID: 36292214 PMCID: PMC9600470 DOI: 10.3390/diagnostics12102525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/06/2022] [Accepted: 10/17/2022] [Indexed: 11/26/2022] Open
Abstract
The present narrative review has covered the current evidence regarding the role of cognitive impairments during the early phase of major depressive disorder (MDD), attempting to describe the cognitive features in childhood, adolescence and in at-risk individuals. These issues were analyzed considering the trait, scar and state hypotheses of MDD by examining the cold and hot dimensions, the latter explained in relation to the current psychological theoretical models of MDD. This search was performed on several electronic databases up to August 2022. Although the present review is the first to have analyzed both cold and hot cognitive impairments considering the trait, scar and state hypotheses, we found that current evidence did not allow to exclusively confirm the validity of one specific hypothesis since several equivocal and discordant results have been proposed in childhood and adolescence samples. Further studies are needed to better characterize possible cognitive dysfunctions assessing more systematically the impairments of cold, hot and social cognition domains and their possible interaction in a developmental perspective. An increased knowledge on these topics will improve the definition of clinical endophenotypes of enhanced risk to progression to MDD and, to hypothesize preventive and therapeutic strategies to reduce negative influences on psychosocial functioning and well-being.
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Affiliation(s)
- Stefano Barlati
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, 25123 Brescia, Italy
| | - Jacopo Lisoni
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, 25123 Brescia, Italy
- Correspondence:
| | - Gabriele Nibbio
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Giulia Baldacci
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Andrea Cicale
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Laura Chiara Ferrarin
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Mauro Italia
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Andrea Zucchetti
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Giacomo Deste
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, 25123 Brescia, Italy
| | - Antonio Vita
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, 25123 Brescia, Italy
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Association between baseline cognitive symptoms and the subsequent presenteeism and global function in patients with major depressive disorder. J Psychiatr Res 2022; 154:324-331. [PMID: 36027860 DOI: 10.1016/j.jpsychires.2022.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 07/07/2022] [Accepted: 07/20/2022] [Indexed: 11/21/2022]
Abstract
Cognitive symptoms in major depressive disorder (MDD) contribute to impaired functional abilities and work productivity, particularly presenteeism. We investigated the association between baseline cognitive symptoms and subsequent presenteeism, and global functional impairment in Japanese patients with MDD from PERFORM-J (Prospective Epidemiological Research on Functioning Outcomes Related to Major Depressive Disorder in Japan) - a 6-month, multicenter, epidemiological study data. A total of 518 patients initiating antidepressant monotherapy (first-line or switched from another drug) were enrolled. Assessments include Perceived Deficits Questionnaire - Depression (PDQ-D) for cognitive complaints, Sheehan Disability Scale (SDS) for global function (analysed n = 318), and Work Productivity and Activity Impairment Questionnaire for presenteeism (analysed n = 122). A strong association between changes in presenteeism and changes in SDS scores (r: total = 0.636; work/school = 0.686) was observed. After adjusting for sociodemographic and MDD-related factors, patients without cognitive complaints at baseline showed lower odds of impaired presenteeism at 6 months versus patients with cognitive complaints (0.243, 95% CI: 0.079 to 0.747, p = 0.014) and also in patients with first episode of MDD against with recurrent MDD (0.327 (95% CI: 0.136 to 0.787). Similarly, patients without cognitive complaints had healthier global functioning (lower mean SDS total score) than patients with cognitive complaints (8.3 vs 11.2; 95% CI, -5.189 to -0.578; p = 0.014). First depressive episode (lower risk of presenteeism), being male, and low baseline SDS total score (better global functioning) were also associated with improved outcomes. These results highlight the potential value of baseline PDQ-D scores in predicting subsequent workplace and global functioning in patients undergoing treatment for MDD.
