Neuropsychological Clustering Highlights Cognitive Differences In Young People Presenting With Depressive Symptoms

Abstract

Early stages of affective or psychotic disorders may be accompanied by neuropsychological changes that help to predict risk of developing more severe disorders. A comprehensive set of neuropsychological measures was collected in 109 help-seeking young people (16 to 30 years; 54 females), recently diagnosed with an affective or psychotic disorder and presenting with current depression. Hierarchical cluster analysis determined three clusters: one deemed to have a "poor memory" profile (n = 40); another with a "poor mental flexibility" profile (n = 38) and a third with widespread difficulties plus "impaired attention and memory" (n = 31). In general, the three clusters were comparable in demographic, functional and clinical factors suggesting some unique role for neurocognitive impairments. A discriminant function analysis confirmed that the clusters were best characterized by performance in "attentional" versus "learning/memory" measures. Furthermore, profiles of independent neuropsychological variables validated the original solution for two of the clusters, distinguishing all cluster-groups on an attentional measure. The findings of this study suggest that despite presenting with very similar levels of current depressive symptomatology, young help-seeking individuals in the early stages of illness have underlying neuropsychological heterogeneity. Distinct neuropsychological profiling may help to predict later psychiatric outcomes and enhance individually-tailored early intervention strategies.

Neuropsychological Clustering in Bipolar and Major Depressive Disorder

“…The presence of patients with mood disorders in all three clusters suggests that individual characteristics may play a more prominent role in cognitive functioning than diagnostic category. This conclusion supports the findings of previous cluster studies, which identify variable levels of cognitive impairment in samples with BD and MDD (Burdick et al, 2014;Hermens et al, 2011). The distribution of clusters identified in the present study was also similar to that revealed by other similar investigations of psychiatric samples.…”

“…The hierarchical clustering procedure used in this study was similar to that described in previous investigations of similar populations (Burdick et al, 2014;Hermens et al, 2011). Patterns of neuropsychological performance were identified using Ward's method of minimum variance (Ward, 1963) with a 586 C. Cotrena et al…”

Letter to the Editor: Neuropsychological subgroups are evident in both mood and psychosis spectrum disorders

“…Our group has previously shown similar cognitive heterogeneity in a sample of younger depressed subjects diagnosed with anxiety disorder, depressive disorder, bipolar disorder or first-episode psychosis (Hermens et al 2011). As shown in the study by Burdick et al (2014), our cluster analysis also revealed three distinct neuropsychological subgroups.…”

A longitudinal proton magnetic resonance spectroscopy study investigating oxidative stress as a result of alcohol and tobacco use in youth with bipolar disorder

“…Participants were recruited as part of a wider Youth Mental Health cohort study (Hermens et al, 2011, Lee et al, 2013, with referral from psychiatrists with a diagnosed bipolar illness using DSM-IV criteria (APA, 2000) as follows: bipolar I (n = 19), bipolar II (n = 30) or bipolar spectrum with family history of BD (n =21) or bipolar NOS (n = 7), defined as an illness pattern consisting of periods of both elevated and depressed mood consistent with a bipolar spectrum disorder (Angst, 2007). Participants were asked at baseline whether they would be interested in being contacted for a follow-up assessment.…”