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Sensitivity of cognitive tests in four cognitive domains in discriminating MDD patients from healthy controls: a meta-analysis

Published online by Cambridge University Press:  03 June 2013

JaeHyoung Lim ,
In Kyung Oh ,
Changsu Han ,
Yu Jeong Huh ,
In-Kwa Jung ,
Ashwin A. Patkar ,
David C. Steffens  and
Bo-Hyoung Jang
JaeHyoung Lim
Affiliation:
Department of Psychiatry, Korea University Ansan Hospital, Ansan-shi, Gyeonggi-do, Republic of Korea
In Kyung Oh
Affiliation:
Department of Psychiatry, Korea University Ansan Hospital, Ansan-shi, Gyeonggi-do, Republic of Korea
Changsu Han*
Affiliation:
Department of Psychiatry, Korea University Ansan Hospital, Ansan-shi, Gyeonggi-do, Republic of Korea
Yu Jeong Huh
Affiliation:
Department of Psychiatry, Korea University Ansan Hospital, Ansan-shi, Gyeonggi-do, Republic of Korea
In-Kwa Jung
Affiliation:
Department of Psychiatry, Korea University Guro Hospital, Guro-gu, Seoul-shi, Republic of Korea
Ashwin A. Patkar
Affiliation:
Department of Psychiatry, Duke University Medical Center, Durham, North Carolina, USA
David C. Steffens
Affiliation:
Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut, USA
Bo-Hyoung Jang
Affiliation:
College of Korean Medicine, Kyung Hee University, Healthcare Collaborating Agency, Jongno-gu, Republic of Korea
*
Correspondence should be addressed to: Dr. Changsu Han, MD, PhD, MHS, Department of Psychiatry, Korea University Ansan Hospital, 516, Gojan-dong, Danwon-gu, Ansan-shi, Gyeonggi-do 425-707, Republic of Korea. Phone: +82-31-412-5140; Fax: +82-2-6442-5008. Email: [email protected].
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Abstract

Background: We performed a meta-analysis in order to determine which neuropsychological domains and tasks would be most sensitive for discriminating between patients with major depressive disorder (MDD) and healthy controls.

Methods: Relevant articles were identified through a literature search of the PubMed and Cochrane Library databases for the period between January 1997 and May 2011. A meta-analysis was conducted using the standardized means of individual cognitive tests in each domain. The heterogeneity was assessed, and subgroup analyses according to age and medication status were performed to explore the sources of heterogeneity.

Results: A total of 22 trials involving 955 MDD patients and 7,664 healthy participants were selected for our meta-analysis. MDD patients showed significantly impaired results compared with healthy participants on the Digit Span and Continuous Performance Test in the attention domain; the Trail Making Test A (TMT-A) and the Digit Symbol Test in the processing speed domain; the Stroop Test, the Wisconsin Card Sorting Test, and Verbal Fluency in the executive function domain; and immediate verbal memory in the memory domain. The Finger Tapping Task, TMT-B, delayed verbal memory, and immediate and delayed visual memory failed to separate MDD patients from healthy controls. The results of subgroup analysis showed that performance of Verbal Fluency was significantly impaired in younger depressed patients (<60 years), and immediate visual memory was significantly reduced in depressed patients using antidepressants.

Conclusions: Our findings have inevitable limitations arising from methodological issues inherent in the meta-analysis and we could not explain high heterogeneity between studies. Despite such limitations, current study has the strength of being the first meta-analysis which tried to specify cognitive function of depressed patients compared with healthy participants. And our findings may provide clinicians with further evidences that some cognitive tests in specific cognitive domains have sensitivity to discriminate MDD patients from healthy controls.

