Comorbidity of anxiety disorders in major depressive disorder: A clinical trial to evaluate neuropsychological deficit

Herrera-Guzmán, Ixchel; Gudayol-Ferré, Esteve; Jarne-Esparcia, Adolfof; Herrera-Abarca, Jorge E.; Herrera-Guzmán, Daniel; Peró‐Cebollero, Maribel; Guàrdia‐Olmos, Joan

doi:10.4321/s0213-61632009000100001

Cited by 7 publications

(6 citation statements)

References 51 publications

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“…Research suggests both that modern antidepressants do not have deleterious effects on cognitive test performance, and that that unmedicated patients may show more impaired attention functions compared to patients on medication (Den Hartog et al, 2003 ). Some studies also suggest that antidepressants may improve cognitive functions, including attention, in MDD patients (Fergusson et al, 2003 ), and that the effects of medication may be different on MDD from those with MDDA (Herrera-Guzmàn et al, 2009 ). Furthermore, functional imaging should be included to provide a greater understanding of the associated neurobiological correlates of cognitive control functions.…”

Section: Discussionmentioning

confidence: 99%

Cognitive Control Functions in Unipolar Major Depression with and without Co-Morbid Anxiety Disorder

Lyche¹,

Jonassen²,

Stiles³

et al. 2010

Front. Psychiatry

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Background: Impaired cognitive control functions have been demonstrated in both major depression (MDD) and anxiety disorder (A), but few studies have systematically examined the impact of MDD with co-morbid A (MDDA), which is the main aim of this study. Method: We compared patients with MDD with (MDDA; n = 24) and without co-morbid A (n = 37) to a group of healthy controls (HC; n = 92) on three subtests from the Cambridge Neuropsychological Test Automated Battery; intra–extra dimensional, stop signal task, and spatial working memory. These tasks correspond to a theoretical model consisting of three separable but interrelated executive control functions: Shifting, Inhibition, and Updating. A simple psychomotor speed measure was also included. Results: After controlling for age, gender, and education level, the results showed that the MDDA group displayed significantly impaired performance on the functions Shifting and Updating compared to HC. There emerged no significant differences between any of the patient groups and HC regarding Inhibition. The pure MDD group did not display dysfunctions relative to the HC group on the main executive control variables, but displayed slowed psychomotor speed. Contrary to expectation there were no significant differences between the MDDA and the MDD groups. Conclusion: Co-morbid anxiety should be taken into account when studying cognitive control functions in major depression.

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Section: Discussionmentioning

confidence: 99%

Cognitive Control Functions in Unipolar Major Depression with and without Co-Morbid Anxiety Disorder

Lyche¹,

Jonassen²,

Stiles³

et al. 2010

Front. Psychiatry

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“…In contrast, they found that depressed patients without comorbid anxiety did not show impaired performance, thus pointing to a specific debilitating role of the comorbid anxiety in the impairment of attention control. However, other studies (e.g., Castaneda et al, 2010;Herrera-Guzmán et al, 2009) did not find any difference between depressed patients with and without comorbid anxiety disorders in tasks measuring attention or executive functions, challenging the claim that comorbid anxiety might damage attention control.…”

Section: Attentional Network In Co-occurring Generalized Anxiety Disorder and Major Depression Disorder: Towards A Staging Hypothesis Of mentioning

confidence: 88%

Attentional Networks in Co-occurring Generalized Anxiety Disorder and Major Depression Disorder: Towards a Staging Approach to the Executive Control Deficits

Coussement¹,

Longueville²,

Heeren³

2021

Preprint

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Background. Major Depression Disorder (MDD) and Generalized Anxiety Disorder (GAD) often co-occur, but the neurocognitive mechanisms of this co-occurrence remain unknown. Prominent views have pointed to attentional processes as potent mechanisms at play in MDD and GAD, respectively. Yet uncertainty remains regarding the very nature of attentional impairments in patients with co-occurring MDD and GAD. Methods. Inspired by contemporary models of attentional networks, we examined the integrity of the three main attentional networks, namely the alerting, orienting, and executive control networks, in patients with co-occurring MDD and GAD (n = 30), MDD only (n = 30), GAD only (n = 30), or neither MDD or GAD (n = 30).Results. Patients with co-occurring MDD and GAD exhibited more severe impairments in the executive control network than those with only one of the disorders. There were no differences between the executive control networks of patients with solely MDD or solely GAD, but both groups showed significantly more severe impairment than those without either MDD and GAD. Limitations. The cross-sectional study design precludes strong inference regarding the cause-effect relationship between the executive control network and the co-occurrence of MDD and GAD. Conclusions. Our findings align with a longstanding staging approach to comorbidity whereby, via synergistic effects, co-occurring disorders yield greater damage than the sum of each disorder. Here, for the first time, we extended this approach to the executive control network of attention in the context of the co-occurrence between MDD and GAD.