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In pursuit of full recovery in major depressive disorder. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01487-5. [PMID: 36085532 DOI: 10.1007/s00406-022-01487-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/29/2022] [Indexed: 11/03/2022]
Abstract
Many individuals with major depression disorder (MDD) who achieve remission of depressive symptoms, do not perceive themselves as fully recovered. This study explores whether clinical remission is related to functional remission and to patient's perception of recovery, as well as, which factors are associated with their functional and subjective remission. 148 patients with MDD in partial clinical remission were included. Demographics and clinical variables were collected through semi-structured interviews. Objective cognition was evaluated through a neuropsychological battery and subjective cognition through a specific questionnaire. The patient's psychosocial functioning and the perception of their remission were also assessed. Apart from descriptive analysis, Pearson correlations and backward stepwise regression models explored the relationship between demographic, clinical, and cognitive factors with patients' functional and self-perceived remission. From the whole sample, 57 patients (38.5%) were considered to achieve full clinical remission, 38 patients (25.7%) showed functional remission, and 55 patients (37.2%) perceived themselves as remitted. Depressive symptoms and objective and subjective executive function were the factors associated with psychosocial functioning. Besides, depressive symptoms, objective and subjective attention, and subjective executive function were the significant explanatory variables for self-perception of remission. The concept of full recovery from an episode of MDD should not only include the clinician's perspective but also the patient's psychosocial functioning along with their self-perceived remission. As residual depressive symptoms and cognition (objective and subjective) are factors with great contribution to a full recovery, clinicians should specifically address them when choosing therapeutic strategies.
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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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Lin Q, Abbey C, Zhang Y, Wang G, Lu J, Dill SE, Jiang Q, Singh MK, She X, Wang H, Rozelle S, Jiang F. Association between mental health and executive dysfunction and the moderating effect of urban-rural subpopulation in general adolescents from Shangrao, China: a population-based cross-sectional study. BMJ Open 2022; 12:e060270. [PMID: 35998954 PMCID: PMC9403159 DOI: 10.1136/bmjopen-2021-060270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To examine the association between mental health and executive dysfunction in general adolescents, and to identify whether home residence and school location would moderate that association. DESIGN A population-based cross-sectional study. SETTING A subsample of the Shanghai Children's Health, Education, and Lifestyle Evaluation-Adolescents project. 16 sampled schools in Shangrao city located in downstream Yangtze River in southeast China (December 2018). PARTICIPANTS 1895 adolescents (48.8% male) which were divided into three subpopulations: (A) adolescents who have urban hukou (ie, household registration in China) and attend urban schools (UU, n=292); (B) adolescents who have rural hukou and attend urban schools (RU, n=819) and (C) adolescents who have rural hukou and attend rural schools (RR, n=784). MEASURES The Depression Anxiety and Stress Scale-21 was used to assess adolescent mental health symptoms, and the Behaviour Rating Inventory of Executive Function (parent form) was applied to measure adolescent executive dysfunction in nature setting. RESULTS Mental health symptoms were common (depression: 25.2%, anxiety: 53.0%, stress: 19.7%) in our sample, and the prevalence rates were lower among UU adolescents than those among the RR and RU, with intersubgroup differences in screen exposure time explaining most of the variance. We found the three types of symptoms were strongly associated with executive dysfunction in general adolescents. We also observed a marginal moderating effect of urban-rural subgroup on the associations: UU adolescents with depression (OR 6.74, 95% CI 3.75 to 12.12) and anxiety (OR 5.56, 95% CI 1.86 to 16.66) had a higher executive dysfunction risk when compared with RR youths with depression (OR 1.93, 95% CI 0.91 to 4.12) and anxiety (OR 1.80, 95% CI 1.39 to 2.33), respectively. CONCLUSIONS Rural adolescents experienced more mental health symptoms, whereas urban individuals with mental health problems had a higher executive dysfunction risk.
