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Knorr U, Simonsen AH, Nilsson J, Brinkmalm A, Zetterberg H, Blennow K, Knudsen MB, Forman J, Hasselbalch SG, Kessing LV. Cerebrospinal fluid synaptic biomarker changes in bipolar disorder - A longitudinal case-control study. J Affect Disord 2024; 358:250-259. [PMID: 38723679 DOI: 10.1016/j.jad.2024.05.034] [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: 01/18/2024] [Revised: 05/03/2024] [Accepted: 05/04/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND This exploratory study investigated cerebrospinal fluid (CSF) synaptic protein biomarkers in bipolar disorder (BD), aiming to highlight the neurobiological basis of the disorder. With shared cognitive impairment features between BD and Alzheimer's disease, and considering increased dementia risk in BD patients, the study explores potential connections. METHODS Fifty-nine well-characterized patients with BD and thirty-seven healthy control individuals were examined and followed for one year. Synaptic proteins encompassing neuronal pentraxins (NPTX)1, NPTX2, and NPTX-receptor, 14-3-3 protein family epsilon, and zeta/delta, activating protein-2 complex subunit beta, synucleins beta-synuclein and gamma-synuclein, complexin-2, phosphatidylethanolamine-binding protein 1, rab GDP dissociation inhibitor alpha, and syntaxins 1B and 7 were measured in CSF using a microflow liquid chromatography-mass spectrometric multiple reaction monitoring set-up. Biomarker levels were compared between BD and HC and in BD before, during, and after mood episodes. RESULTS The synaptic proteins revealed no statistically significant differences between BD and HC, neither at baseline, one-year follow-up, or in terms of changes from baseline to follow-up. Moreover, the CSF synaptic protein levels in patients with BD were unaltered compared to baseline when they stabilized in euthymia following an affective episode and at one-year follow-up. LIMITATION It is uncertain what the CSF biomarker concentrations reflect since we yet do not know the mechanisms of release of these proteins, and we are uncertain of what increased or decreased levels reflect. CONCLUSION This first-ever investigation of a panel of CSF protein biomarkers of synaptic dysfunction in patients with BD and HC individuals found no statistically significant differences cross-sectionally or longitudinally.
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Affiliation(s)
- Ulla Knorr
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Department Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.
| | - Anja Hviid Simonsen
- Danish Dementia Research Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Johanna Nilsson
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Ann Brinkmalm
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease, University College London, Queen Square, London, United Kingdom; UK Dementia Research Institute University College London, London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Paris Brain Institute, ICM, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France; Neurodegenerative Disorder Research Center, Division of Life Sciences and Medicine, and Department of Neurology, Institute on Aging and Brain Disorders, University of Science and Technology of China and First Affiliated Hospital of USTC, Hefei, PR China
| | - Mark Bech Knudsen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Denmark
| | - Julie Forman
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Denmark
| | - Steen Gregers Hasselbalch
- Danish Dementia Research Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Department Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
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Sagar R, Sen MS, Kumar N, Chawla N. Longitudinal assessment of disability amongst patients of bipolar and unipolar depressive disorders presenting to a tertiary care center in North India. Int J Soc Psychiatry 2023; 69:70-77. [PMID: 34996324 DOI: 10.1177/00207640211070158] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To assess and compare the changes in disability scores associated with Bipolar Depression (BD) and Unipolar Depression (UD) over 1 year. METHODS A longitudinal study was taken up in adults diagnosed with unipolar or bipolar depressive disorder with current depressive episode. Diagnosis was made according to Schedule for Clinical Assessment in Neuropsychiatry. Severity scoring was done using Hamilton's Depression (HAM-D) rating scale and Hamilton's Anxiety (HAM-A) rating scale. Disability was assessed using Indian Disability Evaluation and Assessment Scale (IDEAS) and London handicap Scale (LHS) at baseline, 6 and 12 months. RESULTS Sixty participants were recruited (42 UD and 18 BD). No significant differences were seen in socio-demographic parameters, except higher education levels and males being overrepresented in UD. Significant differences at baseline were seen in HAM-D (p = .001) and HAM-A (p = .003) scores. The extent of disability was seen to correlate with severity of illness only in case of BD at baseline. No significant differences were seen in the IDEAS scores at baseline. IDEAS score improved at each follow-up assessment (p < .001). LHS showed significant improvement over time in UD (p < .001), but not BD (p = .076). Percentage individuals meeting cut-off for benchmark disability (>40%) were comparable at baseline but were significantly more in the BD at 12-months (p = .049). CONCLUSION AND IMPLICATIONS Disability in psychiatry occurs equally amongst unipolar and bipolar depressive disorders and tends to improve over time, although the level of improvement may differ. It may not always correspond to severity of illness. These factors should be considered while certifying disability.
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Affiliation(s)
- Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Mahadev Singh Sen
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Nand Kumar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Nishtha Chawla
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
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3
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Xi C, Liu Z, Zeng C, Tan W, Sun F, Yang J, Palaniyappan L. The centrality of working memory networks in differentiating bipolar type I depression from unipolar depression: A task-fMRI study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:22-32. [PMID: 35244484 PMCID: PMC9720478 DOI: 10.1177/07067437221078646] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Up to 70%-80% of patients with bipolar disorder are misdiagnosed as having major depressive disorder (MDD), leading to both delayed intervention and worsening disability. Differences in the cognitive neurophysiology may serve to distinguish between the depressive phase of type 1 bipolar disorder (BDD-I) from MDD, though this remains to be demonstrated. To this end, we investigate the discriminatory signal in the topological organization of the functional connectome during a working memory (WM) task in BDD-I and MDD, as a candidate identification approach. METHODS We calculated and compared the degree centrality (DC) at the whole-brain voxel-wise level in 31 patients with BDD-I, 35 patients with MDD, and 80 healthy controls (HCs) during an n-back task. We further extracted the distinct DC patterns in the two patient groups under different WM loads and used machine learning approaches to determine the distinguishing ability of the DC map. RESULTS Patients with BDD-I had lower accuracy and longer reaction time (RT) than HCs at high WM loads. BDD-I is characterized by decreased DC in the default mode network (DMN) and the sensorimotor network (SMN) when facing high WM load. In contrast, MDD is characterized by increased DC in the DMN during high WM load. Higher WM load resulted in better classification performance, with the distinct aberrant DC maps under 2-back load discriminating the two disorders with 90.91% accuracy. CONCLUSIONS The distributed brain connectivity during high WM load provides novel insights into the neurophysiological mechanisms underlying cognitive impairment of depression. This could potentially distinguish BDD-I from MDD if replicated in future large-scale evaluations of first-episode depression with longitudinal confirmation of diagnostic transition.
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Affiliation(s)
- Chang Xi
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Zhening Liu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Can Zeng
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Wenjian Tan
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Fuping Sun
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Jie Yang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Lena Palaniyappan
- 113611Robarts Research Institute, Western University, London, Canada.,Departments of Psychiatry and Medical Biophysics, Schulich School of Medicine, Western University, London, Canada
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Ali M, Fahmy M, Haggag W, El-Tantawy A, Hassan H. Evaluation of cognitive impairment in patients with major depressive disorder in remission. MIDDLE EAST CURRENT PSYCHIATRY 2021. [DOI: 10.1186/s43045-021-00149-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cognitive symptoms are one of the core symptoms of depressive disorders with a bearing effect on functional outcomes. Cognitive symptoms, including poor concentration and difficulty making decisions, are one of the DSM-IV diagnostic criteria for major depressive disorder. This study was designed to evaluate cognitive deficits in a sample of adult patients with major depressive disorder (MDD) in remission. A cross-sectional study was done on 60 patients fulfilling the diagnostic criteria of MDD in remission state. In addition, 60 normal subjects with matched age, sex, and educational level were compared with the patients group. Participants in both patients and control groups were subjected to clinical assessment using Mini-International Neuropsychiatric Interview plus (MINI-plus), assessment of cognitive functions using Wechsler Memory Scale-Revised (WMS-R) short form, and Wisconsin Card Sorting Test (WCST).
Results
There were statistically significant differences between patients and control groups regarding cognitive function. The patients group scored less in visual memory, verbal memory, attention/concentration, and psychomotor speed. They also performed poorly regarding executive functions. But there was no statistically significant difference between the patients and control groups regarding sustained attention and visuospatial function. No significant correlations did exist between age at onset of MDD and the duration of illness with different domains of cognitive function except for figural memory of WMS-R and categories completed of Wisconsin card sorting test.
Conclusion
Patients with MDD in remission experienced deficits in several cognitive functions when compared to matched control subjects. The cognitive functions do not reach normal levels of performance, particularly in visual memory and executive functioning with remission of depressive symptoms.
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Bogert J, Rofael H, Mosca K, Ross RO, Callaerts G, Wang D, Jaeger J, Narayan VA, Drevets WC, Morrison RL. A randomized, multicenter, crossover psychometric evaluation study of an iPad-administered cognitive test battery in participants with major depressive disorder who responded to treatment with oral antidepressants. J Affect Disord 2021; 292:261-269. [PMID: 34134024 DOI: 10.1016/j.jad.2021.05.046] [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: 09/29/2020] [Revised: 05/14/2021] [Accepted: 05/23/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Performance validity and test-retest reliability of ReVeRe.D, an iPad-administered cognitive test battery in major depressive disorder (MDD) were analyzed. METHODS Participants aged 18-59 years had DSM-5 diagnosis of MDD with adequate visual and hearing acuity. All had responded to oral antidepressant treatment for a major depressive episode within the most recent 24-months and were stable with no greater than mild depressive symptoms as evidenced by Montgomery Asberg Depression Rating Scale total score <17. Participants were randomly assigned to 1 of 2 test sequences (AABB or BBAA; A=ReVeRe.D; B=examiner-administered tests) in a crossover design. RESULTS 244 randomized participants (AABB: n=123; BBAA: n=121) had mean age of 38.3 years; 54.9% had a college, baccalaureate, or higher education. At first administration, Pearson correlation coefficients (PCC) for 6/10 pairs of corresponding ReVeRe.D vs examiner-administered tests exceeded the pre-specified acceptance criterion (PCC=0.53) for the primary analysis; 8 test score pairs had PCC exceeding 0.40. At second administration, PCC for 9/10 test scores pairs exceeded PCC=0.53. Together, the series of PCCs supports the concurrent validity for ReVeRe.D. Test-retest reliability for ReVeRe.D test scores was generally moderate to high. LIMITATIONS The study included stable participants with MDD who had responded to oral antidepressant treatment, with most in at least partial remission. The sample was limited to English-speaking participants, and skewed towards white, college-educated women. Further studies in acutely ill MDD patients who represent a broader demographic, are warranted. CONCLUSIONS iPad-administered ReVeRe.D is a valid and reliable computerized test battery for assessment of cognitive performance in MDD.
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Affiliation(s)
| | - Hany Rofael
- Janssen Research & Development, LLC, NJ, USA
| | | | | | | | - Daniel Wang
- Janssen Research & Development, LLC, CA, USA
| | - Judith Jaeger
- CognitionMetrics, LLC, Wilmington, DE, USA; Albert Einstein College of Medicine, Bronx, NY, USA
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Baker J, Edwards I, Beazley P. Juror decision-making regarding a defendant diagnosed with borderline personality disorder. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2021; 29:516-534. [PMID: 35903499 PMCID: PMC9318233 DOI: 10.1080/13218719.2021.1938273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Stigma is an established consequence of the Borderline Personality Disorder (BPD) diagnosis. This diagnosis is subject to revision in the International Classification of Diseases-11th Revision (ICD-11). Using the legal issue of diminished responsibility, this study applied an experimental mock-jury methodology to explore the impact of diagnostic stigma of BPD on jury decision-making. Participants were allocated to one of two versions of a simplified fictitious homicide trial. The group whose defendant was described as having a 'severe personality disorder, borderline pattern' rated the defendant as more dangerous, and more in need of segregation and coercive treatment, than controls where the defendant was described as having a 'complex mental health problem'. Between-group differences in other measures, including the decision to agree a verdict of diminished responsibility, were not found. The ICD-11 'severe personality disorder, borderline pattern' diagnosis may adversely impact the attitudes of jurors considering the question of diminished responsibility.