Keywords

major depressive disordercognitive functionmeta-analysis
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 9 , September 2013 , pp. 1543 - 1557
Copyright
Copyright © International Psychogeriatric Association 2013 

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References

Alexopoulos, G. S., Kiosses, D. N., Klimstra, S., Kalayam, B. and Bruce, M. L. (2002). Clinical presentation of the “depression-executive dysfunction syndrome” of late life. American Journal of Geriatric Psychiatry, 10, 98–106.Google ScholarPubMed
Austin, M. P., Ross, M., Murray, C., O'Carroll, R. E., Ebmeier, K. P. and Goodwin, G. M. (1992). Cognitive function in major depression. Journal of Affective Disorders, 25, 21–29.CrossRefGoogle ScholarPubMed
Austin, M. P.et al. (1999). Cognitive function in depression: a distinct pattern of frontal impairment in melancholia? Psychological Medicine, 29, 73–85.CrossRefGoogle ScholarPubMed
Austin, M. P.et al. (2000). Effect of apomorphine on motor and cognitive function in melancholic patients: a preliminary report. Psychiatry Research, 97, 207–215.CrossRefGoogle ScholarPubMed
Austin, M. P., Mitchell, P. and Goodwin, G. M. (2001). Cognitive deficits in depression: possible implications for functional neuropathology. British Journal of Psychiatry, 178, 200–206.CrossRefGoogle ScholarPubMed
Baudic, S., Tzortzis, C., Barba, G. D. and Traykov, L. (2004). Executive deficits in elderly patients with major unipolar depression. Journal of Geriatric Psychiatry and Neurology, 17, 195–201.CrossRefGoogle ScholarPubMed
Baxter, L. R. Jr.et al. (1989). Reduction of prefrontal cortex glucose metabolism common to three types of depression. Archives of General Psychiatry, 46, 243–250.CrossRefGoogle ScholarPubMed
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. and Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.CrossRefGoogle ScholarPubMed
Bench, C. J., Friston, K. J., Brown, R. G., Scott, L. C., Frackowiak, R. S. and Dolan, R. J. (1992). The anatomy of melancholia–focal abnormalities of cerebral blood flow in major depression. Psychological Medicine, 22, 607–615.CrossRefGoogle ScholarPubMed
Benoît, G., Fortin, L., Lemelin, S., Laplante, L., Thomas, J. and Everett, J. (1992). Selective attention in major depression: clinical retardation and cognitive inhibition. Canadian Journal of Psychology, 46, 41–52.CrossRefGoogle ScholarPubMed
Boeker, H., Schulze, J., Richter, A., Nikisch, G., Schuepbach, D. and Grimm, S. (2012). Sustained cognitive impairments after clinical recovery of severe depression. Journal of Nervous and Mental Disease, 200, 773–776.CrossRefGoogle ScholarPubMed
Borenstein, M., Hedges, L. V., Higgins, J. P. T. and Rothstein, H. R. (2009). Front matter. In Introduction to Meta-Analysis (pp. i–xxix). Chichester, UK: John Wiley.CrossRefGoogle Scholar
Brown, R. G., Scott, L. C., Bench, C. J. and Dolan, R. J. (1994). Cognitive function in depression: its relationship to the presence and severity of intellectual decline. Psychological Medicine, 24, 829–847.CrossRefGoogle Scholar
Christensen, A. L. (1975). Luria's Neuropsychological Investigation: Manual and Test Materials. New York: Spectrum.Google Scholar
Cohen, R. M., Weingartner, H., Smallberg, S. A., Pickar, D. and Murphy, D. L. (1982). Effort and cognition in depression. Archives of General Psychiatry, 39, 593–597.CrossRefGoogle ScholarPubMed
Colditz, G. A., Burdick, E. and Mosteller, F. (1995). Heterogeneity in meta-analysis of data from epidemiologic studies: a commentary. American Journal of Epidemiology, 142, 371–382.CrossRefGoogle ScholarPubMed
