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Sergio J, Siedlecki KL. Which variables moderate the relationship between depressive symptoms and global neurocognition across adulthood? NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:145-173. [PMID: 36268987 DOI: 10.1080/13825585.2022.2131714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 09/21/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
The current study examined moderators of the relationship between depressive symptoms and global neurocognition in a large non-clinical community-dwelling sample spanning adulthood. Participants comprised 5,430 individuals between the ages of 18-99 years drawn from the Virginia Cognitive Aging Project. Depressive symptoms were measured via the Center for Epidemiologic Studies-Depression scale and neurocognition was operationalized as a composite variable comprising episodic memory, spatial visualization, processing speed, and reasoning tasks. Moderator variables included physical activity, cognitive activity, education, emotional stability, and openness. Hierarchical regressions were used to examine the influence of depressive symptoms and the moderators on neurocognition. Depressive symptoms significantly predicted neurocognition. Cognitive activity, years of education, and emotional stability moderated the depression-neurocognition relationship by buffering the impact of depressive symptoms on neurocognition. Cognitive activity engagement and level of education may function as a protective influence on those with higher levels of depressive symptoms, while emotional stability may be protective for individuals with lower levels of depressive symptoms. No differences in moderation were found across three age groups representing younger, middle, and older adults. Post-hoc analyses showed years of education and openness as moderators in a subsample excluding individuals with potentially clinically meaningful levels of depressive symptoms.
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Affiliation(s)
- Jordan Sergio
- Department of Psychology, Fordham University, New York, NY, USA
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Zavaliangos-Petropulu A, McClintock SM, Joshi SH, Taraku B, Al-Sharif NB, Espinoza RT, Narr KL. Hippocampal subfield volumes in treatment resistant depression and serial ketamine treatment. Front Psychiatry 2023; 14:1227879. [PMID: 37876623 PMCID: PMC10590913 DOI: 10.3389/fpsyt.2023.1227879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/11/2023] [Indexed: 10/26/2023] Open
Abstract
Introduction Subanesthetic ketamine is a rapidly acting antidepressant that has also been found to improve neurocognitive performance in adult patients with treatment resistant depression (TRD). Provisional evidence suggests that ketamine may induce change in hippocampal volume and that larger pre-treatment volumes might be related to positive clinical outcomes. Here, we examine the effects of serial ketamine treatment on hippocampal subfield volumes and relationships between pre-treatment subfield volumes and changes in depressive symptoms and neurocognitive performance. Methods Patients with TRD (N = 66; 31M/35F; age = 39.5 ± 11.1 years) received four ketamine infusions (0.5 mg/kg) over 2 weeks. Structural MRI scans, the National Institutes of Health Toolbox (NIHT) Cognition Battery, and Hamilton Depression Rating Scale (HDRS) were collected at baseline, 24 h after the first and fourth ketamine infusion, and 5 weeks post-treatment. The same data was collected for 32 age and sex matched healthy controls (HC; 17M/15F; age = 35.03 ± 12.2 years) at one timepoint. Subfield (CA1/CA3/CA4/subiculum/molecular layer/GC-ML-DG) volumes corrected for whole hippocampal volume were compared across time, between treatment remitters/non-remitters, and patients and HCs using linear regression models. Relationships between pre-treatment subfield volumes and clinical and cognitive outcomes were also tested. All analyses included Bonferroni correction. Results Patients had smaller pre-treatment left CA4 (p = 0.004) and GC.ML.DG (p = 0.004) volumes compared to HC, but subfield volumes remained stable following ketamine treatment (all p > 0.05). Pre-treatment or change in hippocampal subfield volumes over time showed no variation by remission status nor correlated with depressive symptoms (p > 0.05). Pre-treatment left CA4 was negatively correlated with improved processing speed after single (p = 0.0003) and serial ketamine infusion (p = 0.005). Left GC.ML.DG also negatively correlated with improved processing speed after single infusion (p = 0.001). Right pre-treatment CA3 positively correlated with changes in list sorting working memory at follow-up (p = 0.0007). Discussion These results provide new evidence to suggest that hippocampal subfield volumes at baseline may present a biomarker for neurocognitive improvement following ketamine treatment in TRD. In contrast, pre-treatment subfield volumes and changes in subfield volumes showed negligible relationships with ketamine-related improvements in depressive symptoms.
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Affiliation(s)
- Artemis Zavaliangos-Petropulu
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
| | - Shawn M. McClintock
- Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States
| | - Shantanu H. Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
| | - Brandon Taraku
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
| | - Noor B. Al-Sharif
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
| | - Randall T. Espinoza
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
| | - Katherine L. Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
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Lan X, Wang C, Zhang F, Liu H, Li W, Ye Y, Hu Z, Mai S, Ning Y, Zhou Y. Short-term cognitive effects of repeated-dose esketamine in adolescents with major depressive disorder and suicidal ideation: a randomized controlled trial. Child Adolesc Psychiatry Ment Health 2023; 17:108. [PMID: 37710297 PMCID: PMC10503003 DOI: 10.1186/s13034-023-00647-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/12/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Ketamine and its enantiomer have rapid and robust effects on depressive symptom and suicidal ideation. Little is known about their cognitive effects in adolescents. We aimed to evaluate the short-term effect of esketamine on cognition in adolescents with major depressive disorder (MDD) and suicidal ideation. METHOD In this randomized-controlled trial, 51 participants aged 13-18 with MDD and suicidal ideation received three intravenous infusions of either esketamine (0.25 mg/kg) or midazolam (0.02 mg/kg). Four dimensions of the MATRICS Consensus Cognitive Battery (MCCB), including processing speed, working memory, verbal learning and visual learning, were assessed at Days 0, 6 and 12. RESULTS In the linear mixed model, a significant time main effect (F = 12.803, P < 0.001), drug main effect (F = 6.607, P = 0.013), and interaction effect (F = 3.315, P = 0.041) was found in processing speed. Other dimensions including working memory and verbal learning showed significant time main effect (all P < 0.05), but no significant drug or interaction effect (all P > 0.05). Esketamine group showed improvement in processing speed from baseline to Days 6 and 12, and working memory from baseline to Day 12 (all P < 0.05). The generalized estimation equation showed no significant association between baseline cognition and antidepressant or antisuicidal effect (both P > 0.05). CONCLUSIONS The present study suggested that three-dose subanesthetic esketamine infusions did not harm cognition among adolescents with MDD and suicidal ideation. Instead, esketamine may be associated with improvement in processing speed. TRIAL REGISTRATION This trial was registered in the Chinese Clinical Trials Registry ( http://www.chictr.org.cn , ChiCTR2000041232).
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Affiliation(s)
- Xiaofeng Lan
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Mingxin Road #36, Liwan District, Guangzhou, 510370, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China
| | - Chengyu Wang
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Mingxin Road #36, Liwan District, Guangzhou, 510370, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China
| | - Fan Zhang
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Mingxin Road #36, Liwan District, Guangzhou, 510370, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China
| | - Haiyan Liu
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Mingxin Road #36, Liwan District, Guangzhou, 510370, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China
| | - Weicheng Li
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Mingxin Road #36, Liwan District, Guangzhou, 510370, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China
| | - Yanxiang Ye
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Mingxin Road #36, Liwan District, Guangzhou, 510370, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China
| | - Zhibo Hu
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Mingxin Road #36, Liwan District, Guangzhou, 510370, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China
| | - Siming Mai
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Mingxin Road #36, Liwan District, Guangzhou, 510370, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China
| | - Yuping Ning
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Mingxin Road #36, Liwan District, Guangzhou, 510370, China.
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, China.
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China.
- Department of Psychology, The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China.
| | - Yanling Zhou
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Mingxin Road #36, Liwan District, Guangzhou, 510370, China.
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, China.
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China.
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Erchinger VJ, Craven AR, Ersland L, Oedegaard KJ, Bartz-Johannessen CA, Hammar Å, Haavik J, Riemer F, Kessler U, Oltedal L. Electroconvulsive therapy triggers a reversible decrease in brain N-acetylaspartate. Front Psychiatry 2023; 14:1155689. [PMID: 37363174 PMCID: PMC10289547 DOI: 10.3389/fpsyt.2023.1155689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/02/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Based on previous research on electroconvulsive therapy (ECT) we have proposed a model where disruption, potentiation, and rewiring of brain networks occur in sequence and serve as the underlying therapeutic mechanism of ECT. This model implies that a temporary disturbance of neuronal networks (disruption) is followed by a trophic effect (potentiation), which enables the rewiring of neuronal circuits to a more euthymic functioning brain. We hypothesized that disruption of neuronal networks could trigger biochemical alterations leading to a temporary decrease in N-acetylaspartate (tNAA, considered a marker of neuronal integrity), while choline (a membrane component), myo-Inositol (mI, astroglia marker), and glutamate/glutamine (Glx, excitatory neurotransmitter) were postulated to increase. Previous magnetic resonance spectroscopy studies, reporting diverse findings, have used two different referencing methods - creatine ratios and tissue corrected values referenced to water - for the quantification of brain metabolites. Changes in creatine during ECT have also been reported, which may confound estimates adopting this as an internal reference. Methods Using MR spectroscopy, we investigated 31 moderately to severely depressed patients and 19 healthy controls before, during, and after ECT or at similar time points (for controls). We tested whether biochemical alterations in tNAA, choline, mI, and Glx lend support to the disrupt, potentiate, and rewire hypothesis. We used both creatine ratios and water-scaled values for the quantification of brain metabolites to validate the results across referencing methods. Results Levels of tNAA in the anterior cingulate cortex decreased after an ECT treatment series (average 10.6 sessions) by 6% (p = 0.007, creatine ratio) and 3% (p = 0.02, water referenced) but returned to baseline 6 months after ECT. Compared to after treatment series tNAA levels at 6-month follow-up had increased in both creatine ratio (+6%, p < 0.001) and water referenced data (+7%, p < 0.001). Findings for other brain metabolites varied and could not be validated across referencing methods. Discussion Our findings suggest that prior research must be interpreted with care, as several referencing and processing methods have been used in the past. Yet, the results for tNAA were robust across quantification methods and concur with relevant parts of the disrupt, potentiate, and rewire model.
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Affiliation(s)
- Vera J. Erchinger
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Alexander R. Craven
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- NORMENT—Norwegian Centre for Mental Disorders Research, University of Bergen, Bergen, Norway
- Department of Clinical Engineering, Haukeland University Hospital, Bergen, Norway
| | - Lars Ersland
- Department of Clinical Engineering, Haukeland University Hospital, Bergen, Norway
| | - Ketil J. Oedegaard
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- NORMENT—Norwegian Centre for Mental Disorders Research, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | | | - Åsa Hammar
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Jan Haavik
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Frank Riemer
- Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Ute Kessler
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- NORMENT—Norwegian Centre for Mental Disorders Research, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Leif Oltedal
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway
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Zavaliangos-Petropulu A, McClintock SM, Khalil J, Joshi SH, Taraku B, Al-Sharif NB, Espinoza RT, Narr KL. Neurocognitive effects of subanesthetic serial ketamine infusions in treatment resistant depression. J Affect Disord 2023; 333:161-171. [PMID: 37060953 DOI: 10.1016/j.jad.2023.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 04/05/2023] [Accepted: 04/10/2023] [Indexed: 04/17/2023]
Abstract
INTRODUCTION Ketamine treatment prompts a rapid antidepressant response in treatment-resistant depression (TRD). We performed an exploratory investigation of how ketamine treatment in TRD affects different cognitive domains and relates to antidepressant response. METHODS Patients with TRD (N = 66; 30 M/35F; age = 39.5 ± 11.1 years) received four ketamine infusions (0.5 mg/kg). Neurocognitive function and depressive symptoms were assessed at baseline, 24 h after the first and fourth ketamine infusion, and 5 weeks following end of treatment. Mixed effect models tested for changes in seven neurocognitive domains and antidepressant response, with post-hoc pairwise comparisons between timepoints, including follow-up. Relationships between change in neurocognitive function and antidepressant response over the course of treatment were tested with Pearson's correlation and mediation analyses. Associations between baseline neurocognitive performance and antidepressant response were tested with Pearson's correlation. RESULTS Significant improvements in inhibition, working memory, processing speed, and overall fluid cognition were observed after the first and fourth ketamine infusion. Improvements in processing speed and overall fluid cognition persisted through follow-up. Significant improvements in depressive symptoms reverted towards baseline at follow-up. Baseline working memory and change in inhibition were moderately correlated with antidepressant response, however, improvements in neurocognitive performance were statistically independent from antidepressant response. CONCLUSION Antidepressant ketamine leads to improved neurocognitive function, which persist for at least 5 weeks. Neurocognitive improvements observed appear independent of antidepressant response, suggesting ketamine may target overlapping but distinct functional brain systems. Limitations Research investigating repeated serial ketamine treatments is important to determine cognitive safety. This study is a naturalistic design and does not include placebo.
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Affiliation(s)
- Artemis Zavaliangos-Petropulu
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA.
| | - Shawn M McClintock
- Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Jacqueline Khalil
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Shantanu H Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Brandon Taraku
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Noor B Al-Sharif
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Randall T Espinoza
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Katherine L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
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Mackin RS, Jin C, Burns E, Kassel M, Rhodes E, Nosheny R, Ashford M, Banh T, Eichenbaum J, Knight K, Tank R, Camacho MR, Fockler J, Truran D, Neuhaus J, Weiner M. Association of Major Depressive Disorder with remotely administered measures of cognition and subjective report of cognitive difficulties across the adult age spectrum. J Affect Disord 2023; 326:198-205. [PMID: 36528135 DOI: 10.1016/j.jad.2022.12.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/04/2022] [Accepted: 12/11/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) has increasing prevalence with age. Both objective measures of cognitive dysfunction and subjective report of cognitive difficulties related to MDD are often thought to worsen with increasing age. However, few studies have directly evaluated these characteristics across the adult lifespan. METHODS Participants included 23,594 adults completing objective and subjective measures of cognition on an online research registry. Linear regression including interactions of age group with depression was used to evaluate the association of self-reported MDD with measures of cognition in three age groups: 21-40 years; 41-60 years; 61+ years. RESULTS MDD (n = 2127) demonstrated poorer objective cognitive performance and greater subjective ratings of cognitive difficulties across all domains assessed compared to non-depressed individuals (ND; n = 21,467). Significant interactions of age group and MDD status with objective and subjective measures of cognition were observed for both middle age and older adults when compared to young adults but few significant differences between middle-aged and older adults were evident. LIMITATIONS This study relied on self-report of MDD diagnosis, utilized remotely administered and unsupervised measures of cognition, and the sample was not diverse. CONCLUSIONS The magnitude of association between MDD and cognitive correlates appears to plateau in middle age. Our results suggest that increased rates of dementia are not due to greater cognitive consequence of MDD in older adults and that age effects, and not greater effects of depression, may lead to increased diagnosis of MDD based on subjective report of cognitive symptoms.