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Affiliation(s)
- Qingmin Lin
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Cody Abbey
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, California, USA
| | - Yunting Zhang
- Child Health Advocacy Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Guanghai Wang
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
| | - Jinkui Lu
- Department of Physical Education, Shangrao Normal University, Shangrao, China
| | - Sarah-Eve Dill
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, California, USA
| | - Qi Jiang
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, California, USA
| | - M K Singh
- Stanford University School of Medicine, Stanford, California, USA
| | - Xinshu She
- Stanford University School of Medicine, Stanford, California, USA
| | - Huan Wang
- Stanford Center on China's Economy and Institutions, Stanford University, Stanford, California, USA
| | - Scott Rozelle
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, California, USA
| | - Fan Jiang
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
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Bozzatello P, Giordano B, Montemagni C, Rocca P, Bellino S. Real-World Functioning in Psychiatric Outpatients: Predictive Factors. J Clin Med 2022; 11:jcm11154400. [PMID: 35956015 PMCID: PMC9369214 DOI: 10.3390/jcm11154400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 06/17/2022] [Accepted: 07/27/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction: Investigations on predictors of real-world functioning were mainly performed in patients with schizophrenia, while fewer studies have been conducted in other psychiatric disorders. Objective: Our objective was to identify clinical, socio-demographic, and illness-related predictors of real-world functioning during 12 months of standard treatments in outpatients with different diagnoses. Methods: Outpatients (n = 1019) with schizophrenia (SZ), major depressive disorder (MDD), bipolar disorder (BD), and borderline personality disorder (BPD) were evaluated with the following tools: SCID-5-CV and SCID-5-PD, CGI-S, SAT-P, DAI-10, and PSP. Change of PSP (ΔPSP) between baseline and 12 months was used as the dependent variable in multiple regression analysis. Results: Higher PSP score at baseline and the achievement of main milestones predicted better functioning after follow-up in all subgroups of patients, with the exception of BD. In the total sample, ΔPSP was related to age of onset, treatments, and quality of life, and inversely related to psychiatric anamnesis, antidepressants, and global symptoms. In SZ, ΔPSP was related to adherence and quality of life. In MDD, ΔPSP was related to psychotherapy and quality of life, and inversely related to antidepressants and global symptoms. In BD, ΔPSP was related to age of onset, antipsychotics, and quality of life, while it was inversely related to psychiatric anamnesis. In BPD, antipsychotics, mood stabilizers, psychotherapy, and quality of life were directly related to ΔPSP, while suicidal attempts and global symptoms had an inverse relation. Conclusions: Several socio-demographic and illness-related variables predicted improvement of real-world functioning, besides psychopathology and severity of the disease.
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Birba A, Santamaría-García H, Prado P, Cruzat J, Ballesteros AS, Legaz A, Fittipaldi S, Duran-Aniotz C, Slachevsky A, Santibañez R, Sigman M, García AM, Whelan R, Moguilner S, Ibáñez A. Allostatic-Interoceptive Overload in Frontotemporal Dementia. Biol Psychiatry 2022; 92:54-67. [PMID: 35491275 PMCID: PMC11184918 DOI: 10.1016/j.biopsych.2022.02.955] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/28/2022] [Accepted: 02/16/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND The predictive coding theory of allostatic-interoceptive load states that brain networks mediating autonomic regulation and interoceptive-exteroceptive balance regulate the internal milieu to anticipate future needs and environmental demands. These functions seem to be distinctly compromised in behavioral variant frontotemporal dementia (bvFTD), including alterations of the allostatic-interoceptive network (AIN). Here, we hypothesize that bvFTD is typified by an allostatic-interoceptive overload. METHODS We assessed resting-state heartbeat evoked potential (rsHEP) modulation as well as its behavioral and multimodal neuroimaging correlates in patients with bvFTD relative to healthy control subjects and patients with Alzheimer's disease (N = 94). We measured 1) resting-state electroencephalography (to assess the rsHEP, prompted by visceral inputs and modulated by internal body sensing), 2) associations between rsHEP and its neural generators (source location), 3) cognitive disturbances (cognitive state, executive functions, facial emotion recognition), 4) brain atrophy, and 5) resting-state functional magnetic resonance imaging functional connectivity (AIN vs. control networks). RESULTS Relative to healthy control subjects and patients with Alzheimer's disease, patients with bvFTD presented more negative rsHEP amplitudes with sources in critical hubs of the AIN (insula, amygdala, somatosensory cortex, hippocampus, anterior cingulate cortex). This exacerbated rsHEP modulation selectively predicted the patients' cognitive profile (including cognitive decline, executive dysfunction, and emotional impairments). In addition, increased rsHEP modulation in bvFTD was associated with decreased brain volume and connectivity of the AIN. Machine learning results confirmed AIN specificity in predicting the bvFTD group. CONCLUSIONS Altogether, these results suggest that bvFTD may be characterized by an allostatic-interoceptive overload manifested in ongoing electrophysiological markers, brain atrophy, functional networks, and cognition.