Constant, E. L., Adam, S., Seron, X., Bruyer, R., Seghers, A. and Daumerie, C. (2006). Hypothyroidism and major depression: a common executive dysfunction? Journal of Clinical and Experimental Neuropsychology, 28, 790–807.CrossRefGoogle ScholarPubMed
Degl'Innocenti, A., Agren, H. and Bäckman, L. (1998). Executive deficits in major depression. Acta Psychiatrica Scandinavica, 97, 182–188.CrossRefGoogle ScholarPubMed
Delis, D. C., Karmaer, J. H., Kaplan, E. and Ober, B. A. (1987). California Verbal Learning Test: Adult Version, research edn. New York: Psychological Corporation.Google Scholar
Delis, D. C., Kramer, J. H., Kaplan, E. and Ober, B. A. (2000). California Verbal Learning Test: Adult Version manual, 2nd edn. San Antonio, TX: Psychological Corporation.Google Scholar
Deuschle, M.et al. (2004). Impaired declarative memory in depressed patients is slow to recover: clinical experience. Pharmacopsychiatry, 37, 147–151.CrossRefGoogle ScholarPubMed
Dickersin, K. (1997). How important is publication bias? A synthesis of available data. AIDS Education and Prevention, 9, 15–21.Google ScholarPubMed
Dolan, R. J.et al. (1993). Dorsolateral prefrontal cortex dysfunction in the major psychoses; symptom or disease specificity? Journal of Neurology, Neurosurgery and Psychiatry, 56, 1290–1294.CrossRefGoogle ScholarPubMed
Dotson, V. M., Resnick, S. M. and Zonderman, A. B. (2008). Differential association of concurrent, baseline, and average depressive symptoms with cognitive decline in older adults. American Journal of Geriatric Psychiatry, 16, 318–330.CrossRefGoogle ScholarPubMed
Drevets, W. C., Videen, T. O., Price, J. L., Preskorn, S. H., Carmichael, S. T. and Raichle, M. E. (1992). A functional anatomical study of unipolar depression. Journal of Neuroscience, 12, 3628–3641.CrossRefGoogle ScholarPubMed
Drewe, E. A. (1974). The effect of type and area of brain lesion on Wisconsin card sorting test performance. Cortex, 10, 159–170.CrossRefGoogle ScholarPubMed
Fischer, C.et al. (2008). Neurocognitive profiles in older adults with and without major depression. International Journal of Geriatric Psychiatry, 23, 851–856.CrossRefGoogle ScholarPubMed
Fossati, P., Amar, G., Raoux, N., Ergis, A. M. and Allilaire, J. F. (1999). Executive functioning and verbal memory in young patients with unipolar depression and schizophrenia. Psychiatry Research, 89, 171–187.CrossRefGoogle ScholarPubMed
Franke, P., Maier, W., Hardt, J., Frieboes, R., Lichtermann, D. and Hain, C. (1993). Assessment of frontal lobe functioning in schizophrenia and unipolar major depression. Psychopathology, 26, 76–84.CrossRefGoogle ScholarPubMed
Gallassi, R., Di Sarro, R., Morreale, A. and Amore, M. (2006). Memory impairment in patients with late-onset major depression: the effect of antidepressant therapy. Journal of Affective Disorders, 91, 243–250.CrossRefGoogle ScholarPubMed
Godin, O.et al. (2007). Depressive symptoms, major depressive episode and cognition in the elderly: the three-city study. Neuroepidemiology, 28, 101–108.CrossRefGoogle ScholarPubMed
Grant, M. M., Thase, M. E. and Sweeney, J. A. (2001). Cognitive disturbance in outpatient depressed younger adults: evidence of modest impairment. Biological Psychiatry, 50, 35–43.CrossRefGoogle ScholarPubMed
Gualtieri, C. T., Johnson, L. G. and Benedict, K. B. (2006). Neurocognition in depression: patients on and off medication versus healthy comparison subjects. Journal of Neuropsychiatry and Clinical Neurosciences, 18, 217–225.CrossRefGoogle ScholarPubMed
Hamilton, M. (1967). Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278–296.CrossRefGoogle ScholarPubMed
