Cognition and nondysphoric depression among adoptees at high risk for psychopathology

Abstract

Background Association between poor cognition and symptom clusters including depressive ideation (e.g., guilt) and vegetative symptoms in the absence of dysphoria (nondysphoric depression - NDD) has been suggested in the elderly. The current study examined associations between NDD and pre-morbid and concurrent cognitive functioning in younger adults at high risk for psychopathology. NDD and depressed subjects were expected to show poorer pre-morbid and current cognition than non-depressed participants. Method Subjects were adoptees enrolled in the Iowa Adoption Study [1]. NDD subjects were compared with non-depressed comparison subjects and with subjects with dysphoric depression (DD) on measures of pre-morbid cognition (estimated by standardized school achievement test scores) and concurrent cognition (intelligence, attention, memory, executive abilities). Results NDD and DD showed lower pre-morbid cognition and executive functioning, while DD showed lower verbal and performance IQ compared to non-depressed subjects. The size of the comparison between NDD and non-depressed subjects for pre-morbid cognition was double that between DD and non-depressed subjects. No significant differences in cognition were found between NDD and DD. These effects were no longer significant after controlling for pre-morbid cognition. Conclusions Poorer pre-morbid cognition and executive functions in NDD (and the absence of current cognitive differences compared with DD) suggest that NDD may be a condition of clinical interest. Because poor cognition is a known correlate of alexithymia, these results (including their magnitude) are consistent with the view that NDD may be a paradoxical presentation of depression in persons with limited ability to be aware and verbally report emotions.

Social Adaptive Functioning, Apathy, and Nondysphoric Depression among Nursing Home-Dwelling Very Old Adults

“…Earlier studies have described NDD as subthreshold or subsyndromal depression (by definition not meeting DSM-V criteria)[1][4][7][8]. As expected (based on inclusion criteria) lower HAM-D scores were found among participants with NDD compared to DD [2][46][48][58].…”

“…The DSM-V also contemplates depressive symptoms causing clinically significant distress or impairment in social or occupational functioning, not meeting criteria for major depression or any other mood disorder class (e.g., unspecified depressive disorder in DSM-V) [3]. Recently attention has been drawn to the fact that syndromic clusters of ideational (e.g., guilt) and vegetative (e.g., poor sleep or fatigue) depressive symptoms but at best inconsistent reporting of affective symptoms (nondysphoric depression or NDD) may have psychiatric significance and be present in excess among older adults [4][5][6][7][8]. The exact nature of this clinical condition is currently not fully known.…”

Social Adaptive Functioning, Apathy, and Nondysphoric Depression among Nursing Home-Dwelling Very Old Adults

“…Earlier studies have described NDD as subthreshold or subsyndromal depression (by definition not meeting DSM-V criteria)[1][4][7][8]. As expected (based on inclusion criteria) lower HAM-D scores were found among participants with NDD compared to DD [2][46][48][58].…”

“…The DSM-V also contemplates depressive symptoms causing clinically significant distress or impairment in social or occupational functioning, not meeting criteria for major depression or any other mood disorder class (e.g., unspecified depressive disorder in DSM-V) [3]. Recently attention has been drawn to the fact that syndromic clusters of ideational (e.g., guilt) and vegetative (e.g., poor sleep or fatigue) depressive symptoms but at best inconsistent reporting of affective symptoms (nondysphoric depression or NDD) may have psychiatric significance and be present in excess among older adults [4][5][6][7][8]. The exact nature of this clinical condition is currently not fully known.…”

Association between Alexithymia and Depression among King Khalid University Medical Students: An Analytical Cross-Sectional Study

“…This implies that alexithymia has both state-dependent (e.g., mood but also general psychopathology) and trait-dependent characteristics [ 53 ]. If strong alexithymia hinders a consistent expression of emotional changes, for example, for patients who admit to a sad mood only erratically, a phenomenological form of depression may manifest without sadness [ 53 , 55 ].…”

Social Adaptive Functioning, Apathy, and Nondysphoric Depression among Nursing Home-Dwelling Very Old Adults

“…Earlier studies have described NDD as subthreshold or subsyndromal depression (by definition not meeting DSM-V criteria)[1][4][7][8]. As expected (based on inclusion criteria) lower HAM-D scores were found among participants with NDD compared to DD [2][46][48][58].…”

“…The DSM-V also contemplates depressive symptoms causing clinically significant distress or impairment in social or occupational functioning, not meeting criteria for major depression or any other mood disorder class (e.g., unspecified depressive disorder in DSM-V) [3]. Recently attention has been drawn to the fact that syndromic clusters of ideational (e.g., guilt) and vegetative (e.g., poor sleep or fatigue) depressive symptoms but at best inconsistent reporting of affective symptoms (nondysphoric depression or NDD) may have psychiatric significance and be present in excess among older adults [4][5][6][7][8]. The exact nature of this clinical condition is currently not fully known.…”

Association between Alexithymia and Depression among King Khalid University Medical Students: An Analytical Cross-Sectional Study

“…This implies that alexithymia has both state-dependent (e.g., mood but also general psychopathology) and trait-dependent characteristics [ 53 ]. If strong alexithymia hinders a consistent expression of emotional changes, for example, for patients who admit to a sad mood only erratically, a phenomenological form of depression may manifest without sadness [ 53 , 55 ].…”

Social Adaptive Functioning, Apathy, and Nondysphoric Depression among Nursing Home-Dwelling Very Old Adults

“…Earlier studies have described NDD as subthreshold or subsyndromal depression (by definition not meeting DSM-V criteria)[1][4][7][8]. As expected (based on inclusion criteria) lower HAM-D scores were found among participants with NDD compared to DD [2][46][48][58].…”

“…The DSM-V also contemplates depressive symptoms causing clinically significant distress or impairment in social or occupational functioning, not meeting criteria for major depression or any other mood disorder class (e.g., unspecified depressive disorder in DSM-V) [3]. Recently attention has been drawn to the fact that syndromic clusters of ideational (e.g., guilt) and vegetative (e.g., poor sleep or fatigue) depressive symptoms but at best inconsistent reporting of affective symptoms (nondysphoric depression or NDD) may have psychiatric significance and be present in excess among older adults [4][5][6][7][8]. The exact nature of this clinical condition is currently not fully known.…”

Association between Alexithymia and Depression among King Khalid University Medical Students: An Analytical Cross-Sectional Study

“…This implies that alexithymia has both state-dependent (e.g., mood but also general psychopathology) and trait-dependent characteristics [ 53 ]. If strong alexithymia hinders a consistent expression of emotional changes, for example, for patients who admit to a sad mood only erratically, a phenomenological form of depression may manifest without sadness [ 53 , 55 ].…”