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Affiliation(s)
- James Baker
- Department of Clinical Psychology and Psychological Therapies (CPPT), Norwich Medical School, University of East Anglia, Norwich, UK
- Norfolk and Suffolk Mental Health Trust, Norwich, UK
| | - Ian Edwards
- UEA Law School, University of East Anglia, Norwich, UK
| | - Peter Beazley
- Department of Clinical Psychology and Psychological Therapies (CPPT), Norwich Medical School, University of East Anglia, Norwich, UK
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Ang YS, Frontero N, Belleau E, Pizzagalli DA. Disentangling vulnerability, state and trait features of neurocognitive impairments in depression. Brain 2020; 143:3865-3877. [PMID: 33176359 PMCID: PMC7805803 DOI: 10.1093/brain/awaa314] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/15/2020] [Accepted: 07/31/2020] [Indexed: 12/15/2022] Open
Abstract
Depression is a debilitating disorder that often starts manifesting in early childhood and peaks in onset during adolescence. Neurocognitive impairments have emerged as clinically important characteristics of depression, but it remains controversial which domains specifically index pre-existing vulnerability, state-related or trait-related markers. Here, we disentangled these effects by analysing the Adolescent Brain Cognitive Development dataset (n = 4626). Using information of participants' current and past mental disorders, as well as family mental health history, we identified low-risk healthy (n = 2100), high-risk healthy (n = 2023), remitted depressed (n = 401) and currently depressed children (n = 102). Factor analysis of 11 cognitive variables was performed to elucidate latent structure and canonical correlation analyses conducted to probe regional brain volumes reliably associated with the cognitive factors. Bayesian model comparison of various a priori hypotheses differing in how low-risk healthy, high-risk healthy, remitted depressed and currently depressed children performed in various cognitive domains was performed. Factor analysis revealed three domains: language and reasoning, cognitive flexibility and memory recall. Deficits in language and reasoning ability, as well as in volumes of associated regions such as the middle temporal and superior frontal gyrus, represented state- and trait-related markers of depression but not pre-existing vulnerability. In contrast, there was no compelling evidence of impairments in other domains. These findings-although cross-sectional and specific to 9-10-year-old children-might have important clinical implications, suggesting that cognitive dysfunction may not be useful targets of preventive interventions. Depressed patients, even after remission, might also benefit from less commonly used treatments such as cognitive remediation therapy.
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Affiliation(s)
- Yuen-Siang Ang
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA 02478, USA
| | - Nicole Frontero
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA 02478, USA
| | - Emily Belleau
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA 02478, USA
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA 02478, USA
- McLean Imaging Center, McLean Hospital, Belmont, MA 02478, USA
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Gayete S, Giné A, Miret M, Ayuso-Mateos JL, Haro JM, Olaya B. Cognitive function associated with different diagnoses of anxiety disorders over the lifespan: Results from a Spanish representative sample. J Anxiety Disord 2020; 75:102296. [PMID: 32866758 DOI: 10.1016/j.janxdis.2020.102296] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 08/04/2020] [Accepted: 08/14/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Previous research suggests an association between anxiety disorders and worse cognitive function. However, this association may vary depending on the type of disorder and age. We analysed the association of panic attack, 12-month and lifetime panic disorder (PD), and generalized anxiety disorder (GAD), with cognitive function in a representative sample of Spanish adults, and compared three age groups (18-49, 50-64, and 65+). METHODS Some 4,582 participants were interviewed with an adapted CIDI interview. Unadjusted and adjusted linear regression models were calculated by age group, using T scores of verbal fluency and episodic memory as the outcomes. RESULTS In young adults, 12-month GAD was associated with significantly lower scores of memory performance and verbal fluency, and 12-month PD with worse verbal fluency. In middle-aged participants, lifetime panic attack was related to better performance in verbal fluency, whereas having a diagnosis of lifetime PD was associated with lower scores. However, only participants aged 18-49 with 12-month GAD showed lower memory and verbal fluency, at almost one standard deviation below participants without 12-month GAD. LIMITATIONS Low prevalence rates of anxiety disorder could have led to biased results. CONCLUSIONS In young adults, a concurrent GAD might be particularly associated with memory and verbal fluency deficits, whereas only verbal fluency is affected in middle-aged adults with a history of PD, although this association is small. In older adults, anxiety disorders are not clearly associated with worse cognition, probably because in this age group other confounder variables might be attenuating this link. Overall, our findings suggest that cognitive interventions for anxiety disorders may be relevant, especially for young and middle-aged adults.
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Affiliation(s)
- Silvia Gayete
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Spain
| | - Anna Giné
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Spain
| | - Marta Miret
- Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain; Instituto de Salud Carlos III, CIBER of Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | | | - Josep Maria Haro
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Spain; Instituto de Salud Carlos III, CIBER of Mental Health (CIBERSAM), Madrid, Spain
| | - Beatriz Olaya
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Spain; Instituto de Salud Carlos III, CIBER of Mental Health (CIBERSAM), Madrid, Spain.
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9
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Pu M, Wang X, Zhang J. Impact of GRIK4 gene polymorphisms on cognitive dysfunction in patients with major depression. Rev Neurol (Paris) 2020; 176:823-828. [PMID: 32245654 DOI: 10.1016/j.neurol.2019.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/03/2019] [Accepted: 11/07/2019] [Indexed: 11/28/2022]
Abstract
An increasing body of research has focused on the functions of the glutamate receptor ionotropic kainate 4 (GRIK4) gene in treatment for depression, memory, as well as neurodegenerative diseases. It is widely recognized that major depressive disorder (MDD) patients often display cognitive dysfunctions, which do not strictly correlate with the severity of depressive symptoms, and in some individuals persist after clinical remission. However, little is known regarding the particular role of GRIK4 in cognitive functions of patients suffering from a MDD. The current study therefore sought to examine the impact of GRIK4 polymorphism on cognitive functions in MDD patients. A total of 217 MDD patients participated in this study. Their depressive severity was determined with the 17-item Hamilton Depression Rating Scale, and cognitive functions were evaluated using the Stroop Neuropsychological Screening Test, tests of visual reproduction and immediate logical memory, and the verbal fluency test (VFT). All patients were genotyped to determine GRIK4 polymorphisms. Results of VFT revealed statistical differences among all single-nucleotide polymorphism (SNP) genotypes. In the Stroop-color-word test, only rs6589847 was discovered to be statistically different. No significant difference was found in the Stroop-color task scores, the visual reproduction test, or the immediate logical memory test. GRIK4 polymorphism exerted a significant effect on long-term memory retrieval and selective attention, but did not affect immediate memory.
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Affiliation(s)
- M Pu
- Wuxi People's Hospital, No. 299 Qingyang road, 214000 Wuxi, China
| | - X Wang
- Wuxi People's Hospital, No. 299 Qingyang road, 214000 Wuxi, China
| | - J Zhang
- Wuxi People's Hospital, No. 299 Qingyang road, 214000 Wuxi, China.
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10
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Bai YM, Chen MH, Hsu JW, Huang KL, Tu PC, Chang WC, Su TP, Li CT, Lin WC, Tsai SJ. A comparison study of metabolic profiles, immunity, and brain gray matter volumes between patients with bipolar disorder and depressive disorder. J Neuroinflammation 2020; 17:42. [PMID: 32000805 PMCID: PMC6990475 DOI: 10.1186/s12974-020-1724-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/23/2020] [Indexed: 12/22/2022] Open
Abstract
Background Previous individual studies have shown the differences in inflammatory cytokines and gray matter volumes between bipolar disorder (BD) and unipolar depression (UD). However, few studies have investigated the association between pro-inflammatory cytokines and differences in brain gray matter volumes between BD and UD. Methods In this study, 72 BD patients and 64 UD patients were enrolled, with comparable gender and age distributions (33.8% males and an average age of 39.3 ± 13.7 years). Each participant underwent metabolic profiling (including body mass index (BMI), glucose, triglyceride, high-density lipoprotein (HDL), leptin, insulin, adiponectin), pro-inflammatory cytokine (including soluble interleukin-6 receptor (sIL-6R), soluble interleukin-2 receptor (sIL-2R), C-reactive protein (CRP), soluble tumor necrosis factor receptor type 1 (sTNF-R1) examinations, and structural magnetic resonance imaging exams. Voxel-based morphometry was performed to investigate the gray matter volume differences between BD and UD patients. Correlations between pro-inflammatory cytokines and the gray matter volume difference were analyzed. Results Compared to UD patients, the BD group had significantly higher BMI, and higher levels of sIL-6R and sTNF-R1 than the UD patients. The BMI significantly correlated with the level of pro-inflammatory cytokines. Adjusted for age, sex, BMI, duration of illness and total intracranial volume, the BD individuals had significantly more reduced gray matter volumes over 12 areas: R. cerebellar lobule VIII, R. putamen, L. putamen, R. superior frontal gyrus, L. lingual gyrus, L. precentral gyrus, R. fusiform gyrus, L. calcarine, R. precuneus, L. inferior temporal gyrus, L. hippocampus, and L. superior frontal gyrus. These 12 gray matter volume differences between BP and UD patients negatively correlated with sIL-6R and sTNF-R1 levels. Conclusions Our results suggested that BD patients had higher BMI and pro-inflammatory cytokine levels in comparison to UD patients, especially IL-6 and sTNF-R1, which may contribute to greater gray matter reductions in BD patients in comparison to UD patients. The results support the neuro-inflammation pathophysiology mechanism in mood disorder. It is clinically important to monitor BMI, which, in this investigation, positively correlated with levels of inflammatory cytokines.
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Affiliation(s)
- Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Chi Tu
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Philosophy of Mind and Cognition, National Yang-Ming University, Taipei, Taiwan
| | - Wan-Chen Chang
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Cheng Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan. .,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
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11
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Semkovska M, Quinlivan L, O'Grady T, Johnson R, Collins A, O'Connor J, Knittle H, Ahern E, Gload T. Cognitive function following a major depressive episode: a systematic review and meta-analysis. Lancet Psychiatry 2019; 6:851-861. [PMID: 31422920 DOI: 10.1016/s2215-0366(19)30291-3] [Citation(s) in RCA: 291] [Impact Index Per Article: 58.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/11/2019] [Accepted: 06/12/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Substantial evidence suggests that cognitive deficits might persist after remission of a major depressive episode. However, results are inconsistent relative to the importance, pattern, severity, and moderating factors of this impairment. We aimed to determine how cognitive function following a major depressive episode compares with normal function, to specify the pattern and severity of persistent cognitive dysfunctions, and to examine the potential moderator effect of ten prespecified clinical and demographic variables. METHODS We did a systematic review and meta-analysis of the published research. We searched systematically MEDLINE, Embase, PsycARTICLES, PsycINFO, the Cochrane Library, and relevant reviews identified by our database search, for research published from Jan 1, 1972, up to Jan 31, 2018, for studies of patients with past depression. We included all independent studies of patients who were assessed while in remission from a major depressive episode with at least one cognitive test, with inclusion of a healthy control group assessed with either the same test(s) as the major depressive episode group or with a standardised test with published age-stratified normative data. The main outcome was the difference in cognitive performance between major depressive episode remitters and healthy controls. Effect sizes were calculated using random-effects models for cognitive outcomes classified into 18 standard domains. Moderators of between-study variability were assessed using mixed-effects subgroup analyses and meta-regressions. FINDINGS Of 10 126 citations identified by our search, 75 cognitive variables from 252 eligible studies (11 882 major depressive episode remitters and 8533 healthy controls) were included in our meta-analysis. Significant deficits following major depressive episode remission were observed in 55 (73%) of the 75 cognitive variables. These deficits (in the domains of processing speed, visual selective attention, working memory, verbal learning, and executive functioning), were generally small (30 [40%] of the 75 variables) or medium (22 [29%]) in size, although three long-term memory variables showed large deficits: g=-0·81 [95% CI -1·01 to -0·61] for logical memory immediate recall, g=-0·88 [-1·19 to -0·57] for logical memory delayed recall, and g=-0·84 [-1·18 to -0·50] for Cambridge Neuropsychological Test Automated Battery pattern recognition latency. Auditory attention, general autobiographical memory, inhibition ability unconstrained by speed, and intellectual functioning unconstrained by speed were equivalent between major depressive episode remitters and matched controls. The number of previous depressive episodes explained heterogeneity in the majority of variables (z=-2·06 [p=0·039] to z=-4·26 [p<0·0001]). INTERPRETATION Deficits in selective attention, working memory, and long-term memory persist in remission from a major depressive episode and worsen with repeated episodes. Depression treatments, including relapse prevention, need to target these cognitive functions to optimise prognosis. FUNDING None.