Hart, R. P., Wade, J. B., Calabrese, V. P. and Colenda, C. C. (1998). Vigilance performance in Parkinson's disease and depression. Journal of Clinical and Experimental Neuropsychology, 20, 111–117.CrossRefGoogle ScholarPubMed
Herrera-Guzmán, I., Gudayol-Ferré, E., Herrera-Guzmán, D., Guàrdia-Olmos, J., Hinojosa-Calvo, E. and Herrera-Abarca, J. E. (2009). Effects of selective serotonin reuptake and dual serotonergic-noradrenergic reuptake treatments on memory and mental processing speed in patients with major depressive disorder. Journal of Psychiatric Research, 43, 855–863.CrossRefGoogle ScholarPubMed
Herrera-Guzmán, I.et al. (2010). Effects of selective serotonin reuptake and dual serotonergic-noradrenergic reuptake treatments on attention and executive functions in patients with major depressive disorder. Psychiatry Research, 177, 323–329.CrossRefGoogle ScholarPubMed
Herrmann, L. L., Goodwin, G. M. and Ebmeier, K. P. (2007). The cognitive neuropsychology of depression in the elderly. Psychological Medicine, 37, 1693–1702.CrossRefGoogle ScholarPubMed
Hickie, I., Scott, E., Mitchell, P., Wilhelm, K., Austin, M. P. and Bennett, B. (1995). Subcortical hyperintensities on magnetic resonance imaging: clinical correlates and prognostic significance in patients with severe depression. Biological Psychiatry, 37, 151–160.CrossRefGoogle ScholarPubMed
Higgins, J. P., Thompson, S. G., Deeks, J. J. and Altman, D. G. (2003). Measuring inconsistency in meta-analyses. BMJ, 327, 557–560.CrossRefGoogle ScholarPubMed
Kalayam, B. and Alexopoulos, G. S. (1999). Prefrontal dysfunction and treatment response in geriatric depression. Archives of General Psychiatry, 56, 713–718.CrossRefGoogle ScholarPubMed
Koetsier, G. C., Volkers, A. C., Tulen, J. H., Passchier, J., van den Broek, W. W. and Bruijn, J. A. (2002). CPT performance in major depressive disorder before and after treatment with imipramine or fluvoxamine. Journal of Psychiatric Research, 36, 391–397.CrossRefGoogle ScholarPubMed
Kuroda, Y.et al. (2006). Effects of repetitive transcranial magnetic stimulation on [11C]raclopride binding and cognitive function in patients with depression. Journal of Affective Disorders, 95, 35–42.CrossRefGoogle ScholarPubMed
Landrø, N. I., Stiles, T. C. and Sletvold, H. (2001). Neuropsychological function in nonpsychotic unipolar major depression. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 14, 233–240.Google ScholarPubMed
Lemelin, S., Baruch, P., Vincent, A., Laplante, L., Everett, J. and Vincent, P. (1996). Attention disturbance in clinical depression. Deficient distractor inhibition or processing resource deficit? Journal of Nervous and Mental Disease, 184, 114–121.CrossRefGoogle ScholarPubMed
Lemelin, S., Baruch, P., Vincent, A., Everett, J. and Vincent, P. (1997). Distractibility and processing resource deficit in major depression. Evidence for two deficient attentional processing models. Journal of Nervous and Mental Disease, 185, 542–548.CrossRefGoogle ScholarPubMed
Levkovitz, Y., Caftori, R., Avital, A. and Richter-Levin, G. (2002). The SSRIs drug Fluoxetine, but not the noradrenergic tricyclic drug Desipramine, improves memory performance during acute major depression. Brain Research Bulletin, 58, 345–350.CrossRefGoogle Scholar
Liu, W. H., Wang, L. Z., Zhao, S. H., Ning, Y. P. and Chan, R. C. (2012). Anhedonia and emotional word memory in patients with depression. Psychiatry Research, 200, 361–367.CrossRefGoogle ScholarPubMed
Marazziti, D., Consoli, G., Picchetti, M., Carlini, M. and Faravelli, L. (2010). Cognitive impairment in major depression. European Journal of Pharmacology, 626, 83–86.CrossRefGoogle ScholarPubMed
