A meta‐analysis of executive dysfunctions in unipolar major depressive disorder without psychotic symptoms and their changes during antidepressant treatment

Wagner, Stefanie; Doering, Bettina K.; Helmreich, Isabella; Lieb, Klaus; Tadić, André

doi:10.1111/j.1600-0447.2011.01762.x

Cited by 149 publications

(125 citation statements)

References 46 publications

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“…In cluster 2, a combined evaluation of both sets of results indicates that, while participants showed poorer cognitive performance than that observed in cluster 1, the most marked alterations are limited to the TMT and the semantic verbal fluency task. These alterations are consistent with the literature, which has reported significant impairments on the TMT as well as verbal fluency tasks in both BD and MDD (Bourne et al, 2013;Wagner et al, 2012).…”

Section: Discussionsupporting

confidence: 92%

Neuropsychological Clustering in Bipolar and Major Depressive Disorder

Cotrena

Branco

Ponsoni

et al. 2017

J Int Neuropsychol Soc

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Objectives: Cognitive dysfunction is a key feature of major depressive (MDD) and bipolar (BD) disorders. However, rather than a single cognitive profile corresponding to each diagnostic categories, recent studies have identified significant intra-and cross-diagnostic variability in patterns of cognitive impairment. The goal of this study was to contribute to the literature on cognitive heterogeneity in mood disorders by identifying cognitive subprofiles in a population of patients with MDD, BD type I, BD type II, and healthy adults. Methods: Participants completed a neuropsychological battery; scores were converted into Z-scores using normative data and submitted to hierarchical cluster analysis. Results: Three distinct neuropsychological clusters were identified: (1) a large cluster containing mostly control participants, as well as some patients with BD and MDD, who performed at above-average levels on all neuropsychological domains; (2) a cluster containing some patients from all diagnostic groups, as well as healthy controls, who performed worse than cluster 1 on most tasks, and showed impairments in motor inhibition and verbal fluency; (3) a cluster containing mostly patients with mood disorders with severe impairments in verbal inhibition and cognitive flexibility. Conclusions: These findings revealed multiple cognitive profiles within diagnostic categories, as well as significant cross-diagnostic overlap, highlighting the importance of developing more specific treatment approaches which consider patients' demographic and cognitive profiles in addition to their diagnosis. (JINS, 2017, 23, 584-593)

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Section: Discussionsupporting

confidence: 92%

Neuropsychological Clustering in Bipolar and Major Depressive Disorder

Cotrena

Branco

Ponsoni

et al. 2017

J Int Neuropsychol Soc

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“…This is biologically plausible because MR expression is highest in the hippocampus and prefrontal cortex, two brain areas crucial for memory and executive function. Of note, memory and executive function are among those domains that are most consistently impaired in depressed patients (Rock et al, 2013;Wagner et al, 2012). Indeed, it has been repeatedly shown that depressed patients exhibit decreased MR expression in hippocampus and prefrontal cortex in post-mortem studies (Klok et al, 2011a;Medina et al, 2013;Qi et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…GR are distributed throughout the brain and have a low affinity for cortisol, whereas MR have a high cortisol affinity and are expressed primarily in limbic areas. Both receptors are abundantly expressed in the hippocampus and in the prefrontal cortex, brain areas critical for memory and executive function (Rock et al, 2013;Trivedi and Greer, 2014;Wagner et al, 2012). Lately, animal and human studies have revealed the existence of a membrane-bound MR-mediating rapid non-genomic effects with an intermediate cortisol affinity (Henckens et al, 2011;Joels et al, 2013;van Ast et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Mineralocorticoid Receptor Stimulation Improves Cognitive Function and Decreases Cortisol Secretion in Depressed Patients and Healthy Individuals