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Affiliation(s)
- R Scott Mackin
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA; VA Advanced Imaging Research Center, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA; Mental Illness Research Education and Clinical Centers, Veterans Affairs Medical Center, San Francisco, CA, USA.
| | - Chengshi Jin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Emily Burns
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
| | - Michelle Kassel
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA; Mental Illness Research Education and Clinical Centers, Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Emma Rhodes
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA; Mental Illness Research Education and Clinical Centers, Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Rachel Nosheny
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA; VA Advanced Imaging Research Center, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Miriam Ashford
- VA Advanced Imaging Research Center, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Tim Banh
- VA Advanced Imaging Research Center, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Joseph Eichenbaum
- VA Advanced Imaging Research Center, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Kristen Knight
- VA Advanced Imaging Research Center, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Rachana Tank
- VA Advanced Imaging Research Center, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Monica R Camacho
- VA Advanced Imaging Research Center, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Juliet Fockler
- VA Advanced Imaging Research Center, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Diana Truran
- VA Advanced Imaging Research Center, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - John Neuhaus
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Michael Weiner
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA; VA Advanced Imaging Research Center, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA; Department of Radiology, University of California, San Francisco, USA
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7
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Lu W, Zhang H, Zhou R, Ding L, Wang Y, Su Y, Wang X, Chen J, Wu B, He S, Zhang M, Huang J, Cai Y, Peng D. Differences in cognitive functions of atypical and non-atypical depression based on propensity score matching. J Affect Disord 2023; 325:732-738. [PMID: 36690082 DOI: 10.1016/j.jad.2023.01.071] [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: 09/09/2022] [Revised: 12/26/2022] [Accepted: 01/16/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND Clinical and etiological heterogeneity have hindered our understanding of depression, thus driving the studies of major depressive disorder (MDD) subtypes. Atypical depression (AD) is a subtype of MDD with atypical features. Cognitive impairment is one of the factors that contribute to the suffering of patients with MDD. Therefore, this study investigated the characteristics and differences in cognitive functioning of AD and non-atypical depression (non-AD) using the MATRICS Consensus Cognitive Battery (MCCB). METHODS A total of 101 patients with AD and 252 patients with non-AD were assessed with the MCCB and clinical scales. Propensity score matching (PSM) was used to balance confounders between groups. After PSM, between-group differences were compared for cognitive and clinical variables. In addition, multiple linear regression analyses were performed to explore the effects of cognitive and clinical variables on the quality of life. RESULTS The AD group scored significantly lower in attention/vigilance and social cognition in all cognitive domains than the non-AD group. Attention/vigilance and social cognition were significant positive predictors of quality of life, whereas atypical symptoms and depressive severity were significant negative predictors. CONCLUSIONS This study suggests significant differences in cognitive functions between the AD and non-AD subtypes. Atypical symptoms and impaired cognition have a negative impact on patients' quality of life. Attention/vigilance and social cognition are worse in AD than non-AD, which the atypical features of patients with AD may explain. The pathological mechanisms and treatment strategies of AD should be further explored in the future to promote individualized treatment strategies.
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Affiliation(s)
- Wenxian Lu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Huifeng Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Rubai Zhou
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Lei Ding
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yun Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yousong Su
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Xinyu Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Jiaye Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Baichuan Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Shen He
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Min Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Jia Huang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yiyun Cai
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Daihui Peng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
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Vural Keleş Ö, Yıldırım E. Depression affects working memory performance: A Functional Near Infrared Spectroscopy (fNIRS) Study. Psychiatry Res Neuroimaging 2023; 329:111581. [PMID: 36587535 DOI: 10.1016/j.pscychresns.2022.111581] [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: 09/16/2022] [Revised: 10/30/2022] [Accepted: 12/11/2022] [Indexed: 12/24/2022]
Abstract
Depression is a complex disorder that can be caused by psychosocial and biological conditions, and it not only affects to emotional life, but also cognitive functions, specifically the executive functions, attention, psychomotor speed, and memory. Some results of the studies in the literature show that depressed individuals perform worse on cognitive tasks than healthy individuals, while others indicate that there is no difference. Moreover, there is also no consensus about the depressed people brain functionalities. We aimed to compare the people who has high and low depression score measured with Beck Depression Inventory in terms of their working memory performance by using n-back paradigm and their brain activity by using optical imaging with this study. The age of lower BDI group (n = 11) is 23,9 ± 3,04 and higher BDI group (n = 23) is 22,2 + 2,28. The fNIRS were recorded from each subject while neutral words-faces and emotional words-faces are given to the subjects in the visuospatial 2-back WM task. There are no significant differences between the two groups behaviorally during the working memory performance, however, the high BDI group's PFC activation in right hemisphere is founded to be higher than the lower group. Our findings support the literature who is claiming the difference brain activity in depressed brain but not cognitive performance. Though, the small group size and the task difficulty (easy) could be the explanation of the behavioral results.
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Affiliation(s)
- Özge Vural Keleş
- Department of Psychology, Faculty of Literature, Bartin University, Turkey.
| | - Erol Yıldırım
- Department of Psychology, Faculty of Humanities and Social Sciences, Istanbul Medipol University, Turkey; Regenerative and Restorative Medical Research Center, Istanbul Medipol University, Istanbul, Turkey
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9
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Lan X, Wu F, Wang C, Wu K, Fang Z, Lao G, Zhang B, Ning Y, Zhou Y. Sex differences in the association of plasma cytokines and neurocognition in first-episode major depressive disorder. J Affect Disord 2023; 322:258-266. [PMID: 36370912 DOI: 10.1016/j.jad.2022.11.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/08/2022] [Accepted: 11/06/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Peripheral cytokines were found to be involved in the pathophysiology of neurocognition in individuals with major depressive disorder (MDD). However, whether there are sex differences in this association between cytokines and cognition in MDD remains unknown. Our aim is to examine sex differences in the relationship between plasma cytokines and cognition in MDD. METHOD One hundred and twenty-seven first episode drug naïve patients with MDD and sixty healthy controls (HCs) were recruited for present study. The MATRICS Consensus Cognitive Battery was administered to measure the cognition. Plasma concentrations of nineteen cytokines were measured using high sensitivity multiplex bead-based assays. RESULTS Both female and male patients with MDD had significant cognitive impairment in verbal learning and visual learning and had higher levels of a range of cytokines than HCs (all p < 0.05). Female patients performed worse in trail making (F = 4.442, p = 0.018) and had higher concentration of interleukin (IL)-4 (F = 7.775, p = 0.006) than males. In female MDD, a significant positive association between category frequency and level of IL-4 was observed (B = 8.040, p = 0.031). However, this association was not present in male MDD or HCs (p > 0.05). LIMITATION Present study used a cross-sectional design. CONCLUSION Female MDD patients had worse trail making performance and higher level of IL-4 than males. The elevated IL-4 in female MDD was positively associated with category fluency, suggesting that IL-4 may be involved in the pathophysiology related to specific cognitive domain in female MDD patients.
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Affiliation(s)
- Xiaofeng Lan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Fengchun Wu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Chengyu Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Kai Wu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China; Department of Biomedical Engineering, School of Material Science and Engineering, South China University of Technology, Guangzhou, China
| | - Ziyan Fang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Guohui Lao
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Bin Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.
| | - Yanling Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.
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10
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Colwell MJ, Tagomori H, Chapman S, Gillespie AL, Cowen PJ, Harmer CJ, Murphy SE. Pharmacological targeting of cognitive impairment in depression: recent developments and challenges in human clinical research. Transl Psychiatry 2022; 12:484. [PMID: 36396622 PMCID: PMC9671959 DOI: 10.1038/s41398-022-02249-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022] Open
Abstract
Impaired cognition is often overlooked in the clinical management of depression, despite its association with poor psychosocial functioning and reduced clinical engagement. There is an outstanding need for new treatments to address this unmet clinical need, highlighted by our consultations with individuals with lived experience of depression. Here we consider the evidence to support different pharmacological approaches for the treatment of impaired cognition in individuals with depression, including treatments that influence primary neurotransmission directly as well as novel targets such as neurosteroid modulation. We also consider potential methodological challenges in establishing a strong evidence base in this area, including the need to disentangle direct effects of treatment on cognition from more generalised symptomatic improvement and the identification of sensitive, reliable and objective measures of cognition.
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Affiliation(s)
- Michael J Colwell
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Hosana Tagomori
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Sarah Chapman
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Amy L Gillespie
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Philip J Cowen
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Catherine J Harmer
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Susannah E Murphy
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
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11
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Chen RF, Cai Y, Zhu ZH, Hou WL, Chen P, Wang J, Jia YM, Zhu ZB, Zhang YH, Tao LY, Wu JW, Zhang J, Zhang H, Wang ZX, Jia QF, Hui L. Sleep disorder as a clinical risk factor of major depression: associated with cognitive impairment. Asian J Psychiatr 2022; 76:103228. [PMID: 35973338 DOI: 10.1016/j.ajp.2022.103228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/08/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND This research aims explored the sleep disorder (SD) role in major depressive disorder (MDD), and the SD influencing their cognition. METHODS 372 MDD patients and 457 healthy controls (HCs) were enrolled. RESULTS Patients increased a 38.88 times SD risk compared with HCs. In patients, visuospatial/constructional score was lower in SD than non-SD, and PSQI score was negatively associated with visuospatial/constructional score of SD. In SD and non-SD, RBANS scores were lower in MDD than HCs, excepted for visuospatial/constructional in non-SD. CONCLUSION The SD as a MDD risk factor, has more serious visuospatial/constructional impairment alleviated via improving sleep/depression in patients.
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Affiliation(s)
- Ru Feng Chen
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, School of Basic Medicine and Biological Sciences, Suzhou Medical College of Soochow University, Suzhou 215137, Jiangsu Province, PR China
| | - Yuan Cai
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, School of Basic Medicine and Biological Sciences, Suzhou Medical College of Soochow University, Suzhou 215137, Jiangsu Province, PR China
| | - Zhen Hua Zhu
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, School of Basic Medicine and Biological Sciences, Suzhou Medical College of Soochow University, Suzhou 215137, Jiangsu Province, PR China
| | - Wen Long Hou
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, School of Basic Medicine and Biological Sciences, Suzhou Medical College of Soochow University, Suzhou 215137, Jiangsu Province, PR China
| | - Peng Chen
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, School of Basic Medicine and Biological Sciences, Suzhou Medical College of Soochow University, Suzhou 215137, Jiangsu Province, PR China
| | - Jing Wang
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, School of Basic Medicine and Biological Sciences, Suzhou Medical College of Soochow University, Suzhou 215137, Jiangsu Province, PR China
| | - Yi Ming Jia
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou 215123, Jiangsu Province, PR China
| | - Zheng Bao Zhu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou 215123, Jiangsu Province, PR China
| | - Yong Hong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou 215123, Jiangsu Province, PR China
| | - Lu Yang Tao
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, School of Basic Medicine and Biological Sciences, Suzhou Medical College of Soochow University, Suzhou 215137, Jiangsu Province, PR China
| | - Jia Wei Wu
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, School of Basic Medicine and Biological Sciences, Suzhou Medical College of Soochow University, Suzhou 215137, Jiangsu Province, PR China
| | - Jianping Zhang
- Department of Psychiatry, Weill Cornell Medical College, Cornell University, New York, NY 10605, USA
| | - Huiping Zhang
- Departments of Psychiatry and Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA 02118-2526, USA
| | - Zhi Xin Wang
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, School of Basic Medicine and Biological Sciences, Suzhou Medical College of Soochow University, Suzhou 215137, Jiangsu Province, PR China.
| | - Qiu Fang Jia
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, School of Basic Medicine and Biological Sciences, Suzhou Medical College of Soochow University, Suzhou 215137, Jiangsu Province, PR China.
| | - Li Hui
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, School of Basic Medicine and Biological Sciences, Suzhou Medical College of Soochow University, Suzhou 215137, Jiangsu Province, PR China.
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12
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Comparelli A, Corigliano V, Montalbani B, Nardella A, De Carolis A, Stampatore L, Bargagna P, Forcina F, Lamis D, Pompili M. Building a neurocognitive profile of suicidal risk in severe mental disorders. BMC Psychiatry 2022; 22:628. [PMID: 36162995 PMCID: PMC9511976 DOI: 10.1186/s12888-022-04240-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 08/30/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Research on the influence of neurocognitive factors on suicide risk, regardless of the diagnosis, is inconsistent. Recently, suicide risk studies propose applying a trans-diagnostic framework in line with the launch of the Research Domain Criteria Cognitive Systems model. In the present study, we highlight the extent of cognitive impairment using a standardized battery in a psychiatric sample stratified for different degrees of suicidal risk. We also differentiate in our sample various neurocognitive profiles associated with different levels of risk. MATERIALS AND METHODS We divided a sample of 106 subjects into three groups stratified by suicide risk level: Suicide Attempt (SA), Suicidal Ideation (SI), Patient Controls (PC) and Healthy Controls (HC). We conducted a multivariate Analysis of Variance (MANOVA) for each cognitive domain measured through the standardized battery MATRICS Consensus Cognitive Battery (MCCB). RESULTS We found that the group of patients performed worse than the group of healthy controls on most domains; social cognition was impaired in the suicide risk groups compared both to HC and PC. Patients in the SA group performed worse than those in the SI group. CONCLUSION Social cognition impairment may play a crucial role in suicidality among individuals diagnosed with serious mental illness as it is involved in both SI and SA; noteworthy, it is more compromised in the SA group fitting as a marker of risk severity.