Mayberg, H. S., Lewis, P. J., Regenold, W. and WagnerH. N., Jr. H. N., Jr. (1994). Paralimbic hypoperfusion in unipolar depression. Journal of Nuclear Medicine, 35, 929–934.Google ScholarPubMed
Mazure, C., Nelson, J. C. and Price, L. H. (1986). Reliability and validity of the symptoms of major depressive illness. Archives of General Psychiatry, 43, 451–456.CrossRefGoogle ScholarPubMed
Mazure, C. M., Nelson, J. C. and Jatlow, P. I. (1990). Predictors of hospital outcome without antidepressants in major depression. Psychiatry Research, 33, 51–58.CrossRefGoogle ScholarPubMed
McDermott, L. M. and Ebmeier, K. P. (2009). A meta-analysis of depression severity and cognitive function. Journal of Affective Disorders, 119, 1–8.CrossRefGoogle ScholarPubMed
Merriam, E. P., Thase, M. E., Haas, G. L., Keshavan, M. S. and Sweeney, J. A. (1999). Prefrontal cortical dysfunction in depression determined by Wisconsin Card Sorting Test performance. American Journal of Psychiatry, 156, 780–782.CrossRefGoogle ScholarPubMed
Millan, M. J.et al. (2012). Cognitive dysfunction in psychiatric disorders: characteristics, causes and the quest for improved therapy. Nature Reviews. Drug Discovery, 11, 141–168.CrossRefGoogle ScholarPubMed
Modrego, P. J. and Ferrández, J. (2004). Depression in patients with mild cognitive impairment increases the risk of developing dementia of Alzheimer-type: a prospective cohort study. Archives of Neurology, 61, 1290–1293.CrossRefGoogle ScholarPubMed
Montgomery, S. A. and Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.CrossRefGoogle ScholarPubMed
Moritz, S.et al. (2002). Executive functioning in obsessive-compulsive disorder, unipolar depression, and schizophrenia. Archives of Clinical Neuropsychology, 17, 477–483.Google ScholarPubMed
Nebes, R. D.et al. (2003). Persistence of cognitive impairment in geriatric patients following antidepressant treatment: a randomized, double-blind clinical trial with nortriptyline and paroxetine. Journal of Psychiatric Research, 37, 99–108.CrossRefGoogle ScholarPubMed
Paelecke-Habermann, Y., Pohl, J. and Leplow, B. (2005). Attention and executive functions in remitted major depression patients. Journal of Affective Disorders, 89, 125–135.CrossRefGoogle ScholarPubMed
Panza, F.et al. (2010). Late-life depression, mild cognitive impairment, and dementia: possible continuum? American Journal of Geriatric Psychiatry, 18, 98–116.CrossRefGoogle ScholarPubMed
Parker, G. and Hadzi-Pavlovic, D. (1996). Melancholia: A Disorder of Movement and Mood: A Phenomenological and Neurobiological Review. Cambridge, UK: Cambridge University Press.CrossRefGoogle Scholar
Porter, R. J., Gallagher, P., Thompson, J. M. and Young, A. H. (2003). Neurocognitive impairment in drug-free patients with major depressive disorder. British Journal of Psychiatry, 182, 214–220.CrossRefGoogle ScholarPubMed
Purcell, R., Maruff, P., Kyrios, M. and Pantelis, C. (1997). Neuropsychological function in young patients with unipolar major depression. Psychological Medicine, 27, 1277–1285.CrossRefGoogle ScholarPubMed
Radloff, L. S. (1977). The CES-D scale: a self-report depression scale for research in the general population. Appled Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
Ravnkilde, B., Videbech, P., Clemmensen, K., Egander, A., Rasmussen, N. A. and Rosenberg, R. (2002). Cognitive deficits in major depression. Scandinavian Journal of Psychology, 43, 239–251.CrossRefGoogle ScholarPubMed