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Affiliation(s)
- Maria Semkovska
- Department of Psychology, Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Lisa Quinlivan
- Department of Psychology, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Tara O'Grady
- Department of Psychology, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Rebecca Johnson
- Department of Psychology, University of Strathclyde, Glasgow, UK
| | - Aisling Collins
- Department of Psychology, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Jessica O'Connor
- Department of Psychology, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Hannah Knittle
- Department of Psychology, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Elayne Ahern
- Department of Psychology, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Taylor Gload
- Department of Psychology, Ursinus College, Collegeville, PA, USA
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12
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Zaremba D, Schulze Kalthoff I, Förster K, Redlich R, Grotegerd D, Leehr EJ, Meinert S, Dohm K, Bürger C, Enneking V, Böhnlein J, Repple J, Opel N, Jörgens S, Yüksel D, Schmitt S, Stein F, Kircher T, Krug A, Nenadić I, Zwitserlood P, Baune BT, Arolt V, Dannlowski U. The effects of processing speed on memory impairment in patients with major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2019; 92:494-500. [PMID: 30831198 DOI: 10.1016/j.pnpbp.2019.02.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 02/13/2019] [Accepted: 02/27/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Learning and memory performance have been reported to be impaired in patients with Major Depressive Disorder (MDD). Impairments are associated with diminished psychosocial functioning. Based on the processing-speed theory, we aimed to examine whether processing speed mediates the relationship between depression status and verbal, visuo-spatial and working memory impairment. METHODS A neuropsychological test-battery was administered to 106 patients with current MDD, 119 patients with remitted MDD and 120 healthy controls to assess processing speed, learning and memory performance. To examine the impact of diagnosis status and processing speed on learning and memory performance, simple mediation models were computed. RESULTS Currently depressed patients with MDD showed partially slowed processing speed, impaired short-term verbal and visuo-spatial memory performance compared to healthy controls. A basic deficit in processing speed mediated the relationship between depression status and verbal, visuo-spatial, and working memory impairment. However, there was no processing speed or memory impairment in patients with remitted MDD. CONCLUSION Processing speed is an important factor regarding learning and memory impairment in patients with current MDD. Thereby, our results highlight novel targets for treatment of diminished learning and memory performance via enhancement of processing speed using pharmacological as well as therapeutic interventions.
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Affiliation(s)
- Dario Zaremba
- Department of Psychiatry, University of Münster, Germany
| | | | | | - Ronny Redlich
- Department of Psychiatry, University of Münster, Germany
| | | | | | | | - Katharina Dohm
- Department of Psychiatry, University of Münster, Germany
| | | | | | | | | | - Nils Opel
- Department of Psychiatry, University of Münster, Germany
| | - Silke Jörgens
- Department of Psychiatry, University of Münster, Germany
| | - Dilara Yüksel
- Department of Psychiatry, University of Marburg, Germany
| | - Simon Schmitt
- Department of Psychiatry, University of Marburg, Germany
| | | | - Tilo Kircher
- Department of Psychiatry, University of Marburg, Germany
| | - Axel Krug
- Department of Psychiatry, University of Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry, University of Marburg, Germany
| | | | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Germany; Department of Psychiatry, University of Melbourne, Australia
| | - Volker Arolt
- Department of Psychiatry, University of Münster, Germany
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Germany.
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13
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Tourjman SV, Juster RP, Purdon S, Stip E, Kouassi E, Potvin S. The screen for cognitive impairment in psychiatry (SCIP) is associated with disease severity and cognitive complaints in major depression. Int J Psychiatry Clin Pract 2019; 23:49-56. [PMID: 29553848 DOI: 10.1080/13651501.2018.1450512] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To assess the relationship between the Screen for Cognitive Impairment in Psychiatry (SCIP) score and illness severity, subjective cognition and functioning in a cohort of major depressive disorder (MDD) patients. METHODS Patients (n = 40) diagnosed with MDD (DSM-IV-TR) completed the SCIP, a brief neuropsychological test, and a battery of self-administered questionnaires evaluating functioning (GAF, SDS, WHODAS 2.0, EDEC, PDQ-D5). Disease severity was evaluated with the Hamilton Depression Rating Scale (HDRS) and the Clinical Global Impression (CGI). RESULTS Age and sex were associated with performance in the SCIP. The SCIP-Global index score was associated with disease severity (r = -0.316, p < .05), the SDS, a patient self-assessment of daily functioning (r = -0.368, p < .05), and the EDEC subscales of patient-reported cognitive deficits (r = -0.388, p < .05) and their functional impacts (r = -0.335, p < .05). Multivariate analysis adjusted for age and sex confirmed these tests are independent predictors of performance in the SCIP (CGI-S, F[3,34] = 4.478, p = .009; SDS, F[3,34] = 3.365, p = .030; EDEC-perceived cognitive deficits, F[3,34] = 5.216, p = .005; EDEC-perceived impacts of functional impairment, F[3,34] = 5.154, p = .005). CONCLUSIONS This study confirms that the SCIP can be used during routine clinical evaluation of MDD, and that cognitive deficits objectively assessed in the SCIP are associated with disease severity and self-reported cognitive dysfunction and impairment in daily life.
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Affiliation(s)
| | | | - Scot Purdon
- c Department of Psychiatry , University of Alberta , Edmonton , Canada
| | - Emmanuel Stip
- d Department of Psychiatry , University of Montreal , Montreal , Canada
| | - Edouard Kouassi
- a Institut Universitaire en Santé Mentale de Montréal , Montreal , Canada
| | - Stéphane Potvin
- a Institut Universitaire en Santé Mentale de Montréal , Montreal , Canada
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14
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Seelye A, Thuras P, Doane B, Clason C, VanVoorst W, Urošević S. Steeper aging-related declines in cognitive control processes among adults with bipolar disorders. J Affect Disord 2019; 246:595-602. [PMID: 30605878 DOI: 10.1016/j.jad.2018.12.076] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/20/2018] [Accepted: 12/23/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Little is known about the specificity of executive functioning (EF) decline in older adults with bipolar disorders (OABD), or the impact of bipolar disorders (BD) on the timing and slope of age-related declines in EF processes implicated in both BD etiology and normative aging-cognitive control (CC). This cross-sectional study investigated age-related CC decline in BD. METHODS Participants were 43 adults with BD (M age = 61.5, SD = 15.8; 86% male) and 45 Controls (M age = 65.2, SD = 12.2; 98% male). Two-way ANOVAs examined the effects of median-age-split and diagnostic groups on cognitive processes with established BD deficits-CC processes (mental flexibility and response inhibition), verbal learning, and verbal fluency. RESULTS The median-split-age-by-diagnostic-group interaction was significant for mental flexibility; OABD performed significantly worse than younger adults with BD and younger and older Controls. Exploratory multivariate adaptive regression spline characterized non-linear nature of aging-slope changes in mental flexibility for each diagnostic group, yielding an inflection point at older age and steeper subsequent decline in OABD versus Controls. LIMITATIONS This study is limited by a small sample (particularly for select neuropsychological measures) of mostly Caucasian men and BD diagnoses based on clinical interview and medical records review. CONCLUSIONS Compared to healthy older adults, OABD showed steeper age-related decline in mental flexibility-select EF processes that depend on the integrity of the CC system. Preliminary evidence links CC integrity to daily functioning in OABD; accelerated aging decline in CC may pose a mechanism for high risk of functional impairment and dementia in OABD.
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Affiliation(s)
- Adriana Seelye
- Minneapolis VA Health Care System, Minneapolis, MN, United States; University of Minnesota, Department of Psychiatry, Minneapolis, MN, United States; Oregon Health & Science University, Department of Neurology, Portland, OR, United States; Oregon Center for Aging & Technology, Portland, OR, United States.
| | - Paul Thuras
- Minneapolis VA Health Care System, Minneapolis, MN, United States; University of Minnesota, Department of Psychiatry, Minneapolis, MN, United States
| | - Bridget Doane
- Minneapolis VA Health Care System, Minneapolis, MN, United States
| | - Christie Clason
- Minneapolis VA Health Care System, Minneapolis, MN, United States
| | - Wendy VanVoorst
- Minneapolis VA Health Care System, Minneapolis, MN, United States
| | - Snežana Urošević
- Minneapolis VA Health Care System, Minneapolis, MN, United States; University of Minnesota, Department of Psychiatry, Minneapolis, MN, United States
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15
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Chakrabarty T, Yatham LN. Objective and biological markers in bipolar spectrum presentations. Expert Rev Neurother 2019; 19:195-209. [PMID: 30761925 DOI: 10.1080/14737175.2019.1580145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Subthreshold presentations of bipolarity (BSPs) pose a diagnostic conundrum, in terms of whether they should be conceptualized and treated similarly as traditionally defined bipolar disorders (BD). While it has been argued that BSPs are on a pathophysiologic continuum with traditionally defined BDs, there has been limited examination of biological and objective markers in these presentations to validate this assertion. Areas covered: The authors review studies examining genetic, neurobiological, cognitive and peripheral markers in BSPs, encompassing clinical and non-clinical populations with subthreshold hypo/manic symptoms. Results are placed in the context of previously identified markers in traditionally defined BDs. Expert commentary: There have been few studies of objective and biological markers in subthreshold presentations of BD, and results are mixed. While abnormalities in brain structure/functioning, peripheral inflammatory, and cognitive markers have been reported, it is unclear whether these findings are specific to BD or indicative of broad affective pathology. However, some studies suggest that increased sensitivity to reward and positive stimuli are shared between subthreshold and traditionally defined BDs, and may represent a point of departure from unipolar major depression. Further examination of such markers may improve understanding of subthreshold bipolar presentations, and provide guidance in terms of therapeutic strategies.
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Affiliation(s)
- Trisha Chakrabarty
- a Department of Psychiatry , University of British Columbia , Vancouver , BC , Canada
| | - Lakshmi N Yatham
- a Department of Psychiatry , University of British Columbia , Vancouver , BC , Canada
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16
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Hsieh S, Lin SJ. The Dissociable Effects of Induced Positive and Negative Moods on Cognitive Flexibility. Sci Rep 2019; 9:1126. [PMID: 30718767 PMCID: PMC6362281 DOI: 10.1038/s41598-018-37683-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 12/12/2018] [Indexed: 11/12/2022] Open
Abstract
This study investigates how different valences of induced moods modulate cognitive flexibility in a task-switching paradigm. Forty-eight participants aged 19–25 years performed task switching after watching emotional film clips to induce an emotion (neutral, positive, or negative emotions). Two indicators of flexibility were evaluated: (1) the performance decrement reflected by increased reaction time (RT) or errors on the task-switch trial relative to a task-repetition trial, which is known as the “switching cost,” and (2) the performance improvement reflected by decreased RT or errors when switching from a task-switching context to a single-task context, which is known as the “fade-out” effect. These indicators reflect cognitive flexibility on short and long time scales, respectively. The results show that negative moods reduced switching costs, particularly in incongruent trials. In addition, negative moods were found to cause a prolonged fade-out effect compared with neutral and positive moods, indicating that participants required more trials to adjust to the single-task condition after experiencing the task-switching context. The result suggests that only negative moods and not positive moods modulated both the short and long time scales of cognitive flexibility but with dissociable effects. Possible explanations are discussed.
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Affiliation(s)
- Shulan Hsieh
- Department of Psychology, National Cheng Kung University, Tainan City, Taiwan. .,Institute of Allied Health Sciences, National Cheng Kung University, Tainan City, Taiwan.
| | - Siang Jyun Lin
- Institute of Behavioral Medicine, National Cheng Kung University, Tainan City, Taiwan
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17
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A systematic review on neuropsychological function in bipolar disorders type I and II and subthreshold bipolar disorders-something to think about. CNS Spectr 2019; 24:127-143. [PMID: 30859934 DOI: 10.1017/s1092852918001463] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Neuropsychological dysfunction is a well-established finding in individuals with bipolar disorder type I (BP-I), even during euthymic periods; however, it is less clear whether this also pertains to bipolar disorder type II (BP-II) or those with subthreshold states (SBP; subthreshold bipolar disorder), such as bipolar not otherwise specified (BP-NOS). Herein, we compare the literature regarding neuropsychological performance in BP-II vs BP-I to determine the extent of relative impairment, and we present and review all related studies on cognition in SBP. After systematically searching PubMed, Medline, PsycINFO, and The Cochrane Library, we found 17 papers that comprise all the published studies relevant for this review. The areas that are consistently found to be impaired in BP are executive function, verbal memory, visual spatial working memory, and attention. More studies than not show no significant difference between BP-I and BP-II, particularly in euthymic samples. Preliminary evidence suggests that patients experiencing major depressive episodes who also meet criteria for SBP show similar profiles to BP-II; however, these results pertain only to a depressed sample. SBP were found to perform significantly better than both MDD and healthy controls in a euthymic sample. A consensus on mood state, patient selection, and neuropsychological testing needs to be agreed on for future research. Furthermore, no studies have used the most recent DSM-5 criteria for SBP; future studies should address this. Finally, the underlying bases of cognitive dysfunction in these diagnostic groups need to be further investigated. We suggest recommendations on all of the above current research challenges.