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Affiliation(s)
- Anna Comparelli
- Azienda Ospedaliero-Universitaria Sant'Andrea, Sapienza University of Rome, Via di Grottarossa 1035, Rome, Italy.
| | | | - Benedetta Montalbani
- grid.7841.aPsychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Adele Nardella
- Department of Psychiatry and Substance Abuse, Modena, Italy
| | - Antonella De Carolis
- grid.7841.aDepartment of Neurosciences, Unit of Neurology, Mental Health and Sensory Organs, Sant’Andrea Hospital, Sapienza University, 00185 Rome, Italy
| | - Lorenzo Stampatore
- grid.7841.aPsychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Paride Bargagna
- grid.7841.aPsychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Francesca Forcina
- grid.7841.aPsychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Dorian Lamis
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA USA
| | - Maurizio Pompili
- grid.7841.aAzienda Ospedaliero-Universitaria Sant’Andrea, Sapienza University of Rome, Via di Grottarossa 1035, Rome, Italy ,grid.7841.aSuicide Prevention Centre, Department of Neurosciences, Mental Health and Sensory Organs, Sant’Andrea Hospital, Sapienza University, 00185 Rome, Italy
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13
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Fleischer M, Szepanowski F, Tovar M, Herchert K, Dinse H, Schweda A, Mausberg AK, Holle-Lee D, Köhrmann M, Stögbauer J, Jokisch D, Jokisch M, Deuschl C, Skoda EM, Teufel M, Stettner M, Kleinschnitz C. Post-COVID-19 Syndrome is Rarely Associated with Damage of the Nervous System: Findings from a Prospective Observational Cohort Study in 171 Patients. Neurol Ther 2022; 11:1637-1657. [PMID: 36028604 PMCID: PMC9417089 DOI: 10.1007/s40120-022-00395-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/03/2022] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can affect multiple organs. Reports of persistent or newly emergent symptoms, including those related to the nervous system, have increased over the course of the pandemic, leading to the introduction of post-COVID-19 syndrome. However, this novel syndrome is still ill-defined and structured objectification of complaints is scarce. Therefore, we performed a prospective observational cohort study to better define and validate subjective neurological disturbances in patients with post-COVID-19 syndrome. METHODS A total of 171 patients fulfilling the post-COVID-19 WHO Delphi consensus criteria underwent a comprehensive neurological diagnostic work-up including neurovascular, electrophysiological, and blood analysis. In addition, magnetic resonance imaging (MRI) and lumbar puncture were conducted in subgroups of patients. Furthermore, patients underwent neuropsychological, psychosomatic, and fatigue assessment. RESULTS Patients were predominantly female, middle-aged, and had incurred mostly mild-to-moderate acute COVID-19. The most frequent post-COVID-19 complaints included fatigue, difficulties in concentration, and memory deficits. In most patients (85.8%), in-depth neurological assessment yielded no pathological findings. In 97.7% of the cases, either no diagnosis other than post COVID-19 syndrome, or no diagnosis likely related to preceding acute COVID-19 could be established. Sensory or motor complaints were more often associated with a neurological diagnosis other than post-COVID-19 syndrome. Previous psychiatric conditions were identified as a risk factor for developing post-COVID-19 syndrome. We found high somatization scores in our patient group that correlated with cognitive deficits and the extent of fatigue. CONCLUSIONS Albeit frequently reported by patients, objectifiable affection of the nervous system is rare in post-COVID-19 syndrome. Instead, elevated levels of somatization point towards a pathogenesis potentially involving psychosomatic factors. However, thorough neurological assessment is important in this patient group in order to not miss neurological diseases other than post-COVID-19.
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Affiliation(s)
- Michael Fleischer
- Department of Neurology, University Medicine Essen, University Duisburg-Essen, Essen, Germany ,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Fabian Szepanowski
- Department of Neurology, University Medicine Essen, University Duisburg-Essen, Essen, Germany ,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Muriel Tovar
- Department of Neurology, University Medicine Essen, University Duisburg-Essen, Essen, Germany ,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Klaas Herchert
- Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Medicine Essen, University Duisburg-Essen, Essen, Germany ,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Hannah Dinse
- Clinic for Psychosomatic Medicine, and Psychotherapy, LVR University Hospital Essen, University Duisburg-Essen, Essen, Germany ,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Adam Schweda
- Clinic for Psychosomatic Medicine, and Psychotherapy, LVR University Hospital Essen, University Duisburg-Essen, Essen, Germany ,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Anne K. Mausberg
- Department of Neurology, University Medicine Essen, University Duisburg-Essen, Essen, Germany ,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Dagny Holle-Lee
- Department of Neurology, University Medicine Essen, University Duisburg-Essen, Essen, Germany ,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Martin Köhrmann
- Department of Neurology, University Medicine Essen, University Duisburg-Essen, Essen, Germany ,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Julia Stögbauer
- Department of Neurology, University Medicine Essen, University Duisburg-Essen, Essen, Germany ,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Daniel Jokisch
- Department of Neurology, University Medicine Essen, University Duisburg-Essen, Essen, Germany ,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Martha Jokisch
- Department of Neurology, University Medicine Essen, University Duisburg-Essen, Essen, Germany ,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Cornelius Deuschl
- Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Medicine Essen, University Duisburg-Essen, Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine, and Psychotherapy, LVR University Hospital Essen, University Duisburg-Essen, Essen, Germany ,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine, and Psychotherapy, LVR University Hospital Essen, University Duisburg-Essen, Essen, Germany ,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Mark Stettner
- Department of Neurology, University Medicine Essen, University Duisburg-Essen, Essen, Germany ,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Christoph Kleinschnitz
- Department of Neurology, University Medicine Essen, University Duisburg-Essen, Essen, Germany ,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
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14
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Lai S, Zhong S, Wang Y, Zhang Y, Xue Y, Zhao H, Ran H, Yan S, Luo Y, He J, Zhu Y, Lv S, Song Z, Miao H, Hu Y, Huang X, Lu X, Zhou J, Jia Y. The prevalence and characteristics of MCCB cognitive impairment in unmedicated patients with bipolar II depression and major depressive disorder. J Affect Disord 2022; 310:369-376. [PMID: 35504401 DOI: 10.1016/j.jad.2022.04.153] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 03/16/2022] [Accepted: 04/26/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Cognitive impairment has been acknowledged as a core clinical manifestation of bipolar disorder (BD) as well as major depressive disorder (MDD). Determining the prevalence and characteristics of cognitive impairment is important for clinical interventions. This study investigated the prevalence and characteristics of cognitive impairment based on the Measurement and Treatment Research to Improve Cognition Schizophrenia Consensus Cognitive Battery (MCCB) in both BD and MDD. METHOD One hundred and forty-nine BD II depression, 147 MDD, and 124 demographically matched healthy controls (HC) underwent MCCB cognitive assessment. The prevalence of MCCB cognitive impairment and group difference comparisons were performed. Additionally, association analysis was performed to investigate the relationship between cognitive performance and clinical variables. RESULTS Compared to the HC group, both BD II depression and MDD groups had a significantly reduced performance for all MCCB cognitive domains (all p < 0.05). The numerical scores for visual learning were lower in the BD II depression group compared to the MDD group. 32.89% of the BD II depression patients had clinically significant impairment (>1.5 SD below the normal mean) in two or more MCCB domains compared to 23.13% for MDD patients. CONCLUSIONS A high percent of patients in the BD II depression and MDD group exhibited MCCB cognitive impairments with clinical significance. Cognitive impairments were more common in BD II depression patients compared to MDD patients, particularly for visual learning. These findings suggest that clinicians should be aware of the severe cognitive impairment in mood disorders and establish effective cognitive screening and intervention strategies.
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Affiliation(s)
- Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yiliang Zhang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Ying Xue
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Hui Zhao
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Hanglin Ran
- School of Management, Jinan University, Guangzhou 510316, China
| | - Shuya Yan
- School of Management, Jinan University, Guangzhou 510316, China
| | - Yange Luo
- School of Management, Jinan University, Guangzhou 510316, China
| | - Jiali He
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yunxia Zhu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Sihui Lv
- School of Management, Jinan University, Guangzhou 510316, China
| | - Zijing Song
- School of Management, Jinan University, Guangzhou 510316, China
| | - Haofei Miao
- School of Management, Jinan University, Guangzhou 510316, China
| | - Yilei Hu
- School of Management, Jinan University, Guangzhou 510316, China
| | - Xiaosi Huang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Xiaodan Lu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Jiansong Zhou
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
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15
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Mohammadnia S, Bigdeli I, Mashhadi A, Ghanaei Chamanabad A, Roth RM. Behavior Rating Inventory of Executive Function - adult version (BRIEF-A) in Iranian University students: Factor structure and relationship to depressive symptom severity. APPLIED NEUROPSYCHOLOGY. ADULT 2022; 29:786-792. [PMID: 32866045 DOI: 10.1080/23279095.2020.1810689] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Major depressive disorder is the most common psychiatric illness in Iran, and depression is common among university students in the country. The presence of depression is frequently associated with problems in executive functioning. The Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) is a questionnaire measure designed to assess executive functioning in everyday life in clinical and non-clinical populations. Currently, there is limited empirical validation of the measure for use in Iran. This study evaluated the psychometric properties of a Persian-language BRIEF-A in a sample of Iranian university students (n = 300). The factor structure of the BRIEF-A was examined via a confirmatory factor analysis. We also evaluated whether BRIEF-A scores differed among university students varying in severity of depressive symptoms (Minimal, Mild, Moderate, Severe) as measured by the Beck Depression Inventory - II. Results indicated that a two-factor model structure best fit the data for the BRIEF-A. Acceptable internal consistency was also observed. Furthermore, poorer subjective executive functioning was endorsed by the three depressive subgroups relative to the Minimal symptoms group. Together, these findings support a two-factor model for the Persian translation of the BRIEF-A, and indicate that more severe depressive symptoms in Iranian university students is associated with worse subjective executive functioning.
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Affiliation(s)
- Saeed Mohammadnia
- Department of Psychology, Faculty of Education Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Imanollah Bigdeli
- Department of Psychology, Faculty of Education Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Ali Mashhadi
- Department of Psychology, Faculty of Education Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Ali Ghanaei Chamanabad
- Department of Psychology, Faculty of Education Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Robert M Roth
- Department of Psychiatry, Neuropsychology Program, Geisel School of Medicine at Dartmouth/DHMC, Lebanon, NH, USA
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16
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Cao B, Xiao M, Chen X, Zhao Y, Pan Z, McIntyre RS, Chen H. Application of computerized cognitive test battery in major depressive disorder: a narrative literature review. Nord J Psychiatry 2022; 76:263-271. [PMID: 34423722 DOI: 10.1080/08039488.2021.1965654] [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: 01/10/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is a chronic and debilitating relapsing-remitting mood disorder, characterized by psychological, cognitive, and behavioral disturbances. The assessment of cognitive dysfunction in individuals with MDD has increasingly become a topic of concern in recent years. AIMS To pool and compare the characteristics of various cognition evaluation tools. METHOD Overview of recent research in application of computerized cognitive test battery in MDD. RESULTS With recent technological advances in mobile health technologies and the ubiquity of smartphones, the use of traditional tools is no longer sufficient to monitor the dynamic changes of an individual's cognitive performance, which may be influenced by many factors, including, but not limited to, disease course and medications. Computerized tests have many advantages over traditional neuropsychological testing, chiefly in terms of time and cost savings, accurate recording of multiple response components, and the ability to automatically store and compare performance between testing sessions. In the following review, we summarized cognitive impairment characteristics of MDD, introduced traditional assessment tools of cognitive function in MDD, and reviewed the development of the current computerized cognitive test batteries for MDD. The comparisons among cognitive function evaluation tools were also performed. CONCLUSIONS It is our belief that the improvement of existing novel computerized cognitive test batteries, the development of more comprehensive and easy-to-operate scales, verification techniques and multiple follow-up surveys among large sample populations may provide valuable clues for the evaluation and tracking of cognitive function in individuals with MDD.
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Affiliation(s)
- Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, P. R. China.,National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing, P. R. China
| | - Mingyue Xiao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, P. R. China
| | - Ximei Chen
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, P. R. China
| | - Yuxiao Zhao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, P. R. China
| | - Zihang Pan
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada.,Duke-NUS Medical School, Singapore, Singapore
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada.,Brain and Cognition Discovery Foundation, Toronto, Canada
| | - Hong Chen
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, P. R. China.,National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing, P. R. China
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17
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Tomczyk J, Nezlek JB, Krejtz I. Gratitude Can Help Women At-Risk for Depression Accept Their Depressive Symptoms, Which Leads to Improved Mental Health. Front Psychol 2022; 13:878819. [PMID: 35465539 PMCID: PMC9022718 DOI: 10.3389/fpsyg.2022.878819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Gratitude is commonly known as a positive emotion, but it can also be understood as a disposition—one’s inherent quality that includes being grateful for the positive aspects of one’s life and appreciating altruistic gifts. A growing body of research suggests that having a disposition of gratitude is positively related to wellbeing and psychological adjustment. The present study examined the extent to which acceptance of illness—a measure of adjustment to a distressing condition—mediated relationships between dispositional gratitude and wellbeing among women who had elevated levels of depressive symptoms. Methods Participants were 131 women who, based on scores on the Center for Epidemiological Studies Depression scale, were at-risk for experiencing clinical depression. Thirty-five of these participants had been diagnosed as depressed at some point in their lives and 96 had not. Participants completed measures of dispositional gratitude, wellbeing, anxiety, and acceptance of illness. Results Dispositional gratitude was positively correlated with wellbeing and was negatively correlated with depression and anxiety. Dispositional gratitude was also positively correlated with acceptance of illness. Mediational analyses found that acceptance of illness mediated relationships between dispositional gratitude and wellbeing, between dispositional gratitude and anxiety, and between dispositional gratitude and depression. Moreover, such mediation varied as a function of whether women had ever been diagnosed as depressed. Acceptance of illness was related more strongly to wellbeing for women who had been diagnosed as depressed at some time in their lives than it was for women who had never been diagnosed as depressed. Conclusion Women with elevated depressive symptoms who were more grateful (compared to those who were less grateful) were more accepting of their condition, which was related to increased wellbeing and decreased feelings of depression and anxiety.
