Neuropsychological impairments in unipolar depression: The influence of perceived failure on subsequent performance
Neuropsychological impairments in unipolar depression: The influence of perceived failure on subsequent performance
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DOI：
10.1017/s0033291700035303
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发表时间：
1996-09-01
影响因子：
6.9
通讯作者：
Paykel, ES
中科院分区：
文献类型：
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作者：
Elliott, R;Sahakian, BJ;Paykel, ES
采用CANAB成套神经心理学测验对28例单相抑郁患者和22例年龄、智商相匹配的对照组进行比较。患者在几乎所有研究的测试中都受到损害，在模式和空间识别记忆、与样本的匹配、空间广度、空间工作记忆和规划方面存在缺陷。大多数患者至少表现出一些损害和缺陷，可以在认知领域看到。一个重要的发现是失败对后续表现的不利影响；在错误地解决了一个问题后，患者比对照组更有可能不能通过后续的问题。在一般缺陷的基础上，还存在额纹状体功能障碍的执行任务的具体缺陷和颞叶功能障碍的助记任务的缺陷。这种导致对负面反馈过度敏感的特定形式的动机缺陷的组合，以及叠加的特定神经心理缺陷与抑郁的严重程度相关。最显著的相关性是记忆缺陷和临床评分之间的相关性。将这项研究中抑郁症患者的缺陷与其他用Canab神经心理学组合评估的患者组进行比较，结果表明，抑郁症神经心理缺陷的假设之一，即‘额叶亚皮质’或‘额纹状体’功能障碍，并不被支持。这些发现与抑郁症可能的神经基础有关。
The CANTAB battery of neuropsychological tests was used to compare the performance of 28 patients with unipolar depression with that of 22 age and IQ matched controls. The patients were impaired on almost all tests studied with deficits in pattern and spatial recognition memory, matching to sample, spatial span, spatial working memory and planning. Most of the patients showed at least some impairment and deficits were seen across cognitive domains. An important finding was the detrimental effect of failure on subsequent performance; having solved one problem incorrectly, patients were far more likely than controls to fail the subsequent problem. Superimposed on the general deficits, there were also specific deficits in executive tasks characteristic of frontostriatal dysfunction and deficits in mnemonic tasks characteristic of temporal lobe dysfunction. This combination of a specific form of motivational deficit, resulting in oversensitivity to negative feedback, and superimposed specific neuropsychological deficits were correlated with severity of depression. The most significant correlations were seen between mnemonic deficits and clinical rating scores. Comparisons of the deficits seen in the depressed patients in this study with other patient groups assessed with the CANTAB neuropsychological battery, showed that one of the hypotheses of the neuropsychological deficits in depression, that of 'frontosubcortical' or 'frontostriatal' dysfunction, was not supported. These findings are discussed in relation to the likely neural substrates of depression.