Otte

Wingenfeld

Kuehl

et al. 2014

Neuropsychopharmacol

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Memory and executive function are often impaired in patients with major depression, while cortisol secretion is increased. Mineralocorticoid receptors (MR) are abundantly expressed in the hippocampus and in the prefrontal cortex, brain areas critical for memory, executive function, and cortisol inhibition. Here, we investigated whether MR stimulation with fludrocortisone (1) improves memory and executive function and (2) decreases cortisol secretion in depressed patients and healthy individuals. Twenty-four depressed patients without medication and 24 age-, sex-, and education-matched healthy participants received fludrocortisone (0.4 mg) or placebo in a randomized, double-blind, within-subject cross-over design. We measured verbal memory, visuospatial memory, executive function, psychomotor speed, and salivary cortisol secretion during cognitive testing between 1400 and 1700 hours. For verbal memory and executive function, we found better performance after fludrocortisone compared with placebo across groups. No treatment effect on other cognitive domains emerged. Depressed patients performed worse than healthy individuals in psychomotor speed and executive function. No group effect or group Â treatment interaction emerged on other cognitive domains. Fludrocortisone decreased cortisol secretion across groups and there was a significant correlation between cortisol inhibition and verbal memory performance. Our data suggest a crucial role of MR in verbal memory and executive function and demonstrate the possibility to improve cognition in depressed patients and healthy individuals through MR stimulation.

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“…This finding may be interpreted as trait phenomenon (or scar from a previous depressive episode) or as being due to greater depression severity. Many studies have demonstrated that attentional bias to emotional content can be found in remitted patients, whether on antidepressant treatment or not (Joormann & Gotlib, 2007; Nagane et al., 2014; Paelecke‐Habermann et al., 2005; Teasdale & Dent, 1987), but findings are still mixed (Epp et al., 2012; Wagner et al., 2012). In line with the trait hypothesis, women on antidepressant treatment reported lower scores of self‐rated depression than the depressed women who managed without pharmacological treatment, suggesting the majority were in remission when tested.…”

Section: Discussionmentioning

confidence: 99%

Different patterns of attentional bias in antenatal and postpartum depression

et al. 2017

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BackgroundBiased information processing in attention, memory, and interpretation is proposed to be central cognitive alterations in patients with major depressive disorder, but studies in women with peripartum depression are scarce. Because of the many similarities with depression in nonperipartum states as regards symptom profile and risk factors, we hypothesized that women with antenatal and postpartum depression would display attentional bias to negatively and positively valenced words.MethodsOne hundred and seventy‐seven pregnant and 157 postpartum women were included. Among these, 40 suffered from antenatal depressive disorder and 33 from postpartum depressive disorder. An emotional Stroop task with neutral, positive, negative, and negatively valenced obstetric words was used.ResultsNo significant difference in emotional interference scores was noted between women with antenatal depression and nondepressed pregnant women. In contrast, women with postpartum depression displayed shorter reaction times to both positive (p = .028) and negative (p = .022) stimuli, compared with neutral words. Pregnant women on antidepressant treatment displayed longer reaction times to negatively valenced obstetric words in comparison with untreated depressed women (p = .012), and a trend toward greater interference in comparison with controls (p = .061).ConclusionsIn contrast with the hypothesis, we found no evidence of attentional bias to emotionally valenced stimuli in women with untreated peripartum depression. However, the shorter reaction times to emotional stimuli in women with postpartum depression may indicate emotional numbing, which in turn, is a functional impairment that may have repercussions for child development and well‐being. Our findings emphasize the need to identify and treat women with postpartum depression at the earliest possible time point to ensure swift recovery and support for the family.

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A meta‐analysis of executive dysfunctions in unipolar major depressive disorder without psychotic symptoms and their changes during antidepressant treatment

Cited by 149 publications

References 46 publications

Neuropsychological Clustering in Bipolar and Major Depressive Disorder

Neuropsychological Clustering in Bipolar and Major Depressive Disorder

Mineralocorticoid Receptor Stimulation Improves Cognitive Function and Decreases Cortisol Secretion in Depressed Patients and Healthy Individuals

Different patterns of attentional bias in antenatal and postpartum depression

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