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Affiliation(s)
- Joanna Tomczyk
- Institute of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - John B Nezlek
- Institute of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.,Center for Climate Change and Social Transformation, SWPS University of Social Sciences and Humanities, Warsaw, Poland.,College of William and Mary, Williamsburg, VA, United States
| | - Izabela Krejtz
- Institute of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
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18
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Donix M, Seidlitz A, Buthut M, Löck S, Meissner G, Matthes C, Troost EG, Baumann M, Raschke F, Linn J, Krause M. Subjective memory impairment in glioma patients with curative radiotherapy. Radiother Oncol 2022; 171:101-106. [DOI: 10.1016/j.radonc.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/04/2022] [Accepted: 04/10/2022] [Indexed: 11/26/2022]
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Spagna A, Wang J, Rosario IE, Zhang L, Zu M, Wang K, Tian Y. Cognitive Considerations in Major Depression: Evaluating the Effects of Pharmacotherapy and ECT on Mood and Executive Control Deficits. Brain Sci 2022; 12:brainsci12030350. [PMID: 35326307 PMCID: PMC8946784 DOI: 10.3390/brainsci12030350] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/20/2022] [Accepted: 03/01/2022] [Indexed: 02/04/2023] Open
Abstract
Deficits in the executive control of attention greatly impact the quality of life of patients diagnosed with major depressive disorder (MDD). However, attentional deficits are often underemphasized in clinical contexts compared with mood-based symptoms, and a comprehensive approach for specifically evaluating and treating them has yet to be developed. The present study evaluates the efficacy of bifrontal electroconvulsive therapy (ECT) combined with drug therapy (DT) in alleviating mood-related symptomatology and executive control deficits in drug-refractory MDD patients and compares these effects with those observed in MDD patients undergoing DT only. The Hamilton Rating Scale for Depression and the Lateralized Attentional Network Test-Revised were administered across two test sessions to assess treatment-related changes in mood-based symptoms and conflict processing, respectively, in patients undergoing ECT + DT (n = 23), patients undergoing DT (n = 33), and healthy controls (n = 40). Although both groups showed an improvement in mood-based symptoms following treatment and a deficit in conflict processing estimated on error rate, a post-treatment reduction of an executive control deficit estimated on RT was solely observed in the ECT + DT patient group. Furthermore, Bayesian correlational analyses confirmed the dissociation of mood-related symptoms and of executive control measures, supporting existing literature proposing that attentional deficits and mood symptoms are independent aspects of MDD. The cognitive profile of MDD includes executive control deficits, and while both treatments improved mood-based symptoms, only ECT + DT exerted an effect on both measures of the executive control deficit. Our findings highlight the importance of considering the improvement in both mood and cognitive deficits when determining the efficacy of therapeutic approaches for MDD.
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Affiliation(s)
- Alfredo Spagna
- Department of Psychology, Columbia University in the City of New York, New York, NY 10027, USA; (J.W.); (I.E.R.)
- Institute for Brain and Spinal Cord, Sorbonne University, 75013 Paris, France
- Correspondence: (A.S.); (K.W.); (Y.T.)
| | - Jason Wang
- Department of Psychology, Columbia University in the City of New York, New York, NY 10027, USA; (J.W.); (I.E.R.)
| | - Isabella Elaine Rosario
- Department of Psychology, Columbia University in the City of New York, New York, NY 10027, USA; (J.W.); (I.E.R.)
| | - Li Zhang
- Anhui Mental Health Center, Hefei 230022, China;
| | - Meidan Zu
- Department of Psychology and Sleep Medicine, The Second Hospital of Anhui Medical University, Hefei 230601, China;
| | - Kai Wang
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, China
- Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei 230031, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230032, China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China
- Anhui Province Clinical Research Center for Neurological Disease, Hefei 230032, China
- Correspondence: (A.S.); (K.W.); (Y.T.)
| | - Yanghua Tian
- Department of Psychology and Sleep Medicine, The Second Hospital of Anhui Medical University, Hefei 230601, China;
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, China
- Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei 230031, China
- Department of Neurology, The Second Hospital of Anhui Medical University, Hefei 230601, China
- Correspondence: (A.S.); (K.W.); (Y.T.)
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20
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Hoorelbeke K, Vervaeke J, Siegle GJ, Baeken C, Koster EH. Individual differences associated with treatment adherence and transfer effects following gamified web-based cognitive control training for repetitive negative thinking. Internet Interv 2022; 27:100507. [PMID: 35242588 PMCID: PMC8859013 DOI: 10.1016/j.invent.2022.100507] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 12/27/2022] Open
Abstract
Recent research suggests beneficial effects of cognitive control training (CCT) on repetitive negative thinking (RNT), a key risk factor for internalizing symptomatology. However, relatively little is known regarding predictors of adherence to internet-delivered CCT as well as moderators of treatment effects for this intervention. Answering these questions could improve efficiency of clinical implementation of CCT as an eHealth intervention. The current pre-registered single-arm trial set-out to address these questions using a web-based gamified CCT procedure based on the adaptive Paced Auditory Serial Addition Task. Participants (N = 382) entered the internet-based study, where we observed considerable drop-out during the assessment phase and the first training sessions. Emotional stability and resilience emerged as predictors for deciding not to commence the intervention. Drop-out throughout the course of CCT was explained by age, emotion regulation-, and personality factors. We used latent profile analysis, a probabilistic modeling approach, to identify clusters of participants (User Profiles) based on indicators of baseline cognitive- and emotional functioning, training progress, and user experience. We obtained three User Profiles, reflecting low-, moderate-, and high-risk status. Effortful control, emotion regulation, internalizing symptomatology, resilience, and emotional stability played a central role in these User Profiles. Interestingly, User Profile predicted training related cognitive gains, as well as effects of CCT on anxiety- and stress symptoms, and reappraisal. Our findings suggest that CCT is most effective for the moderate- and high-risk groups. In addition, the high-risk group would likely benefit from a more intensive training procedure or repeated administration of the training procedure over time to foster long-term retention of training related gains.
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Affiliation(s)
- Kristof Hoorelbeke
- Psychopathology and Affective Neuroscience (PAN) lab, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium,Corresponding author at: Henri-Dunantlaan 2, 9000 Ghent, Belgium.
| | - Jasmien Vervaeke
- Psychopathology and Affective Neuroscience (PAN) lab, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium,Imec-Mict-Ghent University, Ghent, Belgium
| | - Greg J. Siegle
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Chris Baeken
- Department of Head and Skin (UZGent), Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium,Department of Psychiatry (UZBrussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium,Department of Electrical Engineering, Eindhoven University of Technology, the Netherlands
| | - Ernst H.W. Koster
- Psychopathology and Affective Neuroscience (PAN) lab, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Abstract
OBJECTIVES The current study aims to examine the prevalence rates and the relationship of symptoms of depression, anxiety, and comorbid depression/anxiety with neurocognitive performance in college athletes at baseline. We hypothesized a priori that the mood disturbance groups would perform worse than healthy controls, with the comorbid group performing worst overall. METHODS Eight hundred and thirty-one (M = 620, F = 211) collegiate athletes completed a comprehensive neuropsychological test battery at baseline which included self-report measures of anxiety and depression. Athletes were separated into four groups [Healthy Control (HC) (n = 578), Depressive Symptoms Only (n = 137), Anxiety Symptoms Only (n = 54), and Comorbid Depressive/Anxiety Symptoms (n = 62)] based on their anxiety and depression scores. Athletes' neurocognitive functioning was analyzed via Z score composites of Attention/Processing Speed and Memory. RESULTS One-way analysis of variance revealed that, compared to HC athletes, the comorbid group performed significantly worse on measures of Attention/Processing Speed but not Memory. However, those in the depressive symptoms only and anxiety symptoms only groups were not significantly different from one another or the HC group on neurocognitive outcomes. Chi-square analyses revealed that a significantly greater proportion of athletes in all three affective groups were neurocognitively impaired compared to the HC group. CONCLUSIONS These results demonstrate that collegiate athletes with comorbid depressive/anxiety symptoms should be identified, as their poorer cognitive performance at baseline could complicate post-concussion interpretation. Thus, assessing for mood disturbance at baseline is essential to obtain an accurate measurement of baseline functioning. Further, given the negative health outcomes associated with affective symptomatology, especially comorbidities, it is important to provide care as appropriate.
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22
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Bergdolt J, Sellin P, Driessen M, Beblo T, Dehn LB. Neuropsychological predictors of vocational rehabilitation outcomes in individuals with major depression: A scoping review. Front Psychiatry 2022; 13:942161. [PMID: 36440409 PMCID: PMC9682155 DOI: 10.3389/fpsyt.2022.942161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Major depression is one of the leading causes of disability and limited capacity to work. Neuropsychological impairment is a common symptom in acute and remitted major depression and is associated with poor psychosocial functioning. This scoping review aimed to identify research on the role of neuropsychological functioning in outcomes of vocational rehabilitation programs in individuals with depression. METHODS We report on the conduct of this pre-registered (https://osf.io/5yrnf) scoping review in accordance with PRISMA-ScR guidelines. PubMed and PsychInfo were systematically searched for English or German research articles published between 1990 and September 2021 that studied objective neuropsychological tests as predictors of vocational rehabilitation interventions and included participants with depression. RESULTS The systematic literature search yielded no studies that specifically targeted subjects with major depression. However, eight articles published since 2016 were included in the review, analyzing data from five trials that evaluated the effectiveness of supported employment in North America and Europe in severe mental illnesses. An estimated 31% of the total number of participants included (n = 3,533) had major depression. Using a variety of cognitive tests and covariates, seven articles found that neuropsychological functioning - especially global cognition scores, verbal and visual learning and memory - significantly predicted vocational outcomes of rehabilitation programs. CONCLUSION Despite a lack of studies specifically targeting major depressive disorder, the identified literature suggests that higher baseline neuropsychological functioning predicts better vocational outcomes of supported employment programs in individuals with depression. In clinical practice, additional neuropsychological modules during return-to-work interventions might be helpful for vocational outcomes of such programs.
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Affiliation(s)
- Juliane Bergdolt
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany
| | - Pauline Sellin
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany
| | - Martin Driessen
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany.,Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany.,Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Lorenz B Dehn
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany.,Department of Psychology, Bielefeld University, Bielefeld, Germany
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23
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Ballantyne EC, King JP, Green SM. Preliminary Support for a Cognitive Remediation Intervention for Women During the Menopausal Transition: A Pilot Study. Front Glob Womens Health 2021; 2:741539. [PMID: 35005701 PMCID: PMC8733617 DOI: 10.3389/fgwh.2021.741539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/23/2021] [Indexed: 11/28/2022] Open
Abstract
Background: Menopause is associated with physical and emotional symptoms, and subjective cognitive concerns that are generally not borne out on objective cognitive measures. This discrepancy suggests that a psychological rather than biological mechanism likely mediates the cognitive concerns of women in menopause. The current study assessed the feasibility and effectiveness of a cognitive remediation intervention with the goal of reducing subjective perceptions of cognitive difficulty during the menopause. Methods: Twenty-seven menopausal women (M age = 53.74, SD = 4.14) completed a 5-week group-based intervention (with a post-group booster) consisting of 2-h weekly sessions. Participants completed pre- and post-intervention measures capturing subjective cognitive ability, mood, anxiety, stress, personality, and objective cognitive tests. The primary variable of interest was self-reported cognitive confidence measured by the Memory and Cognitive Confidence Scale (MACCS). Results: All but one MACCS subscale significantly decreased over the course of treatment (with lower scores associated with higher confidence) and effect sizes ranged from small to large (d = -0.39 to -0.91) with gains maintained at 1-month follow-up. Interestingly, no change in objective cognitive test performance was observed, indicating increases in subjective cognitive confidence in the absence of objective cognitive improvement. There was no change in mood, anxiety, or stress scores. Two-level HLM analyses revealed that those with higher baseline neuroticism, as measured by the NEO Personality Inventory, had smaller decreases in post-group MACCS High Standards subscale relative to those with lower baseline neuroticism (p = 0.027, d = -0.45). Those with higher baseline depression scores on the Depression Anxiety Stress Scale (DASS-21) had a smaller decrease in post-intervention MACCS Total Score relative to those with lower depression ratings. Conclusion: To our knowledge, this is the first feasibility study of its kind targeting perceptions of cognitive impairment during menopause. Although generally well-tolerated, recruitment and scheduling difficulties were flagged as challenges to engagement while a small sample size and lack of control group limit conclusions about efficacy. Providing current results could be replicated with enhanced methods, these results provide support that cognitive remediation is a feasible and credible treatment, and may improve quality of life for women in menopause. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT03311880.
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Affiliation(s)
- Elena C. Ballantyne
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Jelena P. King
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Sheryl M. Green
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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Assessment of Attentional Processes in Patients with Anxiety-Depressive Disorders Using Virtual Reality. J Pers Med 2021; 11:jpm11121341. [PMID: 34945813 PMCID: PMC8705703 DOI: 10.3390/jpm11121341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/04/2021] [Accepted: 12/06/2021] [Indexed: 11/30/2022] Open
Abstract
To characterize the attention deficits in one-hundred-fifteen participants, comprising two types of clinical profiles (affective and anxiety disorder), through a test of continuous VR execution. Method: Three tests (i.e., Nesplora Aquarium, BDI, and STAI) were used to obtain a standardized measure of attention, as well as the existence and severity of depression and anxiety, respectively. Results: Significant differences (CI = 95%) were found between the control group and the group with depression, in variables related to the speed of visual processing (p = 0.008) in the absence of distractors (p = 0.041) and during the first dual execution task (p = 0.011). For scores related to sustained attention, patients with depression and those with anxiety did not differ from controls. Our results suggest attentional deficits in both clinical populations when performing a continuous performance test that involved the participation of the central executive system of working memory.