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18
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Förster K, Jörgens S, Air TM, Bürger C, Enneking V, Redlich R, Zaremba D, Grotegerd D, Dohm K, Meinert S, Leehr EJ, Böhnlein J, Repple J, Opel N, Kavakbasi E, Arolt V, Zwitserlood P, Dannlowski U, Baune BT. The relationship between social cognition and executive function in Major Depressive Disorder in high-functioning adolescents and young adults. Psychiatry Res 2018; 263:139-146. [PMID: 29550719 DOI: 10.1016/j.psychres.2018.02.046] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 02/21/2018] [Accepted: 02/21/2018] [Indexed: 10/18/2022]
Abstract
To understand how cognitive dysfunction contributes to social cognitive deficits in depression, we investigated the relationship between executive function and social cognitive performance in adolescents and young adults during current and remitted depression, compared to healthy controls. Social cognition and executive function were measured in 179 students (61 healthy controls and 118 patients with depression; Mage = 20.60 years; SDage = 3.82 years). Hierarchical regression models were employed within each group (healthy controls, remitted depression, current depression) to examine the nature of associations between cognitive measures. Social cognitive and executive function did not significantly differ overall between depressed patients and healthy controls. There was no association between executive function and social cognitive function in healthy controls or in remitted patients. However, in patients with a current state of depression, lower cognitive flexibility was associated with lower performance in facial-affect recognition, theory-of-mind tasks and overall affect recognition. In this group, better planning abilities were associated with decreased performance in facial affect recognition and overall social cognitive performance. While we infer that less cognitive flexibility might lead to a more rigid interpretation of ambiguous social stimuli, we interpret the counterintuitive negative correlation of planning ability and social cognition as a compensatory mechanism.
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Affiliation(s)
- Katharina Förster
- Department of Psychiatry, University of Münster, Germany; Institute of Psychiatric Phenomics and Genomics, Ludwig-Maximillians-University, Munich, Germany
| | - Silke Jörgens
- Department of Psychiatry, University of Münster, Germany
| | - Tracy M Air
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Australia
| | | | | | - Ronny Redlich
- Department of Psychiatry, University of Münster, Germany
| | - Dario Zaremba
- Department of Psychiatry, University of Münster, Germany
| | | | - Katharina Dohm
- Department of Psychiatry, University of Münster, Germany
| | | | | | | | | | - Nils Opel
- Department of Psychiatry, University of Münster, Germany
| | | | - Volker Arolt
- Department of Psychiatry, University of Münster, Germany
| | | | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Germany
| | - Bernhard T Baune
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Australia.
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19
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Lee CY, Wang LJ, Lee Y, Hung CF, Huang YC, Lee MI, Lee SY. Differentiating bipolar disorders from unipolar depression by applying the Brief Assessment of Cognition in Affective Disorders. Psychol Med 2018; 48:929-938. [PMID: 28826415 DOI: 10.1017/s003329171700229x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Scholars continue to argue about whether bipolar disorders (BD) and unipolar depression (UD) are distinguishable with regard to neurocognitive function. This study aims to explore the cognitive profiles of UD and BD by applying the Brief Assessment of Cognition in Affective Disorders (BAC-A) for neuropsychological assessment. METHOD This cross-sectional study included 68 patients with UD, 67 patients with BD, and 135 healthy control subjects. We evaluated the participants' cognitive functions at euthymic status using the BAC-A, which is made up of six traditional cognitive subtests and the Affective Processing Test. We then used a discriminant function analysis (DFA) to determine whether cognitive performance can be used to distinguish these participant groups. RESULTS Healthy controls demonstrated better performance in all subtests of the BAC-A than both the UD and BD patients, with the exception of delayed recognition of affective interference. Compared with the BD group, the UD group exhibited better performance in working memory and emotion inhibition. Furthermore, using all BAC-A indexes, a total of 70% of participants could be correctly classified using a DFA model, and the discriminating validity between UD and BD was superior to using either the traditional cognitive domains or the Affective Processing Test alone. CONCLUSIONS We have found that UD patients may exhibit an intermediate performance between healthy subjects and BD patients in working memory and emotional inhibition tests. The BAC-A can potentially assist in differentiating BD patients from UD patients at euthymic status in clinical settings.
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Affiliation(s)
- C-Y Lee
- Department of Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan
| | - L-J Wang
- Department of Child and Adolescent Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan
| | - Y Lee
- Department of Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan
| | - C-F Hung
- Department of Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan
| | - Y-C Huang
- Department of Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan
| | - M-I Lee
- Department of Child and Adolescent Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan
| | - S-Y Lee
- Department of Psychiatry,School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University,Kaohsiung,Taiwan
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20
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Kotan VO, Kotan Z, Aydın B, Kırlı S. The Neurobehavioral Cognitive Status Examination Results in Patients with Depression. ANKARA MEDICAL JOURNAL 2018. [DOI: 10.17098/amj.408969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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21
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Afzali MH, Oleary-Barrett M, Séguin JR, Conrod P. Effect of depressive symptoms on the evolution of neuropsychological functions over the course of adolescence. J Affect Disord 2018; 229:328-333. [PMID: 29331690 DOI: 10.1016/j.jad.2017.11.060] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 10/02/2017] [Accepted: 11/12/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Comprehensive understanding of the association between depression and neuropsychological functioning over the course of adolescence requires developmentally sensitive assessment through longitudinal data. The aim of current study is to examine the concurrent and subsequent effects of depressive symptoms on the initial level and evolution of four neuropsychological functioning domains (i.e., spatial working memory, delayed recall memory, perceptual reasoning, and inhibitory control). METHOD Depressive symptoms and neuropsychological functioning were assessed over the course of four years in a sample of 3826 Canadian adolescents. A series of multilevel models estimated the between-person, within-person, and lagged within-person effects of depressive symptoms on each domain of neuropsychological functioning. RESULTS Findings suggest that current year and past year depressive symptoms were associated with poorer performance in delayed recall memory and perceptual reasoning tasks. Likewise, past year depressive symptoms were associated with poorer spatial working memory performance. These detrimental effects were stronger in early adolescence. LIMITATIONS The current study examined the presence of sub-clinical depressive symptoms but not clinical depression. Moreover, although depressive symptoms and neuropsychological functions were assessed using widely used, valid, and reliable computer-based instruments, the results may not match the accuracy of clinician-based assessments. CONCLUSIONS Our results underline the necessity of early intervention for young adolescents to decrease the harms associated with depression. The effect of early-onset depression on the underlying neural substrates of neuropsychological functioning merits further investigation.
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Affiliation(s)
| | | | - Jean R Séguin
- Department of Psychiatry, University of Montreal, Canada.
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22
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Janacsek K, Borbély-Ipkovich E, Nemeth D, Gonda X. How can the depressed mind extract and remember predictive relationships of the environment? Evidence from implicit probabilistic sequence learning. Prog Neuropsychopharmacol Biol Psychiatry 2018; 81:17-24. [PMID: 28958916 DOI: 10.1016/j.pnpbp.2017.09.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 09/11/2017] [Accepted: 09/21/2017] [Indexed: 11/29/2022]
Abstract
A growing body of evidence suggests that emotion and cognition are fundamentally intertwined; impairments in explicit, more effortful and attention-dependent cognitive functions have widely been observed in negative mood. Here we aimed to test how negative mood affects implicit cognition that is less susceptible to motivational and attentional factors associated with negative mood. Therefore, we examined implicit learning and retention of predictive relationships in patients with major depressive episode (MDE). Additionally, we directly compared subgroups of patients with major depressive disorder (MDD) vs. bipolar disorder (BD) in order to gain a deeper understanding of how implicit cognition is affected by these conditions. Implicit probabilistic sequence learning was measured by the Alternating Serial Reaction Time Task. The acquired knowledge was retested after a 24-hour delay period. Consistent with the frontostriatal deficits frequently reported in depression, we found weaker learning in patients with MDE, with a more pronounced deficit in patients with MDD compared to BD. After the 24-hour delay, MDE patients (both subgroups) showed forgetting, while the controls retained the previously acquired knowledge. These results cannot be explained by alterations in motivation, attention and reward processing but suggest more profound impairments of implicit learning and retention of predictive relationships among neutral stimuli in depression. To the best of our knowledge, this is the first study investigating retention of implicitly acquired sequential knowledge and reporting deficits in this domain in MDE. Our findings not only contribute to a better understanding of the complex interplay between affect and cognition but can also help improve screening, diagnosis and treatment protocols of depression.
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Affiliation(s)
- Karolina Janacsek
- MTA ELTE NAP-B Brain, Memory and Language Lab, ICNP, RCNS, Hungarian Academy of Sciences, Budapest, Hungary; Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | | | - Dezso Nemeth
- MTA ELTE NAP-B Brain, Memory and Language Lab, ICNP, RCNS, Hungarian Academy of Sciences, Budapest, Hungary; Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.
| | - Xénia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; MTA-SE Neuropsychopharmacology and Neurochemistry Research Group of the Hungarian Academy of Sciences, Semmelweis University, Hungary
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Petschner P, Gonda X, Baksa D, Eszlari N, Trivaks M, Juhasz G, Bagdy G. Genes Linking Mitochondrial Function, Cognitive Impairment and Depression are Associated with Endophenotypes Serving Precision Medicine. Neuroscience 2018; 370:207-217. [DOI: 10.1016/j.neuroscience.2017.09.049] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 08/01/2017] [Accepted: 09/25/2017] [Indexed: 12/15/2022]
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24
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Depression severity and concentration difficulties are independently associated with HRQOL in patients with unipolar depressive disorders. Qual Life Res 2017; 26:2459-2469. [DOI: 10.1007/s11136-017-1595-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2017] [Indexed: 12/17/2022]
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25
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Bartczak M, Bokus B. Semantic Distances in Depression: Relations Between ME and PAST, FUTURE, JOY, SADNESS, HAPPINESS. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2017; 46:345-366. [PMID: 27339227 PMCID: PMC5368207 DOI: 10.1007/s10936-016-9442-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Using the Semantic Distance Task, we investigated the semantic distances between ME and five metaphorically conceptualized notions: PAST, FUTURE, JOY, SADNESS, and HAPPINESS. Three Polish-speaking groups participated in the study: depressive subjects ([Formula: see text]), patients in remission ([Formula: see text]), and non-depressed individuals ([Formula: see text]). T-test and the Kruskal-Wallis nonparametric equivalent of ANOVA analyses showed that subjects in remission placed ME significantly farther away from PAST than non-depressed individuals and depressed patients. Data mining algorithms indicated the distances ME-SADNESS, ME-PAST, and ME-FUTURE as the three strongest predictors of group membership. We interpret the findings in the light of a contrast effect and defense mechanisms. We propose that intergroup differences are especially prominent in tasks requiring creation of semantic associative relations, that is, in the first stage of conceptual processing. We suggest treating the results as confirmation that Beck's theory of depression applies at the level of notion comprehension, proving that processing of key concepts in depression symptoms (particularly PAST) runs differently in all three groups under consideration.
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Affiliation(s)
- Marlena Bartczak
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183 Warsaw, Poland
| | - Barbara Bokus
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183 Warsaw, Poland
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Abstract
OBJECTIVES Episodic memory deficits are both common and impactful among persons infected with HIV; however, we know little about how to improve such deficits in the laboratory or in real life. Retrieval practice, by which retrieval of newly learned material improves subsequent recall more than simple restudy, is a robust memory boosting strategy that is effective in both healthy and clinical populations. In this study, we investigated the benefits of retrieval practice in 52 people living with HIV and 21 seronegatives. METHODS In a within-subjects design, all participants studied 48 verbal paired associates in 3 learning conditions: Massed-Restudy, Spaced-Restudy, and Spaced-Testing. Retention of verbal paired associates was assessed after short- (30 min) and long- (30 days) delay intervals. RESULTS After a short delay, both HIV+ persons and seronegatives benefited from retrieval practice more so than massed and spaced restudy. The same pattern of results was observed specifically for HIV+ persons with clinical levels of memory impairment. The long-term retention interval data evidenced a floor effect that precluded further analysis. CONCLUSIONS This study provides evidence that retrieval practice improves verbal episodic memory more than some other mnemonic strategies among HIV+ persons. (JINS, 2017, 23, 214-222).