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“…Nuestros resultados están en la línea de los de DeLucca et al (2005) quienes encontraron que los pacientes con TDM y trastornos de ansiedad comórbidos presentaban una mayor alteración de memoria que los pacientes con TDM sin ansiedad. No obstante debemos ser cautos al interpretar nuestros datos en esta dirección dado que otros trabajos han encontrado que la ansiedad comórbida con el TDM se relaciona con alteraciones de la atención y de las funciones ejecutivas (Basso et al, 2007 ) pero no de la memoria y otros trabajos no han encontrado relación entre la presencia de ansiedad comórbida con el TDM y disfunciones neuropsicológicas (Castaneda et al, 2010;Herrera-Guzmán et al, 2009). En nuestro trabajo observamos que un inicio del TDM a edades tempranas aumenta el riesgo de padecer alteraciones de la velocidad de procesamiento de la información y de generación de estrategias.…”

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“…Otros trabajos sugieren que los pacientes que tienen TDM a una edad de inicio temprana presentan alteraciones neuropsicológicas más graves que aquellas personas que tienen un inicio del trastorno a una edad más tardía (Grant et al, 2001) y que un mayor número de episodios depresivos previos se relacionan con una presencia de alteraciones de memoria más graves (Gorwood, Corruble, Falissard y Godwin, 2008). Existen asimismo trabajos que encuentran que la comorbilidad del TDM con algún trastorno de ansiedad conlleva alteraciones neuropsicológicas más graves (DeLucca et al, 2005) mientras que otros trabajos que han explorado el mismo tópico sugieren que este fenómeno no se da (Castaneda et al, 2010;Herrera-Guzmán et al, 2009). El tratamiento con diferentes antidepresivos puede mejorar diversas funciones cognitivas de los pacientes deprimidos (Constant et al, 2005;Fergusson, Wesnes y Schwartz , 2003;Gallassi, Di Sarro, Morreale y Amore, 2006;Herrera-Guzmán et al, 2008;Herrera-Guzmán et al, 2010;Koetsier et al, 2002;Levkowitz, Catfori, Avital y Ritcher-Levin, 2002), pero esto es una fuente potencial de confusión para estudiar el perfil de alteraciones neuropsicológicas del TDM.…”

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Estimación de la prevalencia puntual de alteraciones neuropsicológicas asociadas al trastorno depresivo mayor

Gudayol-Ferré

Guàrdia‐Olmos

Herrera-Guzmán

et al. 2010

Escritos Psicología

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El trastorno depresivo mayor (TDM) es un trastorno afectivo crónico que cursa con alteraciones cognitivas. El objetivo de este estudio es estimar la prevalencia de déficit neuropsicológico en personas con TDM sin tratamiento farmacológico, usando una batería de evaluación neuropsicológica, comparando los resultados obtenidos con los datos normativos de dicha batería. Otro objetivo de este trabajo es ver si existe en el TDM algunas funciones cognitivas que se alteren con mayor frecuencia. También pretendemos ver cuál es la posible relación entre las alteraciones neuropsicológicas propias del TDM y diversas variables clínicas y sociodemográficas. Un total de 174 participantes que cumplían criterios DSM-IV para el diagnóstico de TDM sin comorbilidades mayores de tipo médico (trastornos psicopatológicos o enfermedades físicas) y sin tratamiento farmacológico fueron evaluados con la Mini Entrevista Neuropsiquiátrica Internacional, la escala de Hamilton para la depresión y el Cambridge Neuropsychological Test Automated Batttery (CANTAB). Se determinó la prevalencia del déficit neuropsicológico a partir del CANTAB y se estudiaron las relaciones entre déficit neuropsicológico y las variables edad, años de escolaridad, vocabulario del WAIS, edad del primer episodio y comorbilidad mediante estimación de Odds Ratio. Nuestros datos sugieren que la presencia de deterioro cognitivo en los pacientes con TDM presenta una prevalencia muy alta y es relativamente independiente de variables sociodemográficas y clínicas.

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Comorbidity of anxiety disorders in major depressive disorder: A clinical trial to evaluate neuropsychological deficit

Cited by 7 publications

References 51 publications

Cognitive Control Functions in Unipolar Major Depression with and without Co-Morbid Anxiety Disorder

Cognitive Control Functions in Unipolar Major Depression with and without Co-Morbid Anxiety Disorder

Attentional Networks in Co-occurring Generalized Anxiety Disorder and Major Depression Disorder: Towards a Staging Approach to the Executive Control Deficits

Estimación de la prevalencia puntual de alteraciones neuropsicológicas asociadas al trastorno depresivo mayor

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