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25
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Santos VBD, Saute JAM, Jacinto-Scudeiro LA, Ayres A, Rech RS, Oliveira AAD, Olchik MR. Cognitive profile of patients with facioscapulohumeral muscular dystrophy. Dement Neuropsychol 2021; 15:541-547. [PMID: 35509802 PMCID: PMC9018092 DOI: 10.1590/1980-57642021dn15-040015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 07/13/2021] [Indexed: 08/30/2023] Open
Abstract
Although it is predominantly a muscular disease, impairments in the central nervous system in patients with facioscapulohumeral muscular dystrophy (FSHD) have been described in the literature.
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Affiliation(s)
| | - Jonas Alex Morales Saute
- Department of Internal Medicine, Brazil; Postgraduate Program in Medicine: Medical Sciences, Brazil
| | | | | | | | | | - Maira Rozenfeld Olchik
- Postgraduate Program in Medicine: Medical Sciences, Brazil; Department of Surgery and Orthopedics, Brazil
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Kocsis K, Holczer A, Kazinczi C, Boross K, Horváth R, Németh LV, Klivényi P, Kincses ZT, Must A. Voxel-based asymmetry of the regional gray matter over the inferior temporal gyrus correlates with depressive symptoms in medicated patients with major depressive disorder. Psychiatry Res Neuroimaging 2021; 317:111378. [PMID: 34479177 DOI: 10.1016/j.pscychresns.2021.111378] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/13/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
The number of patients suffering from major depressive disorder (MDD) is increasing worldwide. Imbalanced hemispherical brain activity may be an underlying factor of MDD; however, whether structural asymmetry also contributes to the symptoms experienced in MDD has been scarcely investigated. In this study, we aimed to examine cortical asymmetry in association with the severity of depressive and cognitive symptoms observed in MDD during stable medication. The association between the affective and cognitive symptoms and gray matter asymmetry was evaluated in 17 MDD patients using voxel-wise gray matter asymmetry analysis on high-resolution T1-weighted MR images. Asymmetry index values in the inferior temporal gyrus (ITG) correlated with the scores of the 17-item Hamilton Depression Rating Scale (HDRS), but no association was found with the Beck Hopelessness Scale, and performance on the 1-, 2- and 3-back task. Our results indicate that the asymmetry of gray matter content in the ITG might be associated with higher depression severity. Our findings might help to better understand how structural changes contribute to depression severity in patients with MDD.
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Affiliation(s)
- Krisztián Kocsis
- Department of Neurology, Albert Szent-Györgyi Health Centre, University of Szeged, Hungary
| | - Adrienn Holczer
- Department of Neurology, Albert Szent-Györgyi Health Centre, University of Szeged, Hungary
| | - Csaba Kazinczi
- Department of Neurology, Albert Szent-Györgyi Health Centre, University of Szeged, Hungary
| | - Katalin Boross
- Department of Radiology, Albert Szent-Györgyi Health Centre, University of Szeged, Hungary
| | - Regina Horváth
- Department of Radiology, Albert Szent-Györgyi Health Centre, University of Szeged, Hungary
| | - Luca Viola Németh
- Department of Neurology, Albert Szent-Györgyi Health Centre, University of Szeged, Hungary
| | - Péter Klivényi
- Department of Neurology, Albert Szent-Györgyi Health Centre, University of Szeged, Hungary
| | - Zsigmond Tamás Kincses
- Department of Radiology, Albert Szent-Györgyi Health Centre, University of Szeged, Hungary
| | - Anita Must
- Institute of Psychology, Faculty of Arts, University of Szeged, Egyetem utca 2 H-6722, Szeged, Hungary.
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Ingulfsvann Hagen B, Landrø NI, Hoorelbeke K, Lau B, Stubberud J. Characteristics associated with the discrepancy between subjective and objective executive functioning in depression. APPLIED NEUROPSYCHOLOGY-ADULT 2021:1-10. [PMID: 34523373 DOI: 10.1080/23279095.2021.1969398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Major depressive disorder (MDD) is associated with both self-reported (subjective) cognitive complaints and deficits in neurocognitive (objective) measures, but the correspondence between subjective and objective measures of cognition is low. This cross-sectional study aimed to (1) assess the association between subjective and objective measures of executive functions (EFs), and (2) explore factors associated with the discrepancy between subjective and objective EFs in MDD. Sixty-two participants with current or previous mild to moderate MDD and subjective EF complaints completed a clinical trial baseline assessment. An objective EF composite score was drawn from six neurocognitive measures, while the Behavior Rating Inventory of Executive Function-Adult version was applied as a measure of subjective EF. The association between the subjective and objective composites was evaluated using Spearman's rank order correlation. A discrepancy score was calculated to quantify the difference between subjective and objective EF. Factors associated with the discrepancy score were analyzed using regression analysis (p < .05). Participants reported extensive EF difficulties, but most performed in the normal range on objective EF measures. A weak correlation was detected between the subjective and objective measures (rs = .015). More rumination (β = -.364) and higher IQ (β = -.420) were associated with reporting more subjective complaints than was evident from objective measures of EF (i.e., underestimation). Subjective and objective EF measures are weakly overlapping in MDD. Findings underscore recommendations to include both subjective and objective measures when assessing EFs in depression. In addition, findings suggest that targeting ruminative processes could help correct underestimation.
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Affiliation(s)
- Bjørn Ingulfsvann Hagen
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Kristof Hoorelbeke
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Bjørn Lau
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Jan Stubberud
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
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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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Association of depressive symptoms with cognitive impairment in patients with never-treated first-episode schizophrenia: Analysis of the Depression in Schizophrenia in China (DISC) study. Gen Hosp Psychiatry 2021; 71:108-113. [PMID: 34000518 DOI: 10.1016/j.genhosppsych.2021.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/25/2021] [Accepted: 04/29/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Depressive symptoms and cognitive dysfunction are common in patients with schizophrenia and depressive disorder. This study aimed at exploring whether and how depressive symptoms were correlated with neuro-cognitive impairment in patients with never-treated first-episode (NTFE) schizophrenia. METHODS The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was administered to 79 patients and 80 healthy controls to assess neuropsychological function. For all patients, the 17-item Hamilton Depression Rating Scale (HAMD-17) was adopted to evaluate depressive symptoms, and the Positive and Negative Syndrome Scale (PANSS) was utilized to assess psychopathological symptoms. RESULTS Thirty-nine patients (49.37%) met the criteria for comorbid depressive symptoms. The RBANS total and the four index scores in the patients were significantly lower than those in the healthy controls. Further, compared with patients without depressive symptoms, patients with depressive symptoms scored lower in attention index, but higher in PANSS general psychopathology and total scores. The HAMD-17 total score was significantly correlated with attention, PANSS total, and PANSS general psychopathology scores. Moreover, multiple regression analysis identified education and HAMD-17 score as the contributors to attention. CONCLUSION Our results suggest that the rate of depressive symptoms in NTFE schizophrenia is high, which is correlated with neuro-cognitive impairment, especially attention and psychopathology.
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Polak-Szabela A, Dziembowska I, Bracha M, Pedrycz-Wieczorska A, Kedziora-Kornatowska K, Kozakiewicz M. The Analysis of Oxidative Stress Markers May Increase the Accuracy of the Differential Diagnosis of Alzheimer's Disease with and without Depression. Clin Interv Aging 2021; 16:1105-1117. [PMID: 34163154 PMCID: PMC8215848 DOI: 10.2147/cia.s310750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/14/2021] [Indexed: 12/25/2022] Open
Abstract
Introduction The aim of work is to assess the usefulness of oxidative stress parameters in the differential diagnosis of dementia of the Alzheimer’s type and dementia of the Alzheimer’s type with coexisting depression. Methods The study involved three groups of people: patients with Alzheimer’s disease (AD) (AD; N=27), patients with Alzheimer’s disease and depression (D) (AD+D; N=30), and a control group that consisted of people without dementia and without depression (C; N=24). The assessment of cognitive functioning was carried out using among alia, Auditory Verbal Learning Test and Verbal Fluency Test. Furthermore, we determined the activity of superoxide dismutase (SOD-1) and superoxide anion radical. Results Multiple models with different combinations of independent variables showed that SOD together with Rey delayed recall were the best significant predictors of AD with the area under curve (AUC) of 0.893 (p = 0.001) and superoxide anion radical (O2•−) together with verbal fluency – sharp objects were the best significant predictors of AD +D diagnosis with the AUC of 0.689 (p = 0.034). Conclusion This study confirmed the value of neuropsychological diagnosis and analysis of oxidative stress markers in the diagnosis of AD and major depressive disorder (MDD) in the course of AD. The combination of the use of biochemical markers and neuropsychological tests seems particularly important for differential diagnosis.
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Affiliation(s)
- Anna Polak-Szabela
- Department of Geriatrics, L. Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
| | - Inga Dziembowska
- Department of Pathophysiology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
| | - Marietta Bracha
- Department of Geriatrics, Division of Biochemistry and Biogerontology, L. Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
| | | | | | - Mariusz Kozakiewicz
- Department of Geriatrics, Division of Biochemistry and Biogerontology, L. Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
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Almulla AF, Al-Rawi KF, Maes M, Al-Hakeim HK. In schizophrenia, immune-inflammatory pathways are strongly associated with depressive and anxiety symptoms, which are part of a latent trait which comprises neurocognitive impairments and schizophrenia symptoms. J Affect Disord 2021; 287:316-326. [PMID: 33812245 DOI: 10.1016/j.jad.2021.03.062] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/13/2021] [Accepted: 03/19/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND The aim is to examine whether biomarkers of the immune-inflammatory response (IRS) and endogenous opioid (EOS) systems are associated with affective symptoms in schizophrenia. METHODS We recruited 115 schizophrenia patients and 43 healthy controls and assessed the Hamilton Depression (HDRS) and Anxiety (HAM-A) rating Scale scores as well as serum levels of interleukin (IL)-6, IL-10, eotaxin (CCL11), high mobility group box 1 (HMGB1), Dickkopf-related protein 1 (DKK1), and mu (MOR) and kappa (KOR) opioid receptors. RESULTS The HDRS and HAM-A scores are significantly and positively correlated with a) psychosis, hostility, excitation, mannerism, negative symptoms, psychomotor retardation, and formal thought disorders; and b) lowered scores on semantic and episodic memory, executive functions, and attention tests as measured with the Brief Assessment of Cognition in Psychiatry. Both HDRS and HAM-A are significantly increased in non-responders to treatment as compared with partial responders. Both affective scores are strongly associated with a latent vector extracted from all symptoms, reflecting overall severity of schizophrenia symptoms (OSOS), and neurocognitive test scores, reflecting a generalized cognitive decline (G-CoDe). The HDRS score was strongly and positively associated with IL-6, HMGB1, KOR, and MOR levels, and the HAM-A score with IL-6, IL-10, CCL11, HMGB1, KOR, and MOR levels. A single latent trait may be extracted from OSOS, G-CoDe, and the HDRS and HAMA scores, and this latent vector score is strongly predicted by HMGB1, MOR, and DKK1. CONCLUSION Immune-inflammatory and EOS pathways contribute to the phenome of schizophrenia, which comprises OSOS, affective, and physiosomatic symptoms, and G-CoDe.
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Affiliation(s)
- Abbas F Almulla
- Medical Laboratory Technology Department, College of Medical Technology, The Islamic University, Najaf, Iraq.
| | | | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria; IMPACT Strategic Research Centre, Deakin University, PO Box 281, Geelong, VIC, 3220, Australia.
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Mendes T, Cardoso S, Guerreiro M, Maroco J, Silva D, Alves L, Schmand B, Simões do Couto F, Figueira ML, de Mendonça A. Memory awareness in patients with Major Depressive Disorder. J Psychiatr Res 2021; 137:411-418. [PMID: 33774535 DOI: 10.1016/j.jpsychires.2021.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/27/2021] [Accepted: 03/05/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Subjective Memory Complaints (SMC) along with cognitive deficits are frequently observed in patients with Major Depressive Disorder (MDD). The relationship between SMC and objective memory performance in patients with MDD was evaluated, in comparison with patients with Mild Cognitive Impairment due to Alzheimer's Disease (MCI-AD) and healthy controls (HC). METHODS Patients with MDD (n = 47), MCI-AD (n = 43) and HC (n = 45) were assessed with a self-report memory complaints scale (SMCS) and underwent a comprehensive clinical and neuropsychological assessment. A discrepancy score between the Logical Memory delayed recall and the SMCS total score was calculated as a measure of memory awareness. RESULTS Patients with MDD (12.5 ± 4.4) and patients with MCI-AD (10.9 ± 4.1) had not significantly different SMCS total scores, whereas HC showed significantly lower scores (4.0 ± 3.0). As much as 74.5% of patients with MDD patients and 65.1% of patients with MCI-AD reported prominent memory complaints, whereas only 4.4% of HC did. Patients with MDD had relatively preserved memory tests, resulting in a higher discrepancy score than both patients with MCI-AD and HC. The SMCS total score correlated positively with depressive symptoms in the 3 groups of participants. CONCLUSIONS Patients with MDD showed inaccurate memory self-awareness as they under-estimated their memory functioning, a pattern distinct from both patients with MCI-AD and HC.