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Boonruamkaew P, Sukketsiri W, Panichayupakaranant P, Kaewnam W, Tanasawet S, Tipmanee V, Hutamekalin P, Chonpathompikunlert P. Apium graveolens extract influences mood and cognition in healthy mice. J Nat Med 2017; 71:492-505. [PMID: 28205135 DOI: 10.1007/s11418-017-1077-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 01/25/2017] [Indexed: 02/05/2023]
Affiliation(s)
- Phetcharat Boonruamkaew
- Department of Physiology, Faculty of Science, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand
| | - Wanida Sukketsiri
- Department of Pharmacology, Faculty of Science, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand
| | - Pharkphoom Panichayupakaranant
- Phytomedicine and Pharmaceutical Biotechnology Excellence Center, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand
| | - Wijittra Kaewnam
- Phytomedicine and Pharmaceutical Biotechnology Excellence Center, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand
| | - Supita Tanasawet
- Department of Anatomy, Faculty of Science, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand
| | - Varomyalin Tipmanee
- Department of Biomedical Sciences, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand
| | - Pilaiwanwadee Hutamekalin
- Department of Physiology, Faculty of Science, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand
| | - Pennapa Chonpathompikunlert
- Department of Physiology, Faculty of Science, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand.
- College of Alternative Medicine, Chandrakasem Rajabhat University, 39/1 Ratchadaphisek, Chantharakasem, Chatuchak, Bangkok, 10900, Thailand.
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Szmulewicz AG, Valerio MP, Smith JM, Samamé C, Martino DJ, Strejilevich SA. Neuropsychological profiles of major depressive disorder and bipolar disorder during euthymia. A systematic literature review of comparative studies. Psychiatry Res 2017; 248:127-133. [PMID: 28040657 DOI: 10.1016/j.psychres.2016.12.031] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 11/09/2016] [Accepted: 12/23/2016] [Indexed: 11/16/2022]
Abstract
Bipolar disorder and major depressive disorder have been shown to be associated with neurocognitive abnormalities during periods of clinical remission. However, at present, there is no consensus on whether these disorders have distinctive cognitive profiles. The aim of this study was to provide an updated systematic review of studies comparing neuropsychological functioning between bipolar disorder and major depressive disorder during remission. Main findings included the following: 1) no differences regarding performances in measures of attention and processing speed, executive functions and theory of mind were found between both patient groups and 2) regarding verbal memory, preliminary evidence points towards a more defective performance in patients with bipolar disorder than those with major depressive disorder. However, several variables with negative impact on cognition (medication status, age at onset, premorbid IQ, bipolar subtype, among others) were not adequately controlled in most studies. In conclusion, evidence from studies exploring neuropsychological profiles in bipolar disorder and major depressive disorder could not provide clues to differentiate these mood disorders. Larger studies with adequate control of confounding variables would be necessary to elucidate if the finding of more defective verbal memory performance in bipolar disorder is truly explained by distinct underlying mechanisms.
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Affiliation(s)
- Alejandro G Szmulewicz
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; Hospital de Emergencias Psiquiátricas Torcuato de Alvear, Buenos Aires, Argentina; Department of Pharmacology, University of Buenos Aires, Buenos Aires, Argentina.
| | - Marina P Valerio
- Hospital de Emergencias Psiquiátricas Torcuato de Alvear, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - José M Smith
- Hospital de Emergencias Psiquiátricas Torcuato de Alvear, Buenos Aires, Argentina
| | - Cecilia Samamé
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; School of Psychology, University of Buenos Aires, Buenos Aires, Argentina
| | - Diego J Martino
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Sergio A Strejilevich
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina
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Roh SC, Park EJ, Shim M, Lee SH. EEG beta and low gamma power correlates with inattention in patients with major depressive disorder. J Affect Disord 2016; 204:124-30. [PMID: 27344621 DOI: 10.1016/j.jad.2016.06.033] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 06/02/2016] [Accepted: 06/12/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND Inattention is a common feature of major depressive disorder (MDD). The aim of this study was to explore the relationship between quantitative electroencephalography (qEEG) power of a specific band and inattention severity in patients with MDD. METHODS EEG recordings of 73 patients with MDD were collected in during both eyes closed and eyes open conditions. Inattention was assessed by the inattention sub-scale of the Korean version of the Adult ADHD scale (K-AADHD). The severity of symptoms associated with depression and anxiety was assessed with the Hamilton Rating Scale for Anxiety (HAM-A), the Hamilton Rating Scale for Depression (HAM-D), and the Beck Depression Inventory (BDI). Multiple regression and Hayes mediation model were applied for the statistical analysis to verify the effects of clinical variables on inattention score. RESULTS The beta (12-30Hz) and low gamma (30-50Hz) powers in fronto-central regions were negatively correlated with inattention scores. Symptom severity scores strongly predicted inattention scores; in particular, the BDI accounted for 23.9% of the variance. In mediation analysis, BDI fully mediated the path of anxiety to inattention. LIMITATIONS The medication effect and comorbidity in our participants were not fully controlled. A subjective assessment tool was hired to measure inattention. CONCLUSIONS Beta and low gamma power of the fronto-central regions might be a reliable measure of attention deficits in patients with MDD, which in turn, seems to be related to the severity of subjective depressive symptoms. Further work is needed to confirm this finding on larger, drug and comorbidity-free samples, and to test the clinical utility.
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Affiliation(s)
- Sang-Choong Roh
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
| | - Eun-Jin Park
- Department of Psychiatry, Inje University, Ilsan-Paik Hospital, Juhwa-ro 170, Ilsanseo-gu, Goyang 411-706, Republic of Korea.
| | - Miseon Shim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea; Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea; Department of Psychiatry, Inje University, Ilsan-Paik Hospital, Juhwa-ro 170, Ilsanseo-gu, Goyang 411-706, Republic of Korea.
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30
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Samamé C, Szmulewicz AG, Valerio MP, Martino DJ, Strejilevich SA. Are major depression and bipolar disorder neuropsychologically distinct? A meta-analysis of comparative studies. Eur Psychiatry 2016; 39:17-26. [PMID: 27810614 DOI: 10.1016/j.eurpsy.2016.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 06/18/2016] [Accepted: 06/20/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Neuropsychological deficits are present in both major depression and bipolar disorder. So far, however, reports directly comparing these mood disorders with regard to cognitive outcomes have been scant and yielded inconsistent results. This work aims to combine the findings of comparative studies of cognition in major depression and bipolar disorder in order to explore whether these neuropsychiatric conditions present with distinct cognitive features. METHODS The main online databases were extensively searched to retrieve reports assessing neurocognitive functioning in two groups of mood disorder patients, one with major depressive disorder and another with bipolar disorder, both in the same phase of illness. Between-group effect sizes for cognitive variables were obtained from selected studies and pooled by means of meta-analytic procedures. RESULTS During euthymia, a significant overall effect size (Hedges'g=0.64, P<0.001) favoring major depressive disorder was found for verbal memory as assessed with list learning tests, whereas no significant between-group differences were found for the remaining variables analyzed. During depressive episodes, similar cognitive outcomes were observed between groups. CONCLUSION At present, it is not possible to postulate specific neuropsychological profiles for major depression and bipolar disorder in light of available evidence. It remains to be ascertained whether the differences found for verbal memory constitute an expression of distinct underlying mechanisms or whether they are best explained by sample characteristics or differential exposure to variables with a negative impact on cognition.
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Affiliation(s)
- C Samamé
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; School of Psychology, University of Buenos Aires, Buenos Aires, Argentina
| | - A G Szmulewicz
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; Psychiatric Emergencies Hospital Torcuato de Alvear, Buenos Aires, Argentina
| | - M P Valerio
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Psychiatric Emergencies Hospital Torcuato de Alvear, Buenos Aires, Argentina
| | - D J Martino
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - S A Strejilevich
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina.
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31
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Allott K, Fisher CA, Amminger GP, Goodall J, Hetrick S. Characterizing neurocognitive impairment in young people with major depression: state, trait, or scar? Brain Behav 2016; 6:e00527. [PMID: 27781141 PMCID: PMC5064339 DOI: 10.1002/brb3.527] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 04/29/2016] [Accepted: 06/08/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) affects a quarter of adolescents and young adults and is associated with the greatest global burden of disease in this population. There is a growing literature, mostly in adults, showing that significant neurocognitive impairments are common in MDD. It remains unclear whether these impairments are pre-existing trait markers of MDD, state-related impairments that fluctuate with depressive symptoms, or 'scar' impairments that worsen with illness progression. The aim of this study is to provide a conceptual framework for understanding MDD and neurocognitive impairment in adolescence and young adulthood (ages 12-25 years). METHOD Examination of the evidence for neurocognitive deficits as trait, state, and scar features of MDD according to different study designs (family studies, premorbid studies, current depression, remitted depression, and longitudinal studies with repeated assessment) was conducted. RESULTS The few premorbid and family studies conducted in youth provide equivocal evidence for neurocognitive impairments as trait markers of MDD. The presence of state-based neurocognitive impairment remains unclear as evidence comes mostly from cross-sectional studies. There are a limited, but growing number of longitudinal studies with repeated neurocognitive assessment in youth. Studies that examined neurocognition prior to the onset of MDD and with long-term follow-up provide tentative evidence for neurocognitive scarring. CONCLUSION Neurocognitive impairment is a feature of MDD in adolescents and young adults. To better understand the nature, timing, and pattern of impairment, longitudinal studies that examine neurocognition before and after the development of full-threshold MDD, including following recurrence are needed. This knowledge will have important implications for mechanisms, prevention, and treatment of MDD in youth.
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Affiliation(s)
- Kelly Allott
- OrygenThe National Centre of Excellence in Youth Mental Health Parkville Victoria Australia; The Centre for Youth Mental Health The University of Melbourne Parkville Victoria Australia
| | - Caroline A Fisher
- The Melbourne Clinic Richmond Melbourne Australia; Royal Melbourne Hospital Parkville Melbourne Australia
| | - Gunther Paul Amminger
- OrygenThe National Centre of Excellence in Youth Mental Health Parkville Victoria Australia; The Centre for Youth Mental Health The University of Melbourne Parkville Victoria Australia
| | - Joanne Goodall
- Orygen The National Centre of Excellence in Youth Mental Health Parkville Victoria Australia
| | - Sarah Hetrick
- OrygenThe National Centre of Excellence in Youth Mental Health Parkville Victoria Australia; The Centre for Youth Mental Health The University of Melbourne Parkville Victoria Australia
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Rive MM, Koeter MWJ, Veltman DJ, Schene AH, Ruhé HG. Visuospatial planning in unmedicated major depressive disorder and bipolar disorder: distinct and common neural correlates. Psychol Med 2016; 46:2313-2328. [PMID: 27198937 DOI: 10.1017/s0033291716000933] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cognitive impairments are an important feature of both remitted and depressed major depressive disorder (MDD) and bipolar disorder (BD). In particular, deficits in executive functioning may hamper everyday functioning. Identifying the neural substrates of impaired executive functioning would improve our understanding of the pathophysiology underlying these disorders, and may eventually aid in discriminating between MDD and BD, which is often difficult during depression and remission. To date, mostly medicated MDD and BD subjects have been investigated, which may have influenced results. Therefore, we investigated executive functioning in medication-free depressed and remitted MDD and BD subjects. METHOD We used the Tower of London (ToL) visuospatial planning task to assess behavioural performance and blood oxygen-level dependent responses in 35 healthy controls, 21 remitted MDD, 23 remitted BD, 19 depressed MDD and nine depressed BD subjects. RESULTS Visuospatial planning per se was associated with increased frontostriatal activity in depressed BD compared to depressed MDD. In addition, post-hoc analyses indicated that visuospatial planning load was associated with increased parietal activity in depressed compared to remitted subjects, and BD compared to MDD subjects. Task performance did not significantly differ between groups. CONCLUSIONS More severely affected, medication-free mood disorder patients require greater parietal activity to perform in visuospatial planning, which may be compensatory to maintain relatively normal performance. State-dependent frontostriatal hyperactivity during planning may be a specific BD characteristic, providing clues for further characterization of differential pathophysiology in MDD v. BD. This could potentially provide a biomarker to aid in the differentiation of these disorders.