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Affiliation(s)
- Agustina Birba
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile; National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
| | - Hernando Santamaría-García
- PhD Neuroscience Program, Physiology and Psychiatry Departments, Pontificia Universidad Javeriana, Bogotá, Colombia; Memory and Cognition Center Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia; Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland
| | - Pavel Prado
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Josefina Cruzat
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile
| | | | - Agustina Legaz
- National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
| | - Sol Fittipaldi
- National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
| | - Claudia Duran-Aniotz
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Andrea Slachevsky
- Center for Geroscience, Brain Health and Metabolism, Santiago, Chile; Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, Institute of Biomedical Sciences, Santiago, Chile; Memory and Neuropsychiatric Clinic, Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile; Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Rodrigo Santibañez
- Neurology Service, Hospital Dr. Sótero del Río, Santiago, Chile; Neurology Department, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mariano Sigman
- National Scientific and Technical Research Council, Buenos Aires, Argentina; Laboratorio de Neurociencia, Universidad Torcuato Di Tella, Buenos Aires, Argentina; Facultad de Lenguas y Educación, Universidad Nebrija, Madrid, Spain
| | - Adolfo M García
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile; National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina; Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland
| | - Robert Whelan
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Sebastián Moguilner
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile; National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina; Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland; Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Agustín Ibáñez
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile; National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina; Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
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Miskowiak KW, Fugledalen L, Jespersen AE, Sattler SM, Podlekareva D, Rungby J, Porsberg CM, Johnsen S. Trajectory of cognitive impairments over 1 year after COVID-19 hospitalisation: Pattern, severity, and functional implications. Eur Neuropsychopharmacol 2022; 59:82-92. [PMID: 35561540 PMCID: PMC9008126 DOI: 10.1016/j.euroneuro.2022.04.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/04/2022] [Accepted: 04/07/2022] [Indexed: 02/08/2023]
Abstract
The ongoing Coronavirus Disease (COVID-19) pandemic has so far affected more than 500 million people. Lingering fatigue and cognitive difficulties are key concerns because they impede productivity and quality of life. However, the prevalence and duration of neurocognitive sequelae and association with functional outcomes after COVID-19 are unclear. This longitudinal study explored the frequency, severity and pattern of cognitive impairment and functional implications 1 year after hospitalisation with COVID-19 and its trajectory from 3 months after hospitalisation. Patients who had been hospitalised with COVID-19 from our previously published 3-months study at the Copenhagen University Hospital were re-invited for a 1-year follow-up assessment of cognitive function, functioning and depression symptoms. Twenty-five of the 29 previously assessed patients (86%) were re-assessed after 1 year (11±2 months). Clinically significant cognitive impairments were identified in 48-56 % of patients depending on the cut-off, with verbal learning and executive function being most severely affected. This was comparable to the frequency of impairments observed after 3 months. Objectively measured cognitive impairments scaled with subjective cognitive difficulties, reduced work capacity and poorer quality of life. Further, cognitive impairments after 3 months were associated with the severity of subsequent depressive symptoms after 1 year. In conclusion, the stable cognitive impairments in approximately half of patients hospitalized with COVID-19 and negative implications for work functioning, quality of life and mood symptoms underline the importance of screening for and addressing cognitive sequelae after severe COVID-19.