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Affiliation(s)
- Tiago Mendes
- Faculty of Medicine, University of Lisboa, Lisbon, Portugal; Psychiatry and Mental Health Department, Santa Maria Hospital, Lisbon, Portugal.
| | - Sandra Cardoso
- Faculty of Medicine, University of Lisboa, Lisbon, Portugal
| | | | - João Maroco
- Instituto Superior de Psicologia Aplicada, Lisbon, Portugal
| | - Dina Silva
- Faculty of Medicine, University of Lisboa, Lisbon, Portugal; Cognitive Neuroscience Research Group, Department of Psychology and Educational Sciences and Centre for Biomedical Research (CBMR), Universidade do Algarve, Faro, Portugal
| | - Luísa Alves
- Chronic Diseases Research Centre, NOVA Medical School, NOVA University of Lisbon, Portugal
| | - Ben Schmand
- Faculty of Social and Behavioral Sciences, University of Amsterdam, the Netherlands
| | - Frederico Simões do Couto
- Faculty of Medicine, University of Lisboa, Lisbon, Portugal; Psychiatry and Mental Health Department, Santa Maria Hospital, Lisbon, Portugal
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Francis AM, Bissonnette JN, Hull KM, Leckey J, Pimer L, Berrigan LI, Fisher DJ. Alterations of novelty processing in major depressive disorder. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Chen X, Wang M, Hu Y, Zhan Y, Zhou Y, Zheng W, Liu W, Wang C, Zhong X, Li H, Lan X, Ning Y, Zhang B. Working memory associated with anti-suicidal ideation effect of repeated-dose intravenous ketamine in depressed patients. Eur Arch Psychiatry Clin Neurosci 2021; 271:431-438. [PMID: 33386430 DOI: 10.1007/s00406-020-01221-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 12/02/2020] [Indexed: 12/20/2022]
Abstract
Suicide is a tremendous threat to global public health, and a large number of people who committed suicide suffered the pain of mental diseases, especially major depressive disorder (MDD). Previous study showed that ketamine could reduce suicidal ideation (SI), potentially by improving the impaired working memory (WM). The objective of current study was to illuminate the relationship between WM and SI in MDD with repeated ketamine treatment. MDD patients with SI (n = 59) and without SI (n = 37) completed six intravenous infusions of ketamine (0.5 mg/kg over 40 min) over 12 days (Day 1, 3, 5, 8, 10 and 12). The severity of depressive symptoms, SI and WM were assessed at baseline, day 13 and day 26. We found that WM was significantly improved after 6 ketamine infusions (F = 161.284, p = 0.009) in a linear mixed model. Correlation analysis showed that the improvement of depressive symptom was significantly associated with WM at baseline (r = - 0.265, p = 0.042) and the reduction in SSI-part I was related to the change of WM (r = 0.276, p = 0.034) in the MDD patients with SI. Furthermore, Logistic regression analysis showed that improvement in WM might predict the anti-SI response of ketamine. Our findings suggest that the improvement of working memory may partly account for the anti-SI effect of ketamine, and intervention of improving working memory function may be capable of reducing suicidal ideation.
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Affiliation(s)
- Xiaoyu Chen
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Mingqia Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Yiru Hu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Yanni Zhan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Yanling Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Wei Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Weijian Liu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Chengyu Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Xiaomei Zhong
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Hanqiu Li
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Xiaofeng Lan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China. .,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China.
| | - Bin Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
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Camacho-Conde JA, Galán-López JM. Depression and Cognitive Impairment in Institutionalized Older Adults. Dement Geriatr Cogn Disord 2021; 49:107-120. [PMID: 32634807 DOI: 10.1159/000508626] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/11/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In the last three decades, the relationship between depression and cognition in geriatric patients has been a popular topic among researchers and clinicians. Clinical and epidemiological research has focused on the identification of risk factors that could be modified in pre-dementia syndromes, at a preclinical and early clinical stage of dementia disorders, with specific attention to the role of depression. The objective of this work was to determine the relationship between depressive disorder and cognitive deterioration in institutionalized older adults. METHODS In this descriptive, correlational study, data were gathered from two nursing homes in the province of Jaen (Spain), from a random sample of 140 older adults (70 nondependent and 70 dependent). The variables were measured using comprehensive geriatric assessment, the Cambridge Cognitive Test (CAMCOG), and the Geriatric Depression Scale (GDS). RESULTS Depression was correlated with cognitive level in the nondependent older adult sample (r = -0.471, p = 0.004). Age was inversely associated with the score obtained in the CAMCOG of the nondependent older adult sample (r = -0.352, p = 0.038). The functional capacity in several activities of daily living was correlated with the score obtained in the CAMCOG in each of the two groups. Depression was more prevalent in the dependent than in the nondependent older adults (82.85 vs. 57.14%). No association was observed between institutionalization time and the score obtained on the cognitive and affective scales (GDS and CAMCOG) in both groups (GDS-nondependent, r = -0.209, p = 0.234; CAMCOG-nondependent, r = 0.007, p = 0.967; GDS-dependent, r = 0.251, p = 0.152; CAMCOG-dependent, r = -0.021, p = 0.907). CONCLUSION Depressive symptomatology is associated with cognitive deterioration. Depression is prevalent in institutions that care for older, more dependent adults.
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Quek YF, Yang Z, Dauwels J, Lee J. The Impact of Negative Symptoms and Neurocognition on Functioning in MDD and Schizophrenia. Front Psychiatry 2021; 12:648108. [PMID: 34381384 PMCID: PMC8350050 DOI: 10.3389/fpsyt.2021.648108] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/25/2021] [Indexed: 01/01/2023] Open
Abstract
Introduction: Negative symptoms, neurocognitive deficits and functional impairment are prevalent in individuals with major depressive disorder (MDD) and schizophrenia (SCZ). However, unlike neurocognitive deficits, little is known about the role of negative symptoms toward functioning in individuals with MDD. On the other hand, both factors are well-studied in individuals with SCZ. Thus, this study aimed to examine the contributions of negative symptoms and neurocognitive impairments in functioning in individuals with MDD, compared to individuals with SCZ. Methods: Participants included 50 individuals with MDD, 49 individuals with SCZ and 49 healthy controls. The following measures were administered-Negative Symptom Assessment (NSA-16), Brief Assessment of Cognition in Schizophrenia (BACS), Patient Health Questionnaire (PHQ-9), and MIRECC-Global Assessment of Functioning (MIRECC-GAF) to evaluate negative symptoms, neurocognition, depressive symptoms, and functioning respectively. Results: Both MDD and SCZ groups had significantly more severe negative symptoms, depressive symptoms, and poorer functioning than healthy controls. Individuals with SCZ performed significantly poorer on the BACS than the other two groups. Both negative symptoms and neurocognition were significantly correlated with social and occupational functioning in SCZ. Motivation subdomain of the negative symptoms was significantly correlated with occupational functioning, while depressive symptoms correlated with functioning in MDD. Conclusion: Both negative symptoms and neurocognitive deficits appear to play differential roles on individual domains of functioning between MDD and SCZ. Future longitudinal studies with larger sample sizes should be done for a better understanding about the associations between the factors and functioning.
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Affiliation(s)
- Yue Feng Quek
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Zixu Yang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Justin Dauwels
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, Singapore
| | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore, Singapore.,North Region & Department of Psychosis, Institute of Mental Health, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Glenthøj LB, Mariegaard L, Kristensen TD, Wenneberg C, Medalia A, Nordentoft M. Self-perceived cognitive impairments in psychosis ultra-high risk individuals: associations with objective cognitive deficits and functioning. NPJ SCHIZOPHRENIA 2020; 6:31. [PMID: 33188204 PMCID: PMC7666210 DOI: 10.1038/s41537-020-00124-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/08/2020] [Indexed: 02/06/2023]
Abstract
There is a scarcity of evidence on subjectively reported cognitive difficulties in individuals at ultra-high risk (UHR) for psychosis and whether these self-perceived cognitive difficulties may relate to objective cognitive deficits, psychopathology, functioning, and adherence to cognitive remediation (CR). Secondary, exploratory analyses to a randomized, clinical trial were conducted with 52 UHR individuals receiving a CR intervention. Participants completed the Measure of Insight into Cognition—Self Report (MIC-SR), a measure of daily life cognitive difficulties within the domains of attention, memory, and executive functions along with measures of neuropsychological test performance, psychopathology, functioning, and quality of life. Our study found participants with and without objectively defined cognitive deficits reported self-perceived cognitive deficits of the same magnitude. No significant relationship was revealed between self-perceived and objectively measured neurocognitive deficits. Self-perceived cognitive deficits associated with attenuated psychotic symptoms, overall functioning, and quality of life, but not with adherence to, or neurocognitive benefits from, a CR intervention. Our findings indicate that UHR individuals may overestimate their cognitive difficulties, and higher levels of self-perceived cognitive deficits may relate to poor functioning. If replicated, this warrants a need for both subjective and objective cognitive assessment in at-risk populations as this may guide psychoeducational approaches and pro-functional interventions. Self-perceived cognitive impairments do not seem to directly influence CR adherence and outcome in UHR states. Further studies are needed on potential mediator between self-perceived cognitive deficits and functioning and quality of life.
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Affiliation(s)
- Louise Birkedal Glenthøj
- Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, DK-2900, Hellerup, Denmark. .,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, DK-2600, Glostrup, Denmark.
| | - Lise Mariegaard
- Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, DK-2900, Hellerup, Denmark.,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, DK-2600, Glostrup, Denmark
| | - Tina Dam Kristensen
- Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, DK-2900, Hellerup, Denmark.,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, DK-2600, Glostrup, Denmark
| | - Christina Wenneberg
- Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, DK-2900, Hellerup, Denmark.,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, DK-2600, Glostrup, Denmark
| | - Alice Medalia
- Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Merete Nordentoft
- Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, DK-2900, Hellerup, Denmark.,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, DK-2600, Glostrup, Denmark
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Labad J, Salvat-Pujol N, Armario A, Cabezas Á, de Arriba-Arnau A, Nadal R, Martorell L, Urretavizcaya M, Monreal JA, Crespo JM, Vilella E, Palao DJ, Menchón JM, Soria V. The Role of Sleep Quality, Trait Anxiety and Hypothalamic-Pituitary-Adrenal Axis Measures in Cognitive Abilities of Healthy Individuals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207600. [PMID: 33086584 PMCID: PMC7589840 DOI: 10.3390/ijerph17207600] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 12/27/2022]
Abstract
Sleep plays a crucial role in cognitive processes. Sleep and wake memory consolidation seem to be regulated by glucocorticoids, pointing out the potential role of the hypothalamic-pituitary-adrenal (HPA) axis in the relationship between sleep quality and cognitive abilities. Trait anxiety is another factor that is likely to moderate the relationship between sleep and cognition, because poorer sleep quality and subtle HPA axis abnormalities have been reported in people with high trait anxiety. The current study aimed to explore whether HPA axis activity or trait anxiety moderate the relationship between sleep quality and cognitive abilities in healthy individuals. We studied 203 healthy individuals. We measured verbal and visual memory, working memory, processing speed, attention and executive function. Sleep quality was assessed with the Pittsburgh Sleep Quality Index. Trait anxiety was assessed with the State-Trait Anxiety Inventory. HPA axis measures included the cortisol awakening response (CAR), diurnal cortisol slope and cortisol levels during the day. Multiple linear regression analyses explored the relationship between sleep quality and cognition and tested potential moderating effects by HPA axis measures and trait anxiety. Poor sleep quality was associated with poorer performance in memory, processing speed and executive function tasks. In people with poorer sleep quality, a blunted CAR was associated with poorer verbal and visual memory and executive functions, and higher cortisol levels during the day were associated with poorer processing speed. Trait anxiety was a moderator of visual memory and executive functioning. These results suggest that subtle abnormalities in the HPA axis and higher trait anxiety contribute to the relationship between lower sleep quality and poorer cognitive functioning in healthy individuals.
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Affiliation(s)
- Javier Labad
- Consorci Sanitari del Maresme, 08340 Mataró, Spain;
- Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain; (J.A.M.); (D.J.P.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain; (A.A.); (R.N.); (L.M.); (M.U.); (J.M.C.); (E.V.); (J.M.M.)
| | - Neus Salvat-Pujol
- Department of Mental Health, Parc Taulí Hospital Universitari, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain;
- Department of Psychiatry, Bellvitge University Hospital, 08907 L’Hospitalet de Llobregat, Spain;
- Neurosciences Group—Psychiatry and Mental Health, Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Spain
| | - Antonio Armario
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain; (A.A.); (R.N.); (L.M.); (M.U.); (J.M.C.); (E.V.); (J.M.M.)
- Institut de Neurociències, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Ángel Cabezas
- Hospital Universitari Institut Pere Mata, Institut d’Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili, 43206 Reus, Spain;
| | - Aida de Arriba-Arnau
- Department of Psychiatry, Bellvitge University Hospital, 08907 L’Hospitalet de Llobregat, Spain;
- Neurosciences Group—Psychiatry and Mental Health, Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Spain
| | - Roser Nadal
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain; (A.A.); (R.N.); (L.M.); (M.U.); (J.M.C.); (E.V.); (J.M.M.)
- Institut de Neurociències, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Lourdes Martorell
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain; (A.A.); (R.N.); (L.M.); (M.U.); (J.M.C.); (E.V.); (J.M.M.)
- Hospital Universitari Institut Pere Mata, Institut d’Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili, 43206 Reus, Spain;
| | - Mikel Urretavizcaya
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain; (A.A.); (R.N.); (L.M.); (M.U.); (J.M.C.); (E.V.); (J.M.M.)
- Department of Psychiatry, Bellvitge University Hospital, 08907 L’Hospitalet de Llobregat, Spain;
- Neurosciences Group—Psychiatry and Mental Health, Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, 08907 L’Hospitalet de Llobregat, Spain
| | - José Antonio Monreal
- Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain; (J.A.M.); (D.J.P.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain; (A.A.); (R.N.); (L.M.); (M.U.); (J.M.C.); (E.V.); (J.M.M.)
- Department of Mental Health, Parc Taulí Hospital Universitari, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain;
| | - José Manuel Crespo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain; (A.A.); (R.N.); (L.M.); (M.U.); (J.M.C.); (E.V.); (J.M.M.)
- Department of Psychiatry, Bellvitge University Hospital, 08907 L’Hospitalet de Llobregat, Spain;
- Neurosciences Group—Psychiatry and Mental Health, Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, 08907 L’Hospitalet de Llobregat, Spain
| | - Elisabet Vilella
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain; (A.A.); (R.N.); (L.M.); (M.U.); (J.M.C.); (E.V.); (J.M.M.)