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Affiliation(s)
- M M Rive
- Program for Mood Disorders,Department of Psychiatry,Academic Medical Center,University of Amsterdam,Amsterdam,The Netherlands
| | - M W J Koeter
- Program for Mood Disorders,Department of Psychiatry,Academic Medical Center,University of Amsterdam,Amsterdam,The Netherlands
| | - D J Veltman
- Department of Psychiatry,VU University medical center,Amsterdam,The Netherlands
| | - A H Schene
- Program for Mood Disorders,Department of Psychiatry,Academic Medical Center,University of Amsterdam,Amsterdam,The Netherlands
| | - H G Ruhé
- Program for Mood Disorders,Department of Psychiatry,Academic Medical Center,University of Amsterdam,Amsterdam,The Netherlands
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Hammar Å, Neto E, Clemo L, Hjetland GJ, Hugdahl K, Elliott R. Striatal hypoactivation and cognitive slowing in patients with partially remitted and remitted major depression. Psych J 2016; 5:191-205. [DOI: 10.1002/pchj.134] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 02/26/2016] [Accepted: 04/04/2016] [Indexed: 01/24/2023]
Affiliation(s)
- Åsa Hammar
- Department of Biological and Medical Psychology; University of Bergen; Bergen Norway
- Division of Psychiatry; Haukeland University Hospital; Bergen Norway
- Moodnet Research Group; Haukeland University Hospital; Bergen Norway
| | - Emanuel Neto
- Department of Biological and Medical Psychology; University of Bergen; Bergen Norway
| | - Leila Clemo
- Neuroscience and Psychiatry Department; University of Manchester; Manchester UK
| | - Gunnhild J. Hjetland
- Department of Biological and Medical Psychology; University of Bergen; Bergen Norway
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology; University of Bergen; Bergen Norway
- Division of Psychiatry; Haukeland University Hospital; Bergen Norway
- Department of Radiology; Haukeland University Hospital; Bergen Norway
| | - Rebecca Elliott
- Neuroscience and Psychiatry Department; University of Manchester; Manchester UK
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34
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Li M, Lu S, Wang G, Feng L, Fu B, Zhong N. Emotion, working memory, and cognitive control in patients with first-onset and previously untreated minor depressive disorders. J Int Med Res 2016; 44:529-41. [PMID: 27091861 PMCID: PMC5536703 DOI: 10.1177/0300060516639169] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 02/23/2016] [Indexed: 11/22/2022] Open
Abstract
Objective To explore working memory and the ability to process different emotional stimuli in patients with first-onset and untreated minor (mild or moderate) depression. Methods Patients with first-onset and previously untreated minor depression, and healthy controls, were enrolled. Using a modified Sternberg working memory paradigm to investigate the combined effects of emotional stimuli with working memory, participants were exposed to experimental stimuli comprising pictures that represented positive, neutral and negative emotions. Working memory ability was measured using reaction time and accuracy, and emotion-processing ability was measured using pupil diameter. Results Out of 36 participants (18 patients with minor depression and 18 controls), there were no statistically significant between-group differences in response time and accuracy. Positive stimuli evoked changes in pupil diameter that were significantly smaller in patients with minor depression versus controls, but changes in pupil diameter evoked by negative stimuli were not significantly different between the two groups. Conclusions Healthy subjects showed a stronger emotional response to positive emotional stimuli than patients with first onset and previously untreated minor depression, but there were no differences in response to negative emotions. There were no statistically significant between-group differences in terms of speed of cognitive response, but this may have been due to the relatively small samples sizes assessed. Studies with larger sample populations are required to further investigate these results.
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Affiliation(s)
- Mi Li
- The International WIC Institute, Beijing University of Technology, Beijing, China The Beijing International Collaboration Base on Brain Informatics and Wisdom Services, Beijing, China The Beijing Key Laboratory of MRI and Brain Informatics, Beijing, China
| | - Shengfu Lu
- The International WIC Institute, Beijing University of Technology, Beijing, China The Beijing International Collaboration Base on Brain Informatics and Wisdom Services, Beijing, China The Beijing Key Laboratory of MRI and Brain Informatics, Beijing, China
| | - Gang Wang
- Mood Disorders Center & China Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China Center of Depression, Beijing Institute for Brain Disorders, Beijing, China
| | - Lei Feng
- Mood Disorders Center & China Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China Beijing Key Laboratory for Mental Disorders, Beijing, China
| | - Bingbing Fu
- Mood Disorders Center & China Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Ning Zhong
- The International WIC Institute, Beijing University of Technology, Beijing, China The Beijing International Collaboration Base on Brain Informatics and Wisdom Services, Beijing, China The Beijing Key Laboratory of MRI and Brain Informatics, Beijing, China Department of Life Science and Informatics, Maebashi Institute of Technology, Maebashi City, Japan
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35
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Gale CR, Harris A, Deary IJ. Reaction time and onset of psychological distress: the UK Health and Lifestyle Survey. J Epidemiol Community Health 2016; 70:813-7. [PMID: 26847135 PMCID: PMC4975803 DOI: 10.1136/jech-2015-206479] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 01/24/2016] [Indexed: 11/28/2022]
Abstract
Background Cross-sectional studies have shown that depression is often accompanied by less efficient cognitive function, as indicated by slower speed of information processing. The direction of effect is unclear. We investigated prospectively whether slower processing speed, as indexed by longer simple or choice reaction time, is associated with an increased risk of psychological distress. Methods Participants were 3088 men and women aged 18 and over who had taken part in the UK Health and Lifestyle Survey. Simple and choice reaction time was measured in the baseline survey. Symptoms of psychological distress were assessed at baseline and at the 7-year follow-up survey with the 30-item General Health Questionnaire (GHQ). Results In unadjusted models, a SD slower simple or choice reaction time at baseline was associated with ORs for psychological distress (≥5 on GHQ) at follow-up of 1.14 (1.06 to 1.23; p<0.001) or 1.13 (1.04 to 1.22; p=0.002), respectively. Further adjustment for age, sex, social class, educational attainment, health behaviours, number of chronic physical illnesses present, neuroticism and GHQ score at baseline had only slight attenuating effects on these associations. In fully adjusted models, a SD slower simple or choice reaction time at baseline was associated with ORs for psychological distress of 1.11 (1.02 to 1.21; p=0.017) or 1.11 (1.00 to 1.24; p=0.048), respectively. Conclusions Slower processing speed may be a risk factor for the development of psychological distress. Future studies should explore the extent to which slower processing speed explains previously demonstrated associations between lower intelligence and poorer mental health.
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Affiliation(s)
- Catharine R Gale
- Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Alicia Harris
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Ian J Deary
- Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK Department of Psychology, University of Edinburgh, Edinburgh, UK
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36
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Woo YS, Rosenblat JD, Kakar R, Bahk WM, McIntyre RS. Cognitive Deficits as a Mediator of Poor Occupational Function in Remitted Major Depressive Disorder Patients. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2016; 14:1-16. [PMID: 26792035 PMCID: PMC4730927 DOI: 10.9758/cpn.2016.14.1.1] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/21/2015] [Accepted: 08/26/2015] [Indexed: 01/19/2023]
Abstract
Cognitive deficits in major depressive disorder (MDD) patients have been described in numerous studies. However, few reports have aimed to describe cognitive deficits in the remitted state of MDD and the mediational effect of cognitive deficits on occupational outcome. The aim of the current review is to synthesize the literature on the mediating and moderating effects of specific domains of cognition on occupational impairment among people with remitted MDD. In addition, predictors of cognitive deficits found to be vocationally important will be examined. Upon examination of the extant literature, attention, executive function and verbal memory are areas of consistent impairment in remitted MDD patients. Cognitive domains shown to have considerable impact on vocational functioning include deficits in memory, attention, learning and executive function. Factors that adversely affect cognitive function related to occupational accommodation include higher age, late age at onset, residual depressive symptoms, history of melancholic/psychotic depression, and physical/psychiatric comorbidity, whereas higher levels of education showed a protective effect against cognitive deficit. Cognitive deficits are a principal mediator of occupational impairment in remitted MDD patients. Therapeutic interventions specifically targeting cognitive deficits in MDD are needed, even in the remitted state, to improve functional recovery, especially in patients who have a higher risk of cognitive deficit.
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Affiliation(s)
- Young Sup Woo
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.,Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto
| | - Ron Kakar
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto
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Feeling Without Thinking? Anger Provocation Task Predicts Impaired Cognitive Performance in Bipolar Disorder but not Major Depression or Healthy Adults. COGNITIVE THERAPY AND RESEARCH 2015. [DOI: 10.1007/s10608-015-9734-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Bangasser DA, Kawasumi Y. Cognitive disruptions in stress-related psychiatric disorders: A role for corticotropin releasing factor (CRF). Horm Behav 2015; 76:125-35. [PMID: 25888454 PMCID: PMC4605842 DOI: 10.1016/j.yhbeh.2015.04.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 04/06/2015] [Accepted: 04/07/2015] [Indexed: 12/28/2022]
Abstract
This article is part of a Special Issue "SBN 2014". Stress is a potential etiology contributor to both post-traumatic stress disorders (PTSD) and major depression. One stress-related neuropeptide that is hypersecreted in these disorders is corticotropin releasing factor (CRF). Dysregulation of CRF has long been linked to the emotion and mood symptoms that characterize PTSD and depression. However, the idea that CRF also mediates the cognitive disruptions observed in patients with these disorders has received less attention. Here we review literature indicating that CRF can alter cognitive functions. Detailed are anatomical studies revealing that CRF is poised to modulate regions required for learning and memory. We also describe preclinical behavioral studies that demonstrate CRF's ability to alter fear conditioning, impair memory consolidation, and alter a number of executive functions, including attention and cognitive flexibility. The implications of these findings for the etiology and treatment of the cognitive impairments observed in stress-related psychiatric disorders are described.
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Affiliation(s)
- Debra A Bangasser
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA, USA.
| | - Yushi Kawasumi
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA, USA
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Hunt SA, Kay-Lambkin FJ, Baker AL, Michie PT. Systematic review of neurocognition in people with co-occurring alcohol misuse and depression. J Affect Disord 2015; 179:51-64. [PMID: 25845750 DOI: 10.1016/j.jad.2015.03.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 03/06/2015] [Accepted: 03/12/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Alcohol misuse and depression represent two major social and health problems globally. These conditions commonly co-occur and both are associated with significant cognitive impairment. Despite this, few studies have examined the impact on cognitive functioning of co-occurring alcohol misuse and depression. This study aims to critically review findings from peer-reviewed published articles examining neuropsychological test performance among samples of people with co-occurring alcohol misuse and depression. METHOD A comprehensive literature search was conducted, yielding six studies reporting neuropsychological profiles of people with co-occurring alcohol misuse and depression. Results comparing cognitive functioning of people with this comorbidity to those with alcohol misuse alone, depression alone, healthy controls and published norms were examined as well as those describing the correlation between depressive symptoms and cognitive functioning in people with alcohol use disorders. RESULTS In the majority of instances, the comorbid groups did not differ significantly from those with depression only or alcohol misuse only, nor from healthy controls or published norms. In the cases where a difference in neuropsychological test scores between groups was found, it was not consistently identified across studies. However, visual memory was identified in two studies as being impaired in comorbid samples and is worthy of inclusion in future studies. LIMITATIONS Due to the small number of included studies and the large variation in inclusion criteria as well as differing assessment tools and methodologies between studies, the review did not include a quantitative synthesis. CONCLUSIONS Research into cognitive deficits among people with singly occurring versus co-occurring alcohol misuse and depression is accumulating. Evidence suggests that the neuropsychological performance among samples with this comorbidity is generally not severely impaired and is unlikely to preclude benefit from treatment.
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Affiliation(s)
- Sally A Hunt
- Centre for Translational Neuroscience and Mental Health, University of Newcastle, Australia; NHMRC Centre of Research Excellence in Mental Health and Substance Use, Australia.
| | - Frances J Kay-Lambkin
- Centre for Translational Neuroscience and Mental Health, University of Newcastle, Australia; NHMRC Centre of Research Excellence in Mental Health and Substance Use, Australia; National Drug and Alcohol Research Centre, University of New South Wales, Australia.
| | - Amanda L Baker
- Centre for Translational Neuroscience and Mental Health, University of Newcastle, Australia; NHMRC Centre of Research Excellence in Mental Health and Substance Use, Australia.
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Mahableshwarkar AR, Zajecka J, Jacobson W, Chen Y, Keefe RSE. A Randomized, Placebo-Controlled, Active-Reference, Double-Blind, Flexible-Dose Study of the Efficacy of Vortioxetine on Cognitive Function in Major Depressive Disorder. Neuropsychopharmacology 2015; 40:2025-37. [PMID: 25687662 PMCID: PMC4839526 DOI: 10.1038/npp.2015.52] [Citation(s) in RCA: 199] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 01/26/2015] [Accepted: 02/10/2015] [Indexed: 01/05/2023]
Abstract
This multicenter, randomized, double-blind, placebo-controlled, active-referenced (duloxetine 60 mg), parallel-group study evaluated the short-term efficacy and safety of vortioxetine (10-20 mg) on cognitive function in adults (aged 18-65 years) diagnosed with major depressive disorder (MDD) who self-reported cognitive dysfunction. Efficacy was evaluated using ANCOVA for the change from baseline to week 8 in the digit symbol substitution test (DSST)-number of correct symbols as the prespecified primary end point. The patient-reported perceived deficits questionnaire (PDQ) and physician-assessed clinical global impression (CGI) were analyzed in a prespecified hierarchical testing sequence as key secondary end points. Additional predefined end points included the objective performance-based University of San Diego performance-based skills assessment (UPSA) (ANCOVA) to measure functionality, MADRS (MMRM) to assess efficacy in depression, and a prespecified multiple regression analysis (path analysis) to calculate direct vs indirect effects of vortioxetine on cognitive function. Safety and tolerability were assessed at all visits. Vortioxetine was statistically superior to placebo on the DSST (P < 0.05), PDQ (P < 0.01), CGI-I (P < 0.001), MADRS (P < 0.05), and UPSA (P < 0.001). Path analysis indicated that vortioxetine's cognitive benefit was primarily a direct treatment effect rather than due to alleviation of depressive symptoms. Duloxetine was not significantly different from placebo on the DSST or UPSA, but was superior to placebo on the PDQ, CGI-I, and MADRS. Common adverse events (incidence ⩾ 5%) for vortioxetine were nausea, headache, and diarrhea. In this study of MDD adults who self-reported cognitive dysfunction, vortioxetine significantly improved cognitive function, depression, and functionality and was generally well tolerated.