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Affiliation(s)
- K W Miskowiak
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark; Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
| | - L Fugledalen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - A E Jespersen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark; Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - S M Sattler
- Department of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen; Denmark; Respiratory Research Unit, Department of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen; Denmark
| | - D Podlekareva
- Department of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen; Denmark; Respiratory Research Unit, Department of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen; Denmark
| | - J Rungby
- Department of Endocrinology, Bispebjerg University Hospital, Denmark and Copenhagen Center for Translational Research, Copenhagen University Hospital, Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark
| | - C M Porsberg
- Department of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen; Denmark; Respiratory Research Unit, Department of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen; Denmark
| | - S Johnsen
- Department of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen; Denmark; Respiratory Research Unit, Department of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen; Denmark
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Yen YC, Chiu NY, Hwang TJ, Su TP, Yang YK, Chen CS, Li CT, Su KP, Lai TJ, Chang CM. A Multi-Center Study for the Development of the Taiwan Cognition Questionnaire (TCQ) in Major Depressive Disorder. J Pers Med 2022; 12:jpm12030359. [PMID: 35330360 PMCID: PMC8949511 DOI: 10.3390/jpm12030359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 11/23/2022] Open
Abstract
Cognitive dysfunction is associated with functional impairment of patients with Major Depressive Disorder (MDD). The goals were to explore the associated factors of cognitive impairment in MDD and to develop and validate a brief and culture-relevant questionnaire, the Taiwan Cognition Questionnaire (TCQ), among patients with MDD. This was a cross-sectional, multi-center observational study of MDD patients in Taiwan. Participants of Group 1 from 10 centers contributed to the validation of the TCQ by their response and sociodemographics. The participants of Group 2 from one center received an objective cognitive assessment for clarification of the relationship between the TCQ score and its associated factors. In Group 1, 493 participants were recruited. As for Group 2, an extra 100 participants were recruited. The global Cronbach’s alpha for the TCQ was 0.908. According to the coordinates of the ROC curve, 9/10 was the ideal cut-off point. With the criteria, the sensitivity/specificity of the TCQ was 0.610/0.689. The TCQ score was positively associated with a history of being admitted to acute psychiatric care and the severity of depression and negatively associated with objective cognitive measures. The TCQ provides a reliable, valid, and convenient measure of subjective cognitive dysfunction in patients with MDD.
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Affiliation(s)
- Yung-Chieh Yen
- Department of Psychiatry, E-Da Hospital, Kaohsiung 824, Taiwan; or
- School of Medicine, I-Shou University, Kaohsiung 824, Taiwan
| | - Nan-Ying Chiu
- Center for Sleep Medicine, Department of Psychiatry, Chang-Hua Christian Medical System, Chang-Hua 500, Taiwan;
- Lukang Christian Hospital, Chang-Hua 505, Taiwan
| | - Tzung-Jeng Hwang
- Department of Psychiatry, National Taiwan University Hospital, Taipei 100, Taiwan;
- School of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan;
- Institute of Philosophy of Mind and Cognition, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Department of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Department of Psychiatry, General Cheng Hsin Hospital, Taipei 112, Taiwan
| | - Yen-Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, Tainan 701, Taiwan;
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan 700, Taiwan
| | - Cheng-Sheng Chen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan;
- School of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Cheng-Ta Li
- Institute of Brain Science, Brain Research Center, National Yang Ming Chiao Tung University, Taipei 112, Taiwan;
- Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan;
| | - Kuan-Pin Su
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan;
- College of Medicine, China Medical University, Taichung 404, Taiwan
- An-Nan Hospital, China Medical University, Tainan 709, Taiwan
| | - Te-Jen Lai
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan;
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Chia-Ming Chang
- Department of Psychiatry, Chang Gung Memorial Hospital at Linko, Taoyuan 333, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Correspondence:
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46