- Hospital Universitari Institut Pere Mata, Institut d’Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili, 43206 Reus, Spain;
| | - Diego José Palao
- Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain; (J.A.M.); (D.J.P.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain; (A.A.); (R.N.); (L.M.); (M.U.); (J.M.C.); (E.V.); (J.M.M.)
- Department of Mental Health, Parc Taulí Hospital Universitari, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain;
| | - José Manuel Menchón
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain; (A.A.); (R.N.); (L.M.); (M.U.); (J.M.C.); (E.V.); (J.M.M.)
- Department of Psychiatry, Bellvitge University Hospital, 08907 L’Hospitalet de Llobregat, Spain;
- Neurosciences Group—Psychiatry and Mental Health, Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, 08907 L’Hospitalet de Llobregat, Spain
| | - Virginia Soria
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain; (A.A.); (R.N.); (L.M.); (M.U.); (J.M.C.); (E.V.); (J.M.M.)
- Department of Psychiatry, Bellvitge University Hospital, 08907 L’Hospitalet de Llobregat, Spain;
- Neurosciences Group—Psychiatry and Mental Health, Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, 08907 L’Hospitalet de Llobregat, Spain
- Correspondence:
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Gregory E, Torres IJ, Ge R, Blumberger DM, Downar JH, Daskalakis ZJ, Lam RW, Vila-Rodriguez F. Predictors of cognitive impairment in treatment-resistant depression. J Affect Disord 2020; 274:593-601. [PMID: 32663992 DOI: 10.1016/j.jad.2020.05.101] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/18/2020] [Accepted: 05/16/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Cognitive impairment is a well-recognized symptom of major depressive disorder; however, contributing factors are not fully characterized. The present study examined the neurocognitive profiles and predictors of cognitive impairment in patients with treatment-resistant depression (TRD). METHODS Moderate to severely depressed TRD patients were compared to matched healthy volunteers (HV) in verbal learning and recall and executive functions. Based on cognitive scores, cluster analysis was performed to identify subsets within the TRD sample. Predictors of cognitive impairment were also investigated. RESULTS TRD patients showed worse performance in tests assessing verbal memory, executive attentional shifting, and inhibitory control. The cluster analysis revealed two groups: a cognitively impaired (CI) group that showed a generalized deficit across cognitive domains, and a relatively cognitively intact group that performed better than CI in all domains except attentional shifting. A logistic binomial regression of the two groups revealed three significant contributing risk factors for CI: 1) older age, 2) lower premorbid IQ, and 3) benzodiazepine use. Cognitive impairment and benzodiazepine use were associated with worse functioning. CONCLUSIONS Significant cognitive impairment is present in TRD and is associated with worse functioning. Age, lower premorbid IQ, and benzodiazepine use increased the likelihood of generalized cognitive impairment in TRD patients. The detrimental effect of benzodiazepine on cognitive impairment is independent of anxiety symptoms. Further research is needed to characterize the timeline of cognitive impairment in depression.
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Affiliation(s)
- Elizabeth Gregory
- Non-Invasive Neurostimulation Therapies (NINET) Laboratory, Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC V6T 2A1, Canada
| | - Ivan J Torres
- Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC V6T 2A1, Canada; British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC
| | - Ruiyang Ge
- Non-Invasive Neurostimulation Therapies (NINET) Laboratory, Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC V6T 2A1, Canada
| | - Daniel M Blumberger
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jonathan H Downar
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; MRI-Guided rTMS Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Zafiris J Daskalakis
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC V6T 2A1, Canada
| | - Fidel Vila-Rodriguez
- Non-Invasive Neurostimulation Therapies (NINET) Laboratory, Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC V6T 2A1, Canada.
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Li JM, Zhao Y, Sun Y, Kong LD. Potential effect of herbal antidepressants on cognitive deficit: Pharmacological activity and possible molecular mechanism. JOURNAL OF ETHNOPHARMACOLOGY 2020; 257:112830. [PMID: 32259666 DOI: 10.1016/j.jep.2020.112830] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cognitive symptom is a "core" symptom of major depressive disorder (MDD) patients with clear deficit in memory, social and occupational function, and may persist during the remitting phase. Therefore, the remission of cognitive symptom has been considered as one of the main objectives in the treatment of MDD. Herbal antidepressants have been used to treat MDD, and there has been great advances in the understanding of the ability of these herbs to improve cognitive deficit linked to brain injury and various diseases including depression, Alzheimer disease, diabetes and age-related disorders. This systematic review summarizes the evidence from preclinical studies and clinical trials of herbal antidepressants with positive effects on cognitive deficit. The potential mechanisms by which herbal antidepressants prevent cognitive deficit are also reviewed. This review will facilitate further research and applications. MATERIALS AND METHODS We conducted an open-ended, English restricted search of MEDLINE (PubMed), Web of Science and Scopus for all available articles published or online before 31 December 2019, using terms pertaining to medical herb/phytomedicine/phytochemical/Chinese medicine and depression/major depressive disorder/antidepressant and/or cognitive impairment/cognitive deficit/cognitive dysfunction. RESULTS 7 prescriptions, more than 30 individual herbs and 50 phytochemicals from China, Japan, Korea and India with positive effects on the depressive state and cognitive deficit are reviewed herein. The evidence from preclinical studies and clinical trials proves that these herbal antidepressants exhibit positive effects on one or more aspects of cognitive defect including spatial, episodic, aversive, and short- and long-term memory. The action mode of the improvement of cognitive deficit by these herbal antidepressants is mediated mainly through two pathways. One pathway is to promote hippocampal neurogenesis through activating brain derived neurotrophic factor-tropomyosin-related kinase B signaling. The other pathway is to prevent neuronal apoptosis through the inhibition of neuro-inflammation and neuro-oxidation. CONCLUSION These herbal antidepressants, having potential therapy for cognitive deficit, may prevent pathological processes of neurodegenerative diseases. Furthermore, these herbal medicines should provide a treasure trove, which will accelerate the development of new antidepressants that can effectively improve cognitive symptom in MDD. Studies on their molecular mechanisms may provide more potential targets and therapeutic approaches for new drug discovery.
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Affiliation(s)
- Jian-Mei Li
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, 210023, PR China
| | - Yue Zhao
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, 210023, PR China
| | - Yang Sun
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, 210023, PR China
| | - Ling-Dong Kong
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, 210023, PR China.
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Association between cognition and suicidal ideation in patients with major depressive disorder: A longitudinal study. J Affect Disord 2020; 272:146-151. [PMID: 32379606 DOI: 10.1016/j.jad.2020.03.141] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/13/2020] [Accepted: 03/29/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Suicidal ideation (SI) is common in patients with major depressive disorder (MDD) and often related to cognitive deficits. Limited longitudinal study has shown that cognitive improvement is associated with reduced SI. However, the comparatively study in Chinese depressed patients is still absent. The objective of this study was to explore the specific cognitive deficits in Chinese MDD with SI and investigate the relationship between changes in cognition and change in SI across antidepressant treatment. METHODS Three hundred and five patients with MDD received four weeks of antidepressant treatment. The 17-item Hamilton Depression Rating Scale (HAMD-17) and four domains of the MATRICS Consensus Cognitive Battery (MCCB), including speed of processing, working memory, visual learning and verbal learning were measured at baseline and four-week follow-up. RESULTS One hundred and thirty patients (42.6%) expressed suicidal ideation. Suicidal patients performed worse on verbal learning than non-suicidal patients. Change in speed of processing domain was negatively associated with change in suicidal scores over time. Logistic regression analysis showed that reduction of SI was associated with improvement of speed of processing. LIMITATION The major limitation was that there was no healthy control group in the current study, which might limit the interpretation of cognitive deficits in depressed patients with SI. CONCLUSIONS Our findings suggest that suicidal patients performed worse on verbal learning which can potentially serve as a cognitive biomarker of suicide risk in MDD. Moreover, reduced suicidal ideation was associated with improved speed of processing.
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Activation of alpha7 nicotinic and NMDA receptors is necessary for performance in a working memory task. Psychopharmacology (Berl) 2020; 237:1723-1735. [PMID: 32162104 PMCID: PMC7313359 DOI: 10.1007/s00213-020-05495-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 02/19/2020] [Indexed: 10/24/2022]
Abstract
RATIONALE Working memory deficits are present in schizophrenia (SZ) but remain insufficiently resolved by medications. Similar cognitive dysfunctions can be produced acutely in animals by elevating brain levels of kynurenic acid (KYNA). KYNA's effects may reflect interference with the function of both the α7 nicotinic acetylcholine receptor (α7nAChR) and the glycineB site of the NMDA receptor. OBJECTIVES The aim of the present study was to examine, using pharmacological tools, the respective roles of these two receptor sites on performance in a delayed non-match-to-position working memory (WM) task (DNMTP). METHODS DNMTP consisted of 120 trials/session (5, 10, and 15 s delays). Rats received two doses (25 or 100 mg/kg, i.p.) of L-kynurenine (KYN; bioprecursor of KYNA) or L-4-chlorokynurenine (4-Cl-KYN; bioprecursor of the selective glycineB site antagonist 7-Cl-kynurenic acid). Attenuation of KYN- or 4-Cl-KYN-induced deficits was assessed by co-administration of galantamine (GAL, 3 mg/kg) or PAM-2 (1 mg/kg), two positive modulators of α7nAChR function. Reversal of 4-Cl-KYN-induced deficits was examined using D-cycloserine (DCS; 30 mg/kg), a partial agonist at the glycineB site. RESULTS Both KYN and 4-Cl-KYN administration produced dose-related deficits in DNMTP accuracy that were more severe at the longer delays. In KYN-treated rats, these deficits were reversed to control levels by GAL or PAM-2 but not by DCS. In contrast, DCS eliminated performance deficits in 4-Cl-KYN-treated animals. CONCLUSIONS These experiments reveal that both α7nAChR and NMDAR activity are necessary for normal WM accuracy. They provide substantive new support for the therapeutic potential of positive modulators at these two receptor sites in SZ and other major brain diseases.
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Baeza-Velasco C, Guillaume S, Olié E, Alacreu-Crespo A, Cazals A, Courtet P. Decision-making in major depressive disorder: Subjective complaint, objective performance, and discrepancy between both. J Affect Disord 2020; 270:102-107. [PMID: 32339098 DOI: 10.1016/j.jad.2020.03.064] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 01/13/2020] [Accepted: 03/22/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Studies comparing objective and subjective cognition in major depressive disorder (MDD) are scarce, and available data concern different cognitive functions but not decision-making specifically. This cross-sectional study aimed to explore objective (O-DMI) and subjective decision-making impairment (S-DMI) as well as the discrepancy between both in people with MDD. Secondly, we assessed the association between S-DMI and O-DMI. Finally, we explored sociodemographic, clinical, and psychosocial factors related to decision-making impairment status. METHOD One hundred and nine people with MDD were assessed with the Iowa Gambling Task to identify "O-DMI". The item 9 of the Beck Depression Inventory was used to compose the variable "S-DMI". Psychiatric history, medication adherence, childhood trauma, physical and psychological pain, and negative life experiences were also collected. RESULTS Forty-six percent of participants have O-DMI and 65.1% S-DMI. From 49.5% showing a discrepancy between both, 68,6% have positive discrepancy and 31,4% negative (i.e. under and overestimation respectively). O-DMI and S-DMI were not associated. Binary logistic regressions showed that the number of negative life events in the past 6 months was predictor of O-DMI, while depression severity and medication adherence predicted S-DMI. Finally, medication adherence and depression severity predicted the type of discrepancy. LIMITATIONS The variable S-DMI was obtained through a single item. CONCLUSION These results confirm the lack of association between objective and subjective measures of cognition in MDD, and for the first-time concerning decision-making. This suggest that both assessments should be done in order to have a deeper knowledge of the cognitive functioning of each patient.
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Affiliation(s)
- Carolina Baeza-Velasco
- Département d'Urgence & Post Urgence Psychiatrique, Neuropsychiatrie: recherche épidémiologique et clinique, INSERM, Université Montpellier, CHU Montpellier, Montpellier, France; University of Paris, LPPS, Institut de Psychologie, 71 Avenue Édouard Vaillant, Boulogne-Billancourt F-92100, France.
| | - Sébastien Guillaume
- Département d'Urgence & Post Urgence Psychiatrique, Neuropsychiatrie: recherche épidémiologique et clinique, INSERM, Université Montpellier, CHU Montpellier, Montpellier, France
| | - Emilie Olié
- Département d'Urgence & Post Urgence Psychiatrique, Neuropsychiatrie: recherche épidémiologique et clinique, INSERM, Université Montpellier, CHU Montpellier, Montpellier, France
| | - Adrian Alacreu-Crespo
- Département d'Urgence & Post Urgence Psychiatrique, Neuropsychiatrie: recherche épidémiologique et clinique, INSERM, Université Montpellier, CHU Montpellier, Montpellier, France
| | - Aurélie Cazals
- Département d'Urgence & Post Urgence Psychiatrique, Neuropsychiatrie: recherche épidémiologique et clinique, INSERM, Université Montpellier, CHU Montpellier, Montpellier, France
| | - Philippe Courtet
- Département d'Urgence & Post Urgence Psychiatrique, Neuropsychiatrie: recherche épidémiologique et clinique, INSERM, Université Montpellier, CHU Montpellier, Montpellier, France
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Dhillon S, Videla-Nash G, Foussias G, Segal ZV, Zakzanis KK. On the nature of objective and perceived cognitive impairments in depressive symptoms and real-world functioning in young adults. Psychiatry Res 2020; 287:112932. [PMID: 32272334 DOI: 10.1016/j.psychres.2020.112932] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 02/09/2020] [Accepted: 03/18/2020] [Indexed: 01/29/2023]
Abstract
Cognitive impairments in depression contribute to disability. According to prevailing cognitive theories, one's perception related to cognitive ability can cause and maintain depression, and related outcomes. Here, we investigate the degree to which perceived cognitive impairment predicts functional impairment above and beyond objective neurocognition. A sample of young adults (n = 123) completed a battery of tests measuring objective cognitive ability, perceived cognitive function (e.g., Perceived Deficits Questionnaire), disability (e.g., World Health Organization Disability Assessment Schedule) and depressive symptoms (Beck Depression Inventory-2). Hierarchical multiple regression analyses tested the incremental variance that perceived cognitive impairment accounts for above and beyond neuropsychological test measures and disability related to depression. Results show that perceived cognitive impairment accounts for significant incremental variance in depressive symptoms beyond neuropsychological test scores; disability measures were significantly associated with depressive symptoms, as was perceived cognitive impairment. Individuals with depression and related disorders are more likely to report cognitive impairments and experience diminished cognitive ability - relative to healthy controls - regardless of objective impairments, highlighting the importance of considering, measuring, and treating this perceived cognitive impairment, that is, Cognitive Impairment Bias (Dhillon and Zakzanis, 2019).