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Affiliation(s)
| | - John Zajecka
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA
| | | | - Yinzhong Chen
- Takeda Development Center Americas, Deerfield, IL, USA
| | - Richard SE Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA,Department of Psychiatry and Behavioral Science, Duke University Medical Center, Box 3270 Medical Center, Durham, NC 27710, USA, Tel: +1 919 684 4306, Fax: +1 919 684 2632, E-mail:
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Demant KM, Vinberg M, Kessing LV, Miskowiak KW. Effects of Short-Term Cognitive Remediation on Cognitive Dysfunction in Partially or Fully Remitted Individuals with Bipolar Disorder: Results of a Randomised Controlled Trial. PLoS One 2015; 10:e0127955. [PMID: 26070195 PMCID: PMC4467086 DOI: 10.1371/journal.pone.0127955] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 04/20/2015] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Cognitive dysfunction is common in bipolar disorder (BD) but is not sufficiently addressed by current treatments. Cognitive remediation (CR) may improve cognitive function in schizophrenia but no randomised controlled trial has investigated this intervention in BD. The present study aimed to investigate the effects of CR on persistent cognitive dysfunction in BD. METHOD Patients with BD in partial remission with cognitive complaints were randomised to 12 weeks group-based CR (n=23) or standard treatment (ST) (n=23). Outcomes were improved verbal memory (primary), sustained attention, executive and psychosocial function (secondary) and additional measures of cognitive and psychosocial function (tertiary). Participants were assessed at baseline and weeks 12 and 26. RESULTS Of the 46 randomised participants five dropped out and one was excluded after baseline. CR (n=18) had no effect on primary or secondary measures of cognitive or psychosocial function compared with ST (n=22). However, CR improved subjective sharpness at week 12, and quality of life and verbal fluency at week 26 follow-up (tertiary outcomes). Although the trial turned out to have suboptimal statistical power for the primary outcome analysis, calculation of the 95% confidence interval showed that it was highly unlikely that an increase in sample size would have rendered any beneficial effects of CR vs. ST on the verbal memory. CONCLUSIONS Short-term group-based CR did not seem to improve overall cognitive or psychosocial function in individuals with BD in full or partial remission. The present findings suggest that that longer-term, more intensive and individualised CR may be necessary to improve cognition in BD. TRIAL REGISTRATION ClinicalTrials.gov NCT01457235.
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Affiliation(s)
- Kirsa M. Demant
- Copenhagen Affective Disorder Clinic, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Maj Vinberg
- Copenhagen Affective Disorder Clinic, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lars V. Kessing
- Copenhagen Affective Disorder Clinic, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Kamilla W. Miskowiak
- Copenhagen Affective Disorder Clinic, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Chen MH, Li CT, Tsai CF, Lin WC, Chang WH, Chen TJ, Pan TL, Su TP, Bai YM. Risk of Subsequent Dementia Among Patients With Bipolar Disorder or Major Depression: A Nationwide Longitudinal Study in Taiwan. J Am Med Dir Assoc 2015; 16:504-8. [DOI: 10.1016/j.jamda.2015.01.084] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 01/14/2015] [Indexed: 10/23/2022]
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Reaction time in adolescence, cumulative allostatic load, and symptoms of anxiety and depression in adulthood: the West of Scotland Twenty-07 Study. Psychosom Med 2015; 77:493-505. [PMID: 25984823 PMCID: PMC4459883 DOI: 10.1097/psy.0000000000000189] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the relation between reaction time in adolescence and subsequent symptoms of anxiety and depression and investigate the mediating role of sociodemographic measures, health behaviors, and allostatic load. METHODS Participants were 705 members of the West of Scotland Twenty-07 Study. Choice reaction time was measured at age 16. At age 36 years, anxiety and depression were assessed with the 12-item General Health Questionnaire (GHQ) and the Hospital Anxiety and Depression Scale (HADS), and measurements were made of blood pressure, pulse rate, waist-to-hip ratio, and total and high-density lipoprotein cholesterol, C-reactive protein, albumin, and glycosolated hemoglobin from which allostatic load was calculated. RESULTS In unadjusted models, longer choice reaction time at age 16 years was positively associated with symptoms of anxiety and depression at age 36 years: for a standard deviation increment in choice reaction time, regression coefficients (95% confidence intervals) for logged GHQ score, and square-root-transformed HADS anxiety and depression scores were 0.048 (0.016-0.080), 0.064 (0.009-0.118), and 0.097 (0.032-0.163) respectively. Adjustment for sex, parental social class, GHQ score at age 16 years, health behaviors at age 36 years and allostatic load had little attenuating effect on the association between reaction time and GHQ score, but weakened those between reaction time and the HADS subscales. Part of the effect of reaction time on depression was mediated through allostatic load; this mediating role was of borderline significance after adjustment. CONCLUSIONS Adolescents with slower processing speed may be at increased risk for anxiety and depression. Cumulative allostatic load may partially mediate the relation between processing speed and depression.
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Bai YM, Su TP, Li CT, Tsai SJ, Chen MH, Tu PC, Chiou WF. Comparison of pro-inflammatory cytokines among patients with bipolar disorder and unipolar depression and normal controls. Bipolar Disord 2015; 17:269-77. [PMID: 25257835 DOI: 10.1111/bdi.12259] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 06/27/2014] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Research evidence has shown that bipolar disorder (BD) and unipolar depression (UD) are both related to inflammatory dysregulation, but few studies have compared the levels of cytokines between these two disorders. METHODS Study subjects were age- and gender-matched outpatients with BD or UD and normal controls (NC). Severities of depression and mania symptoms were assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Young Mania Rating Scale (YMRS). Pro-inflammatory cytokines, including soluble interleukin-6 receptor (sIL-6R), soluble interleukin-2 receptor (sIL-2R), C-reactive protein (CRP), soluble tumor necrosis factor receptor type 1 (sTNF-R1), soluble p-selectin receptor (sP-selectin), and monocyte chemotactic protein-1 (MCP-1), were assessed in all subjects by enzyme-linked immunosorbent assays. RESULTS In all, 130 patients with BD, 149 patients with UD, and 130 NC were enrolled in the study; 67.6% were female and the average age was mean ± standard deviation (SD) 43.5 ± 11.8 years. The BD group had a significantly higher smoking rate, more medical comorbidity, higher body mass index (BMI), and higher levels of sIL-2R, sIL-6R, CRP, sTNF-R1, and MCP-1 (all p < 0.01) than the UD and NC groups. When the remitted patients with BD (YMRS scores ≤ 12) were compared with the patients with UD, controlling for age, MADRS score, smoking, medical comorbidity, and BMI in the regression model, the results showed that the BD group had significantly higher levels of sIL-6R (p < 0.001), CRP (p = 0.045), sTNF-R1 (p = 0.036), and MCP-1 (p = 0.001) than the UD group. CONCLUSIONS Higher levels of sIL-6R, CRP, sTNF-R1, and MCP-1 were noted in BD than in UD. These results may suggest a more severe inflammatory dysregulation in BD. Further studies are required to investigate whether these cytokines could be biomarkers for affective disorders.
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Affiliation(s)
- Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital; Department of Psychiatry, College of Medicine, National Yang-Ming University
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Ryan KA, Dawson EL, Kassel MT, Weldon AL, Marshall DF, Meyers KK, Gabriel LB, Vederman AC, Weisenbach SL, McInnis MG, Zubieta JK, Langenecker SA. Shared dimensions of performance and activation dysfunction in cognitive control in females with mood disorders. Brain 2015; 138:1424-34. [PMID: 25818869 DOI: 10.1093/brain/awv070] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 01/16/2015] [Indexed: 11/12/2022] Open
Abstract
Major depressive disorder and bipolar disorder share symptoms that may reflect core mood disorder features. This has led to the pursuit of intermediate phenotypes and a dimensional approach to understand neurobiological disruptions in mood disorders. Executive dysfunction, including cognitive control, may represent a promising intermediate phenotype across major depressive disorder and bipolar disorder. This study examined dimensions of cognitive control in women with major depressive disorder or bipolar disorder in comparison to healthy control subjects using two separate, consecutive experiments. For Experiment 1, participants completed a behavioural cognitive control task (healthy controls = 150, major depressive disorder = 260, bipolar disorder = 202; age range 17-84 years). A sample of those participants (healthy controls = 17, major depressive disorder = 19, and bipolar disorder = 16) completed a similar cognitive control task in an event-related design functional magnetic resonance imaging protocol for Experiment 2. Results for Experiment 1 showed greater impairments on the cognitive control task in patients with mood disorders relative to healthy controls (P < 0.001), with more of those in the mood disorder group falling into the 'impaired' range when using clinical cut-offs (<5th percentile). Experiment 2 revealed only a few areas of shared activation differences in mood disorder greater than healthy controls. Activation analyses using performance as a regressor, irrespective of diagnosis, revealed within and extra-network areas that were more active in poor performers. In summary, performance and activation during cognitive control tasks may represent an intermediate phenotype for mood disorders. However, cognitive control dysfunction is not uniform across women with mood disorders, and activation is linked to performance more so than disease. These findings support subtype and dimensional approaches to understanding risk and expression of mood disorders and are a promising area of inquiry, in line with the Research Domain Criteria initiative of NIMH.
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Affiliation(s)
- Kelly A Ryan
- University of Michigan Medical School, Department of Psychiatry, 2101 Commonwealth Blvd, Suite C, Ann Arbor, MI 48105, USA‡ Present address: Ohio State University, Department of Psychiatry, Columbus, OH, USAδ Present address: Now in private practice in Portland, OR, USA† Present address: University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - Erica L Dawson
- ‡ Present address: Ohio State University, Department of Psychiatry, Columbus, OH, USA
| | - Michelle T Kassel
- University of Michigan Medical School, Department of Psychiatry, 2101 Commonwealth Blvd, Suite C, Ann Arbor, MI 48105, USA‡ Present address: Ohio State University, Department of Psychiatry, Columbus, OH, USAδ Present address: Now in private practice in Portland, OR, USA† Present address: University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - Anne L Weldon
- University of Michigan Medical School, Department of Psychiatry, 2101 Commonwealth Blvd, Suite C, Ann Arbor, MI 48105, USA‡ Present address: Ohio State University, Department of Psychiatry, Columbus, OH, USAδ Present address: Now in private practice in Portland, OR, USA† Present address: University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - David F Marshall
- University of Michigan Medical School, Department of Psychiatry, 2101 Commonwealth Blvd, Suite C, Ann Arbor, MI 48105, USA‡ Present address: Ohio State University, Department of Psychiatry, Columbus, OH, USAδ Present address: Now in private practice in Portland, OR, USA† Present address: University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - Kortni K Meyers
- University of Michigan Medical School, Department of Psychiatry, 2101 Commonwealth Blvd, Suite C, Ann Arbor, MI 48105, USA‡ Present address: Ohio State University, Department of Psychiatry, Columbus, OH, USAδ Present address: Now in private practice in Portland, OR, USA† Present address: University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - Laura B Gabriel
- University of Michigan Medical School, Department of Psychiatry, 2101 Commonwealth Blvd, Suite C, Ann Arbor, MI 48105, USA‡ Present address: Ohio State University, Department of Psychiatry, Columbus, OH, USAδ Present address: Now in private practice in Portland, OR, USA† Present address: University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | | | - Sara L Weisenbach
- † Present address: University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - Melvin G McInnis
- University of Michigan Medical School, Department of Psychiatry, 2101 Commonwealth Blvd, Suite C, Ann Arbor, MI 48105, USA‡ Present address: Ohio State University, Department of Psychiatry, Columbus, OH, USAδ Present address: Now in private practice in Portland, OR, USA† Present address: University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - Jon-Kar Zubieta
- University of Michigan Medical School, Department of Psychiatry, 2101 Commonwealth Blvd, Suite C, Ann Arbor, MI 48105, USA‡ Present address: Ohio State University, Department of Psychiatry, Columbus, OH, USAδ Present address: Now in private practice in Portland, OR, USA† Present address: University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - Scott A Langenecker
- ‡ Present address: Ohio State University, Department of Psychiatry, Columbus, OH, USA
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Lin K, Xu G, Lu W, Ouyang H, Dang Y, Guo Y, So KF, Lee TM. Neuropsychological performance of patients with soft bipolar spectrum disorders. Bipolar Disord 2015; 17:194-204. [PMID: 25048414 DOI: 10.1111/bdi.12236] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 05/09/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVES There is much evidence that shows that a substantial number of individuals with DSM-IV-defined unipolar depression (UP) manifest hypomanic sub-syndrome and bipolar diathesis. Other definitions have conceptualized the term soft bipolar spectrum (SBP) for these individuals. Little is known about the cognitive profiles of individuals with SBP. We hypothesized that they are representative of individuals with bipolar II disorder and are different from that of 'strict' UP. METHODS Consecutive referrals suffering major depressive episodes were categorically assigned to groups of either bipolar I disorder (n = 98), bipolar II disorder (n = 138), or UP (n = 300). Based on the SBP criteria by Akiskal and Pinto (17), patients with UP were subdivided into 81 SBP and 219 strict UP. We administered self- and clinician-administered scales to evaluate affective temperaments, and neuropsychological tests to assess seven cognitive domains. RESULTS Patients with SBP performed significantly better than strict UP patients in the domains of processing speed (p = 0.002), visual-spatial memory (p = 0.017), and verbal working memory (p = 0.017). Compared to patients with bipolar I disorder, patients with SBP were significantly better in set shifting (p < 0.001) and visual-spatial memory (p = 0.042). Patients with SBP performed similarly to patients with bipolar II disorder in all of the cognitive domains tested (p > 0.05). There was a group × cognitive domain interaction effect between bipolar I disorder, bipolar II disorder, SBP, and strict UP groups [Pillai's F = 2.231, df = (18,1437), p = 0.002]. CONCLUSIONS Our data suggest that patients with SBP differ from patients with UP not only in external validators (e.g., family history of bipolar disorder) and hypomanic symptoms, but also in neuropsychological performance and that the profiles of cognitive functioning were different across bipolar I disorder and 'bipolar II spectrum' that subsumes bipolar II disorder and SBP.