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Matcham F, Leightley D, Siddi S, Lamers F, White KM, Annas P, de Girolamo G, Difrancesco S, Haro JM, Horsfall M, Ivan A, Lavelle G, Li Q, Lombardini F, Mohr DC, Narayan VA, Oetzmann C, Penninx BWJH, Bruce S, Nica R, Simblett SK, Wykes T, Brasen JC, Myin-Germeys I, Rintala A, Conde P, Dobson RJB, Folarin AA, Stewart C, Ranjan Y, Rashid Z, Cummins N, Manyakov NV, Vairavan S, Hotopf M. Remote Assessment of Disease and Relapse in Major Depressive Disorder (RADAR-MDD): recruitment, retention, and data availability in a longitudinal remote measurement study. BMC Psychiatry 2022; 22:136. [PMID: 35189842 PMCID: PMC8860359 DOI: 10.1186/s12888-022-03753-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 02/02/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Major Depressive Disorder (MDD) is prevalent, often chronic, and requires ongoing monitoring of symptoms to track response to treatment and identify early indicators of relapse. Remote Measurement Technologies (RMT) provide an opportunity to transform the measurement and management of MDD, via data collected from inbuilt smartphone sensors and wearable devices alongside app-based questionnaires and tasks. A key question for the field is the extent to which participants can adhere to research protocols and the completeness of data collected. We aimed to describe drop out and data completeness in a naturalistic multimodal longitudinal RMT study, in people with a history of recurrent MDD. We further aimed to determine whether those experiencing a depressive relapse at baseline contributed less complete data. METHODS Remote Assessment of Disease and Relapse - Major Depressive Disorder (RADAR-MDD) is a multi-centre, prospective observational cohort study conducted as part of the Remote Assessment of Disease and Relapse - Central Nervous System (RADAR-CNS) program. People with a history of MDD were provided with a wrist-worn wearable device, and smartphone apps designed to: a) collect data from smartphone sensors; and b) deliver questionnaires, speech tasks, and cognitive assessments. Participants were followed-up for a minimum of 11 months and maximum of 24 months. RESULTS Individuals with a history of MDD (n = 623) were enrolled in the study,. We report 80% completion rates for primary outcome assessments across all follow-up timepoints. 79.8% of people participated for the maximum amount of time available and 20.2% withdrew prematurely. We found no evidence of an association between the severity of depression symptoms at baseline and the availability of data. In total, 110 participants had > 50% data available across all data types. CONCLUSIONS RADAR-MDD is the largest multimodal RMT study in the field of mental health. Here, we have shown that collecting RMT data from a clinical population is feasible. We found comparable levels of data availability in active and passive forms of data collection, demonstrating that both are feasible in this patient group.
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Affiliation(s)
- Faith Matcham
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Daniel Leightley
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Sara Siddi
- grid.5841.80000 0004 1937 0247Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - Femke Lamers
- grid.12380.380000 0004 1754 9227Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Katie M. White
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Peter Annas
- grid.424580.f0000 0004 0476 7612H. Lundbeck A/S, Valby, Denmark
| | - Giovanni de Girolamo
- grid.419422.8IRCCS Instituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Sonia Difrancesco
- grid.12380.380000 0004 1754 9227Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Josep Maria Haro
- grid.5841.80000 0004 1937 0247Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - Melany Horsfall
- grid.12380.380000 0004 1754 9227Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Alina Ivan
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Grace Lavelle
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Qingqin Li
- grid.497530.c0000 0004 0389 4927Janssen Research and Development, LLC, Titusville, NJ USA
| | - Federica Lombardini
- grid.5841.80000 0004 1937 0247Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - David C. Mohr
- grid.16753.360000 0001 2299 3507Center for Behavioral Intervention Technologies, Department of Preventative Medicine, Northwestern University, Chicago, IL USA
| | - Vaibhav A. Narayan
- grid.497530.c0000 0004 0389 4927Janssen Research and Development, LLC, Titusville, NJ USA
| | - Carolin Oetzmann
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Brenda W. J. H. Penninx
- grid.12380.380000 0004 1754 9227Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Stuart Bruce
- grid.13097.3c0000 0001 2322 6764RADAR-CNS Patient Advisory Board, King’s College London, London, UK
| | - Raluca Nica
- grid.13097.3c0000 0001 2322 6764RADAR-CNS Patient Advisory Board, King’s College London, London, UK
| | - Sara K. Simblett
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Til Wykes
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | | | - Inez Myin-Germeys
- grid.5596.f0000 0001 0668 7884Department for Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Aki Rintala
- grid.5596.f0000 0001 0668 7884Department for Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium ,grid.508322.eFaculty of Social and Health Care, LAB University of Applied Sciences, Lahti, Finland
| | - Pauline Conde
- grid.13097.3c0000 0001 2322 6764Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Richard J. B. Dobson
- grid.13097.3c0000 0001 2322 6764Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Amos A. Folarin
- grid.13097.3c0000 0001 2322 6764Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Callum Stewart
- grid.13097.3c0000 0001 2322 6764Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Yatharth Ranjan
- grid.13097.3c0000 0001 2322 6764Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Zulqarnain Rashid