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Affiliation(s)
- Sonya Dhillon
- Graduate Department of Psychological Clinical Science, University of Toronto, Canada.
| | | | - George Foussias
- Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Zindel V Segal
- Graduate Department of Psychological Clinical Science, University of Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Konstantine K Zakzanis
- Graduate Department of Psychological Clinical Science, University of Toronto, Canada; Department of Psychology, University of Toronto, Toronto, Canada
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Basso L, Bönke L, Aust S, Gärtner M, Heuser-Collier I, Otte C, Wingenfeld K, Bajbouj M, Grimm S. Antidepressant and neurocognitive effects of serial ketamine administration versus ECT in depressed patients. J Psychiatr Res 2020; 123:1-8. [PMID: 31981856 DOI: 10.1016/j.jpsychires.2020.01.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/13/2020] [Accepted: 01/13/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND While electroconvulsive therapy (ECT) is considered the gold standard for acute treatment of patients with otherwise treatment-resistant depression, ketamine has recently emerged as a fast-acting treatment alternative for these patients. Efficacy and onset of action are currently among the main factors that influence clinical decision making, however, the effect of these treatments on cognitive functions should also be a crucial point, given that cognitive impairment in depression is strongly related to disease burden and functional recovery. ECT is known to induce transient cognitive impairment, while little is known about ketamine's impact on cognition. This study therefore aims to compare ECT and serial ketamine administration not only with regard to their antidepressant efficacy but also to acute neurocognitive effects. METHODS Fifty patients suffering from depression were treated with either serial ketamine infusions or ECT. Depression severity and cognitive functions were assessed before, during, and after treatment. RESULTS ECT and ketamine administration were equally effective, however, the antidepressant effects of ketamine occurred faster. Ketamine improved neurocognitive functioning, especially attention and executive functions, whereas ECT was related to a small overall decrease in cognitive performance. CONCLUSIONS Due to its pro-cognitive effects and faster antidepressant effect, serial ketamine administration might be a more favorable short-term treatment option than ECT. LIMITATIONS As this research employed a naturalistic study design, patients were not systematically randomized, there was no control group and patients received concurrent and partially changing medications during treatment. CLINICAL TRIALS REGISTRATION Functional and Metabolic Changes in the Course of Antidepressive Treatment, https://clinicaltrials.gov/ct2/show/NCT02099630, NCT02099630.
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Affiliation(s)
- Laura Basso
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt - Universität zu Berlin, Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland
| | - Luisa Bönke
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt - Universität zu Berlin, Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany.
| | - Sabine Aust
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt - Universität zu Berlin, Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Matti Gärtner
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt - Universität zu Berlin, Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Isabella Heuser-Collier
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt - Universität zu Berlin, Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Christian Otte
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt - Universität zu Berlin, Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Katja Wingenfeld
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt - Universität zu Berlin, Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Malek Bajbouj
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt - Universität zu Berlin, Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Simone Grimm
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt - Universität zu Berlin, Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland; Department of Psychology, MSB Medical School Berlin, Calandrellistr. 1-9, 12247, Berlin, Germany
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Cordner ZA, MacKinnon DF, DePaulo JR. The Care of Patients With Complex Mood Disorders. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2020; 18:129-138. [PMID: 33162850 PMCID: PMC7587882 DOI: 10.1176/appi.focus.20200007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This article focuses on some common dilemmas facing clinicians, patients, and families in managing the treatment of complicated mood disorders. Specifically, this article reviews the interaction of depressive states, including unipolar, bipolar, and mixed, with other adversities, including comorbid physical and psychological disorders, personality vulnerabilities, misuse of drugs and alcohol, and social and family problems. These issues are not always clearly differentiated from the depressive illness. Each of these adversities can worsen an existing mood disorder and influence the patient's resolve to persist with a treatment plan. Although this article is not focused strictly on treatment-resistant depression, these coexisting issues make depressive states harder to manage therapeutically. For brevity, the aim of this article has been limited to discussion of some complex situations that psychiatrists in general practice may encounter.
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Affiliation(s)
- Zachary A Cordner
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Cordner, MacKinnon, DePaulo)
| | - Dean F MacKinnon
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Cordner, MacKinnon, DePaulo)
| | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Cordner, MacKinnon, DePaulo)
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Liang S, Yu W, Ma X, Luo S, Zhang J, Sun X, Luo X, Zhang Y. Psychometric properties of the MATRICS Consensus Cognitive Battery (MCCB) in Chinese patients with major depressive disorder. J Affect Disord 2020; 265:132-138. [PMID: 32090734 DOI: 10.1016/j.jad.2020.01.052] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 12/13/2019] [Accepted: 01/13/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Major depression disorder (MDD) is often associated with cognitive impairment. The development of an accurate and effective battery to measure cognitive deficit is necessary for both research and clinical practice in MDD. Our study was designed to test the psychometric properties of the MATRICS Consensus Cognitive Battery (MCCB) in patients with MDD. METHOD Forty-eight patients with MDD, forty-three euthymic patients with bipolar disorder (BD) and thirty-two remitted patients with schizophrenia (SCH) were recruited from Tianjin Anding Hospital in Tianjin, China. The MCCB, the Montreal Cognitive Assessment (MoCA) and the Hamilton Depression Rating Scale-17 (HDRS-17) were administered to assess cognitive impairment and depressive symptoms at both baseline and one month later. RESULT Our findings showed that the MCCB had good internal consistency and acceptable reliability in Chinese MDD patients. Our findings revealed a high correlation between the MCCB and the MoCA, indicating good concurrent validity of the MCCB. Furthermore, the MCCB showed high discriminant ability between MDD patients and healthy controls, and a principal component analysis of the MCCB in MDD patients revealed four domains with acceptable internal structure. LIMITATIONS We did not consider confounding factors, such as the course, severity of symptoms and medication treatments, which might bias the cognitive assessment. In addition, the use of the MoCA as a reference scale for mild cognitive impairment could weaken the concurrent validity of the MCCB in MDD patients. CONCLUSION Our findings demonstrated that the MCCB may be clinically useful as a cognitive impairment rating battery in Chinese patients with MDD.
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Affiliation(s)
- Sixiang Liang
- Tianjin Anding Hospital, Tianjin 300222, China; The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Wenwen Yu
- Tianjin Anding Hospital, Tianjin 300222, China
| | - Xiaojuan Ma
- Tianjin Medical College, Tianjin 300222, China
| | - Shuqing Luo
- Department of Obstetrics, Baoding Second Central Hospital, Hebei 072750, China
| | - Jian Zhang
- Tianjin Anding Hospital, Tianjin 300222, China
| | - Xia Sun
- Tianjin Anding Hospital, Tianjin 300222, China
| | - Xingguang Luo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, United States
| | - Yong Zhang
- Tianjin Anding Hospital, Tianjin 300222, China.
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Hu WM, Yin XY, Yin XL, Zhu ZH, Guan LY, Hou WL, Yin GZ, Jiang CX, Xu XW, Gao ST, Jia QF, Hui L. Prevalence, social-demographic and cognitive correlates of depression in Chinese psychiatric medical staff. J Affect Disord 2020; 263:60-63. [PMID: 31818797 DOI: 10.1016/j.jad.2019.11.133] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/22/2019] [Accepted: 11/29/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND The high prevalence of depression in general population was related to its social-demographics and cognitive performance. However, no studies investigated the prevalence of depression, its social-demographic and cognitive correlates in psychiatric medical staff. Thus, the aims of this study investigated the prevalence, social-demographic and cognitive correlates of depression in Chinese psychiatric medical staff. METHODS 186 Chinese psychiatric medical staff were enrolled in Wenzhou Kangning Hospital. Depressive symptom score was assessed by the Self-rating Depression Scale (SDS). Cognition was assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). RESULTS The prevalence of depression was 17.74% in these medical staff. The RBANS total score in participants with depressive symptom was significantly lower than that in participants with not depressive symptom after controlling for the confounding variables. The Person correlation analysis found that the normal SDS score in these medical staff was significantly related to age, education, occupations, RBANS total score and subscale scores. Stepwise multivariate regression analysis further identified that age and RBANS total score were significantly associated with the normal SDS score in these medical staff. LIMITATIONS The limitations included cross-sectional study design, the small sample size, and the self-rating scale of depression. CONCLUSIONS The prevalence of depression in Chinese psychiatric medical staff was higher in comparison with Chinese general population, but lower in comparison with Chinese medical staff. Cognitive deficits might be considered a core feather of depression that should be a valuable target for future interventions. Age influenced depressive symptom in these medical staff .
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Affiliation(s)
- Wei Ming Hu
- Mental Health Center of Yanqing District, Beijing 102115, China; Research Center of Biological Psychiatry, Suzhou Guangji Hospital, Suzhou 215137, Jiangsu, China
| | - Xu Yuan Yin
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, Suzhou 215137, Jiangsu, China
| | - Xiao Li Yin
- Kangning Hospital attached to Wenzhou Medical University, Wenzhou 325007, Zhejiang, China
| | - Zhen Hua Zhu
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, Suzhou 215137, Jiangsu, China
| | - Lu Yang Guan
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, Suzhou 215137, Jiangsu, China; Kangning Hospital attached to Wenzhou Medical University, Wenzhou 325007, Zhejiang, China
| | - Wen Long Hou
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, Suzhou 215137, Jiangsu, China; Kangning Hospital attached to Wenzhou Medical University, Wenzhou 325007, Zhejiang, China
| | - Guang Zhong Yin
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, Suzhou 215137, Jiangsu, China
| | - Cai Xia Jiang
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, Suzhou 215137, Jiangsu, China
| | - Xiao Wen Xu
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, Suzhou 215137, Jiangsu, China
| | - Song Tian Gao
- Xinghua Forth People's Hospital, Xinghua 225700, Jiangsu, China
| | - Qiu Fang Jia
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, Suzhou 215137, Jiangsu, China
| | - Li Hui
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, Suzhou 215137, Jiangsu, China; Kangning Hospital attached to Wenzhou Medical University, Wenzhou 325007, Zhejiang, China; Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health Institute of Psychiatry, Beijing 100101, China; The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu, China.
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49
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Dehn LB, Driessen M, Beblo T. Patients with major depression show greater memory improvement if motivation is increased: An exploratory study under real-life-like conditions. J Clin Exp Neuropsychol 2020; 42:307-318. [DOI: 10.1080/13803395.2020.1711874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Lorenz B. Dehn
- Clinic for Psychiatry and Psychotherapy, Evang. Klinikum Bethel, Bielefeld, Germany
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Martin Driessen
- Clinic for Psychiatry and Psychotherapy, Evang. Klinikum Bethel, Bielefeld, Germany
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Thomas Beblo
- Clinic for Psychiatry and Psychotherapy, Evang. Klinikum Bethel, Bielefeld, Germany
- Department of Psychology, Bielefeld University, Bielefeld, Germany
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50
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Moore RA, Lippa SM, Brickell TA, French LM, Lange RT. Clinical utility of WAIS-IV 'excessive decline from premorbid functioning' scores to detect invalid test performance following traumatic brain injury. Clin Neuropsychol 2019; 34:512-528. [PMID: 31608766 DOI: 10.1080/13854046.2019.1668059] [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: 10/25/2022]
Abstract
Objective: Excessive Decline from Premorbid Functioning (EDPF), an atypical discrepancy between demographically predicted and obtained Wechsler Adult Intelligence Scale-4th Edition (WAIS-IV) scores, has been recently proposed as a potential embedded performance validity test (PVT). This study examined the clinical utility of EDPF scores to detect invalid test performance following traumatic brain injury (TBI).Methods: Participants were 194 U.S. military service members who completed neuropsychological testing on average 2.4 years (SD = 4.0) following uncomplicated mild, complicated mild, moderate, severe, or penetrating TBI (Age: M = 34.0, SD = 9.9). Using TBI severity and PVT performance (i.e., PVT Pass/Fail), participants were classified into three groups: Uncomplicated Mild TBI-PVT Fail (MTBI-Fail; n = 21), Uncomplicated Mild TBI-PVT Pass (MTBI-Pass; n = 94), and Complicated Mild to Severe/Penetrating TBI-PVT Pass (CM/STBI-Pass; n = 79). Seven EDPF measures were calculated by subtracting WAIS-IV obtained index scores from the demographically predicted scores from the Test of Premorbid Functioning (TOPF). Cutoff scores to detect invalid test performance were examined for each EDPF measure separately.Results: The MTBI-Fail group had higher scores than the MTBI-Pass and CM/STBI-Pass groups on five of the seven EDPF measures (p<.05). Overall, the EDPF measure using the Processing Speed Index (EDPF-PSI) was the most useful score to detect invalid test performance. However, sensitivity was only low to moderate depending on the cutoff score used.Conclusions: These findings provide support for the use of EDPF as an embedded PVT to be considered along with other performance validity data when administering the WAIS-IV.
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Affiliation(s)
- Rich A Moore
- Neuropsychology Assessment Services, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Sara M Lippa
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Silver Spring, MD, USA.,National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Tracey A Brickell
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Silver Spring, MD, USA.,National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA.,Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Louis M French
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Silver Spring, MD, USA.,National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA.,Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Rael T Lange
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Silver Spring, MD, USA.,National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA.,University of British Columbia, Vancouver, British Columbia, Canada
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