Neurocognitive impairment in adolescent major depressive disorder: state vs. trait illness markers.
Neurocognitive impairment in adolescent major depressive disorder: state vs. trait illness markers.
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DOI：
10.1016/j.jad.2011.04.041
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发表时间：
2011-10
影响因子：
6.6
通讯作者：
Phillips, Mary L.
中科院分区：
文献类型：
--
作者：
Maalouf, Fadi T.;Brent, David;Clark, Luke;Tavitian, Lucy;McHugh, Rebecca Munnell;Sahakian, Barbara J.;Phillips, Mary L.
目前青少年重度抑郁症（MDD）的治疗结果仍然不理想。区分青少年 MDD 的状态和特征标记将有助于识别标记，这些标记可以指导选择适当的干预措施，并有助于改善患有该疾病的个体的长期结果。我们比较了 20 名急性抑郁症青少年 (MDDa)、20 名抑郁症缓解期青少年 (MDDr) 和 17 名健康对照参与者 (HC) 的执行功能、持续注意力和短期记忆的神经认知表现。随着任务难度的增加，执行功能出现了组间差异（p = 0.033）。相对于 MDDr 和 HC（分别为 p = 0.01、d = 0.94 和 p = 0.015、d = 0.77），MDDa 显示执行功能受损，这是通过使用更多动作来解决前瞻性规划任务中的 4 步问题来衡量的。 MDDa 在持续注意力任务上表现出比 MDDr 和 HC 更低的反应偏差 (B") 更冲动（分别为 p = 0.01、d = 0.85 和 p = 0.008、d = 0.49）。较高的冲动性与较严重的抑郁症（r = -0.365，p = 0.022）和较早的抑郁症发病年龄（r = 0.402，p = 0.012）相关，并且在 MDDa 和 MDDr 中，更多的执行功能障碍与更严重的抑郁症（r = 0.301 p = 0.059）之间存在相关趋势。三组在持续注意力任务的短期记忆或目标检测方面没有显着差异。这些结果需要在未来以更大的样本量进行复制。执行功能障碍和冲动似乎是青少年 MDD 的状态特异性标志物，与抑郁症的严重程度相关，但在缓解期不存在。
Current treatment outcomes of Major Depressive Disorder (MDD) in adolescents remain suboptimal. Discriminating between state and trait markers of MDD in adolescents would help identify markers that may guide choice of appropriate interventions and help improve longer-term outcome for individuals with the illness. We compared neurocognitive performance in executive function, sustained attention and short-term memory in 20 adolescents with MDD in acute episode (MDDa), 20 previously depressed adolescents in remission (MDDr) and 17 healthy control participants (HC). There was a group difference that emerged for executive function with increasing task difficulty (p = 0.033). MDDa showed impaired executive function, as measured by using more moves to solve 4-move problems on a forward planning task, relative to MDDr and HC (p = 0.01, d = 0.94 and p = 0.015, d = 0.77 respectively). MDDa showed more impulsivity as measured by lower response bias (B″) on a sustained attention task than both MDDr and HC (p = 0.01, d = 0.85 and p = 0.008, d = 0.49 respectively). Higher impulsivity was associated with more severe depression (r = −0.365, p = 0.022) and earlier age of onset of depression (r = 0.402, p = 0.012) and there was a trend for a correlation between more executive dysfunction and more severe depression (r = 0.301 p = 0.059) in MDDa and MDDr combined. The three groups did not differ significantly on short-term memory or target detection on the sustained attention task. These results need to be replicated in the future with a larger sample size. Executive dysfunction and impulsivity appear to be state-specific markers of MDD in adolescents that are related to depression severity and not present in remission.
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