- grid.13097.3c0000 0001 2322 6764Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Nick Cummins
- grid.13097.3c0000 0001 2322 6764Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,grid.7307.30000 0001 2108 9006Chair of Embedded Intelligence for Health Care and Wellbeing, University of Augsburg, Augsburg, Germany
| | | | - Srinivasan Vairavan
- grid.497530.c0000 0004 0389 4927Janssen Research and Development, LLC, Titusville, NJ USA
| | - Matthew Hotopf
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839South London and Maudsley NHS Foundation Trust, London, UK
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Tieks A, Oude Voshaar RC, Zuidersma M. Daily associations between affect and cognitive performance in older adults with depression and cognitive impairment: a series of seven single-subject studies in the Netherlands. BMC Geriatr 2022; 22:133. [PMID: 35177005 PMCID: PMC8851709 DOI: 10.1186/s12877-022-02797-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background Comorbidity between depression and cognitive impairment is common in older adults, increases the disease burden disproportionally, and leads to diagnostic uncertainty. Insight into individual daily associations between affect and cognitive performance may help in personalizing diagnosis and treatment decisions. Our objective was to get insight into the daily associations between affect and cognitive performance within individual older adults. Methods In this single-subject study seven older adults with both depression and cognitive impairment filled in electronic diaries daily for 62-93 consecutive days evaluating positive affect (PA), negative affect (NA), working memory (WM) and visual learning (VL). Time-series analyses using vector autoregressive modelling, Granger causality tests and cumulative orthogonalized impulse response function analyses were performed for each individual separately. Results In one patient higher NA was associated with better WM the next day. For another patient days with higher NA and lower PA were days with worse WM. For a third patient better VL was associated with lower NA and higher PA the next day. No associations were found for four patients. Conclusions These results highlight heterogeneity in the daily associations between affect and cognitive performance and stress the relevance of single-subject studies. These studies may be an important step towards personalized diagnosis and treatment in old age psychiatry. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02797-y.
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Affiliation(s)
- Alieke Tieks
- University of Groningen, University Medical Center Groningen, Interdisciplinary center Psychopathology and Emotion regulation, Groningen, the Netherlands
| | - Richard C Oude Voshaar
- University of Groningen, University Medical Center Groningen, Interdisciplinary center Psychopathology and Emotion regulation, Groningen, the Netherlands
| | - Marij Zuidersma
- University of Groningen, University Medical Center Groningen, Interdisciplinary center Psychopathology and Emotion regulation, Groningen, the Netherlands. .,Department of Psychiatry, HPC CC72, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, Netherlands.
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Bergdolt J, Sellin P, Driessen M, Beblo T, Dehn LB. Neuropsychological predictors of vocational rehabilitation outcomes in individuals with major depression: A scoping review. Front Psychiatry 2022; 13:942161. [PMID: 36440409 PMCID: PMC9682155 DOI: 10.3389/fpsyt.2022.942161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Major depression is one of the leading causes of disability and limited capacity to work. Neuropsychological impairment is a common symptom in acute and remitted major depression and is associated with poor psychosocial functioning. This scoping review aimed to identify research on the role of neuropsychological functioning in outcomes of vocational rehabilitation programs in individuals with depression. METHODS We report on the conduct of this pre-registered (https://osf.io/5yrnf) scoping review in accordance with PRISMA-ScR guidelines. PubMed and PsychInfo were systematically searched for English or German research articles published between 1990 and September 2021 that studied objective neuropsychological tests as predictors of vocational rehabilitation interventions and included participants with depression. RESULTS The systematic literature search yielded no studies that specifically targeted subjects with major depression. However, eight articles published since 2016 were included in the review, analyzing data from five trials that evaluated the effectiveness of supported employment in North America and Europe in severe mental illnesses. An estimated 31% of the total number of participants included (n = 3,533) had major depression. Using a variety of cognitive tests and covariates, seven articles found that neuropsychological functioning - especially global cognition scores, verbal and visual learning and memory - significantly predicted vocational outcomes of rehabilitation programs. CONCLUSION Despite a lack of studies specifically targeting major depressive disorder, the identified literature suggests that higher baseline neuropsychological functioning predicts better vocational outcomes of supported employment programs in individuals with depression. In clinical practice, additional neuropsychological modules during return-to-work interventions might be helpful for vocational outcomes of such programs.