Reppermund, S.et al. (2007). Persistent cognitive impairment in depression: the role of psychopathology and altered hypothalamic-pituitary-adrenocortical (HPA) system regulation. Biological Psychiatry, 62, 400–406.CrossRefGoogle ScholarPubMed
Rey, A. (1964). L'examen Clinique en Psychologie. Paris, France: Presses Universitaires de France.Google Scholar
Rezai, K., Andreasen, N. C., Alliger, R., Cohen, G., Swayze, V. 2nd and O'Leary, D. S. (1993). The neuropsychology of the prefrontal cortex. Archives of Neurology, 50, 636–642.CrossRefGoogle ScholarPubMed
Ridout, N., O'Carroll, R. E., Dritschel, B., Christmas, D., Eljamel, M. and Matthews, K. (2007). Emotion recognition from dynamic emotional displays following anterior cingulotomy and anterior capsulotomy for chronic depression. Neuropsychologia, 45, 1735–1743.CrossRefGoogle ScholarPubMed
Sabbe, B., Hulstijn, W., Van Hoof, J. and Zitman, F. (1996). Fine motor retardation and depression. Journal of Psychiatric Research, 30, 295–306.CrossRefGoogle ScholarPubMed
Schmitt, J. A., Kruizinga, M. J. and Riedel, W. J. (2001). Non-serotonergic pharmacological profiles and associated cognitive effects of serotonin reuptake inhibitors. Journal of Psychopharmacology, 15, 173–179.CrossRefGoogle ScholarPubMed
Sobin, C. and Sackeim, H. A. (1997). Psychomotor symptoms of depression. American Journal of Psychiatry, 154, 4–17.Google ScholarPubMed
Stordal, K. I.et al. (2004). Impairment across executive functions in recurrent major depression. Nordic Journal of Psychiatry, 58, 41–47.CrossRefGoogle ScholarPubMed
Trichard, C.et al. (1995). Time course of prefrontal lobe dysfunction in severely depressed in-patients: a longitudinal neuropsychological study. Psychological Medicine, 25, 79–85.CrossRefGoogle ScholarPubMed
Videbech, P.et al. (2002). The Danish PET/depression project: clinical symptoms and cerebral blood flow. A regions-of-interest analysis. Acta Psychiatrica Scandinavica, 106, 35–44.CrossRefGoogle ScholarPubMed
Vythilingam, M.et al. (2004). Hippocampal volume, memory, and cortisol status in major depressive disorder: effects of treatment. Biological Psychiatry, 56, 101–112.CrossRefGoogle ScholarPubMed
Wechsler, D. (1987). Wechsler Memory Scale-Revised [Manual]. San Antonio, TX: Psychological Corporation.Google Scholar
Weiland-Fiedler, P.et al. (2004). Evidence for continuing neuropsychological impairments in depression. Journal of Affective Disorders, 82, 253–258.CrossRefGoogle ScholarPubMed
Werner-Seidler, A. and Moulds, M. L. (2012). Characteristics of self-defining memory in depression vulnerability. Memory, 20, 935–948.CrossRefGoogle ScholarPubMed
Widlöcher, D. J. (1983). Psychomotor retardation – clinical, theoretical, and psychometric aspects. Psychiatric Clinics of North America, 6, 27–40.CrossRefGoogle ScholarPubMed
Wilkins, V. M., Kiosses, D. and Ravdin, L. D. (2010). Late-life depression with comorbid cognitive impairment and disability: nonpharmacological interventions. Clinical Interventions in Aging, 5, 323–331.Google ScholarPubMed
Wroolie, T. E.et al. (2006). Mood and neuropsychological changes in women with midlife depression treated with escitalopram. Journal of Clinical Psychopharmacology, 26, 361–366.CrossRefGoogle ScholarPubMed
Yesavage, J. A.et al. (1983). Development and validation of a Geriatric Depression Screening Scale – a preliminary report. Journal of Psychiatric Research, 17, 37–49.CrossRefGoogle Scholar
Zobel, A. W.et al. (2004). Improvement of working but not declarative memory is correlated with HPA normalization during antidepressant treatment. Journal of Psychiatric Research, 38, 377–383.CrossRefGoogle Scholar