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Affiliation(s)
- Kangguang Lin
- Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong; Department of Psychiatry, Guangzhou Psychiatric Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou; Laboratory of Cognitive Affective Neuroscience, The University of Hong Kong
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Roca M, Monzón S, Vives M, López-Navarro E, Garcia-Toro M, Vicens C, Garcia-Campayo J, Harrison J, Gili M. Cognitive function after clinical remission in patients with melancholic and non-melancholic depression: a 6 month follow-up study. J Affect Disord 2015; 171:85-92. [PMID: 25299439 DOI: 10.1016/j.jad.2014.09.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 09/02/2014] [Accepted: 09/04/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Cognitive symptoms are core symptoms with an impact on functioning in depression. Remission is considered as the main objective of the management and treatment of depression. This study was aimed to compare cognitive performance between melancholic (MelD) and non-melancholic depression (NMelD) and to determine whether these cognitive alterations remain after clinical remission. METHODS We performed a 6 month follow-up study of 88 melancholic and non-melancholic depressive patients. Sociodemographic and clinical characteristics were recorded. Depression was examined using the Hamilton Depression Rating Scale and the CORE Index for Melancholia. Cognitive performance was assessed with the Trail Making Test (TMT), the Digit Span subtest of the WAIS-III, Stroop Colour Word Test (SCWT), the Tower of London (TOL DX), the Controlled Oral Word Association Test (FAS), Semantic Verbal Fluency and Finger Tapping Test (FTT). RESULTS MelD patients show worse performance than N-MelD at baseline, with significant differences at Digit Span subtest of WAIS Part I and Part II, SCWT Part I and Part II, TOL DX, Total Problem Solving, Total Execution Time and FTT- Preferred hand. Cognitive impairment remains at six months follow-up after clinical remission in MelD. In the comparison between remitted and non-remitted patients, cognitive impairment in Trail Making Test Part B and Verbal and Semantic Fluency (Animals) remains after clinical remission in MelD group but not in non-melancholic patients. LIMITATIONS The use of psychopharmacological treatment and the small sample of melancholic patients. CONCLUSIONS Patients with MelD do not improve cognitive performance despite clinical remission compared with remitted NMelD patients. The persistence of some cognitive dysfunctions in MelD remitted patients could represent a trait marker of a different depressive subtype and not be secondary to disease severity.
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Affiliation(s)
- Miquel Roca
- Institut Universitari d׳Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain; Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Spain.
| | - Saray Monzón
- Institut Universitari d׳Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain
| | - Margalida Vives
- Institut Universitari d׳Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain; Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Spain
| | - Emilio López-Navarro
- Institut Universitari d׳Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain; Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Spain
| | - Mauro Garcia-Toro
- Institut Universitari d׳Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain; Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Spain
| | - Caterina Vicens
- Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Spain; Centro de Salud Son Serra-La Vileta, Ib-Salut., Baleares, Spain
| | - Javier Garcia-Campayo
- Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Spain; Department of Psychiatry, Miguel Servet Hospital, University of Zaragoza, Zaragoza, Spain
| | - John Harrison
- Department of Medicine, Imperial College, London, UK
| | - Margalida Gili
- Institut Universitari d׳Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain; Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Spain
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Tsitsipa E, Fountoulakis KN. The neurocognitive functioning in bipolar disorder: a systematic review of data. Ann Gen Psychiatry 2015; 14:42. [PMID: 26628905 PMCID: PMC4666163 DOI: 10.1186/s12991-015-0081-z] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 11/18/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND During the last decades, there have been many different opinions concerning the neurocognitive function in Bipolar disorder (BD). The aim of the current study was to perform a systematic review of the literature and to synthesize the data in a comprehensive picture of the neurocognitive dysfunction in BD. METHODS Papers were located with searches in PubMed/MEDLINE, through June 1st 2015. The review followed a modified version of the recommendations of the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses statement. RESULTS The initial search returned 110,403 papers. After the deletion of duplicates, 11,771 papers remained for further evaluation. Eventually, 250 were included in the analysis. CONCLUSION The current review supports the presence of a neurocognitive deficit in BD, in almost all neurocognitive domains. This deficit is qualitative similar to that observed in schizophrenia but it is less severe. There are no differences between BD subtypes. Its origin is unclear. It seems it is an enduring component and represents a core primary characteristic of the illness, rather than being secondary to the mood state or medication. This core deficit is confounded (either increased or attenuated) by the disease phase, specific personal characteristics of the patients (age, gender, education, etc.), current symptomatology and its treatment (especially psychotic features) and long-term course and long-term exposure to medication, psychiatric and somatic comorbidity and alcohol and/or substance abuse.
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Affiliation(s)
| | - Konstantinos N Fountoulakis
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos street (1st Parodos, Ampelonon str.) 55536 Pournari Pylaia, Thessaloniki, Greece
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Gonda X, Pompili M, Serafini G, Carvalho AF, Rihmer Z, Dome P. The role of cognitive dysfunction in the symptoms and remission from depression. Ann Gen Psychiatry 2015; 14:27. [PMID: 26396586 PMCID: PMC4578787 DOI: 10.1186/s12991-015-0068-9] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 09/14/2015] [Indexed: 11/10/2022] Open
Abstract
The disability and burden associated with major depression comes only in part from its affective symptoms; cognitive dysfunctions associated with depression also play a crucial role. Furthermore, these cognitive impairments during depression are manifold and multilevel affecting elementary and more complex cognitive processes equally. Several models from different directions tried to evaluate, conceptualize and understand the depth and magnitude of cognitive dysfunctions in depression and their bidirectional interactions with other types of depressive symptomatology including mood symptoms. In the current review, we briefly overview different types of cognitive symptoms and deficits related to major depression including hot and cold as well as trait- and state-like cognitive alterations and we also describe current knowledge related to the impact of cognitive impairments on the course and outcomes of depression including remission, residual symptoms, function, and response to treatment. We also emphasize shortcomings of currently available treatments for depression in sufficiently improving cognitive dysfunctions and point out the need for newer pharmacological approaches especially in cooperation with psychotherapeutic interventions.
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Affiliation(s)
- Xenia Gonda
- Department of Clinical and Theoretical Mental Health, Faculty of Medicine, Semmelweis University, Kutvolgyi ut 4., Budapest, 1125 Hungary ; Laboratory for Suicide Research and Prevention, National Institute of Psychiatry and Addictions, Budapest, Hungary ; MTA-SE Neuropsychopharmacology and Neurochemistry Research Group of Semmelweis Univeristy and the Hungarian Academy of Sciences, Budapest, Hungary
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs Sant'Andrea Hospital Sapienza University of Roma, Rome, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, IRCCS San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Andre F Carvalho
- Translational Psychiatry Research Group, Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE Brazil
| | - Zoltan Rihmer
- Department of Clinical and Theoretical Mental Health, Faculty of Medicine, Semmelweis University, Kutvolgyi ut 4., Budapest, 1125 Hungary ; Laboratory for Suicide Research and Prevention, National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Peter Dome
- Department of Clinical and Theoretical Mental Health, Faculty of Medicine, Semmelweis University, Kutvolgyi ut 4., Budapest, 1125 Hungary ; Laboratory for Suicide Research and Prevention, National Institute of Psychiatry and Addictions, Budapest, Hungary
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Frydecka D, Eissa AM, Hewedi DH, Ali M, Drapała J, Misiak B, Kłosińska E, Phillips JR, Moustafa AA. Impairments of working memory in schizophrenia and bipolar disorder: the effect of history of psychotic symptoms and different aspects of cognitive task demands. Front Behav Neurosci 2014; 8:416. [PMID: 25506320 PMCID: PMC4246891 DOI: 10.3389/fnbeh.2014.00416] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 11/13/2014] [Indexed: 11/13/2022] Open
Abstract
Comparisons of cognitive impairments between schizophrenia (SZ) and bipolar disorder (BPD) have produced mixed results. We applied different working memory (WM) measures (Digit Span Forward and Backward, Short-delay and Long-delay CPT-AX, N-back) to patients with SZ (n = 23), psychotic BPD (n = 19) and non-psychotic BPD (n = 24), as well as to healthy controls (HC) (n = 18) in order to compare the level of WM impairments across the groups. With respect to the less demanding WM measures (Digit Span Forward and Backward, Short-delay CPT-AX), there were no between group differences in cognitive performance; however, with respect to the more demanding WM measures (Long-delay CPT-AX, N-back), we observed that the groups with psychosis (SZ, psychotic BPD) did not differ from one another, but performed poorer than the group without a history of psychosis (non-psychotic BPD). A history of psychotic symptoms may influence cognitive performance with respect to WM delay and load effects as measured by Long-delay CPT-AX and N-back tests, respectively. We observed a positive correlation of WM performance with antipsychotic treatment and a negative correlation with depressive symptoms in BPD and with negative symptoms in SZ subgroup. Our study suggests that WM dysfunctions are more closely related to a history of psychosis than to the diagnostic categories of SZ and BPD described by psychiatric classification systems.
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Affiliation(s)
- Dorota Frydecka
- Department and Clinic of Psychiatry, Wroclaw Medical University Wroclaw, Poland
| | - Abeer M Eissa
- Faculty of Medicine, Psychogeriatric Research Center, Institute of Psychiatry, Ain Shams University Cairo, Egypt
| | - Doaa H Hewedi
- Faculty of Medicine, Psychogeriatric Research Center, Institute of Psychiatry, Ain Shams University Cairo, Egypt
| | - Manal Ali
- Faculty of Medicine, Psychogeriatric Research Center, Institute of Psychiatry, Ain Shams University Cairo, Egypt
| | - Jarosław Drapała
- Institute of Computer Science, Wroclaw University of Technology Wroclaw, Poland
| | - Błażej Misiak
- Department and Clinic of Psychiatry, Wroclaw Medical University Wroclaw, Poland ; Department of Genetics, Wroclaw Medical University Wroclaw, Poland
| | - Ewa Kłosińska
- Department and Clinic of Psychiatry, Wroclaw Medical University Wroclaw, Poland
| | - Joseph R Phillips
- School of Social Sciences and Psychology, Marcs Institute for Brain and Behaviour, University of Western Sydney Sydney, NSW, Australia
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Marcs Institute for Brain and Behaviour, University of Western Sydney Sydney, NSW, Australia
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