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Affiliation(s)
- Juliane Bergdolt
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany
| | - Pauline Sellin
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany
| | - Martin Driessen
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany.,Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany.,Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Lorenz B Dehn
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany.,Department of Psychology, Bielefeld University, Bielefeld, Germany
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Brain activity during pursuit and goal-conflict threat avoidance in major depressive disorder. PERSONALITY NEUROSCIENCE 2022; 5:e9. [PMID: 36105154 PMCID: PMC9428662 DOI: 10.1017/pen.2022.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 05/16/2022] [Accepted: 05/21/2022] [Indexed: 11/06/2022]
Abstract
Abstract
Threat avoidance is a prominent symptom of affective disorders, yet its biological basis remains poorly understood. Here, we used a validated task, the Joystick Operated Runway Task (JORT), combined with fMRI, to explore whether abnormal function in neural circuits responsible for avoidance underlies these symptoms. Eighteen individuals with major depressive disorder (MDD) and 17 unaffected controls underwent the task, which involved using physical effort to avoid threatening stimuli, paired with mild electric shocks on certain trials. Activity during anticipation and avoidance of threats was explored and compared between groups. Anticipation of aversive stimuli was associated with significant activation in the dorsal anterior cingulate cortex, superior frontal gyrus, and striatum, while active avoidance of aversive stimuli was associated with activity in dorsal anterior cingulate cortex, insula, and prefrontal cortex. There were no significant group differences in neural activity or behavioral performance on the JORT; however, participants with depression reported more dread while being chased on the task. The JORT effectively identified neural systems involved in avoidance and anticipation of aversive stimuli. However, the absence of significant differences in behavioral performance and activation between depressed and non-depressed groups suggests that MDD is not associated with abnormal function in these networks. Future research should investigate the basis of passive avoidance in major depression. Further, the JORT should be explored in patients with anxiety disorders, where threat avoidance may be a more prominent characteristic of the disorder.
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Long-term consequences of COVID-19 on cognitive functioning up to 6 months after discharge: role of depression and impact on quality of life. Eur Arch Psychiatry Clin Neurosci 2022; 272:773-782. [PMID: 34698871 PMCID: PMC8546751 DOI: 10.1007/s00406-021-01346-9] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/19/2021] [Indexed: 01/04/2023]
Abstract
Neurologic and psychiatric symptoms have been reported in the months following the infection with COVID-19. A low-grade inflammation has been associated both with depression and cognitive symptoms, suggesting a link between these disorders. The aim of the study is to investigate cognitive functioning 6 months following hospital discharge for COVID-19, the impact of depression, and the consequences on quality of life. Ninety-two COVID-19 survivors evaluated at 1-month follow-up, 122 evaluated at 3 months and 98 evaluated at 6 months performed neuropsychological and psychiatric evaluations and were compared with a healthy comparison group (HC) of 165 subjects and 165 patients with major depression (MDD). Cognitive performances were adjusted for age, sex, and education. Seventy-nine percent of COVID-19 survivors at 1 month and 75% at 3- and 6-month follow-up showed cognitive impairment in at least one cognitive function. No significant difference in cognitive performances was observed between 1-, 3-, and 6-months follow-up. COVID-19 patients performed worse than HC but better than MDD in psychomotor coordination and speed of information processing. No difference between COVID-19 survivors and MDD was observed for verbal fluency, and executive functions, which were lower than in HC. Finally, COVID-19 survivors performed the same as HC in working memory and verbal memory. The factor that most affected cognitive performance was depressive psychopathology which, in turn, interact with cognitive functions in determining quality of life. Our results confirm that COVID-19 sequelae include signs of cognitive impairment which persist up to 6 months after hospital discharge and affect quality of life.
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