Korean Journal of Biological Psychiatry (생물정신의학)

The Korean Society of Biological Psychiatry (대한생물정신의학회)
권호 표지

Neurocognitive Characteristics According to Depression Severity in Patients with Major Depressive Disorder

주요우울장애 환자의 증상 심각도에 따른 신경인지적 특성

  • 황선희 (고려대학교 안암병원 정신건강의학과) ;
  • 이헌정 (고려대학교 안암병원 정신건강의학과) ;
  • 김명선 (성신여자대학교 심리학과)
  • Received : 2017.04.26
  • Accepted : 2017.07.26
  • Published : 2017.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives This study investigated associations between symptom severity and neurocognitive functions in patients with major depressive disorder using comprehensive neuropsychological tests. Methods Ten patients with low depression (LD) and 22 patients with high depression (HD) participated. Symptom severity was determined by both the Beck Depression Inventory and the Hamilton Depression Rating Scale. Additionally, anxiety was measured by the Korean version of the State-Trait Anxiety Inventory (STAI-KYZ). Ten subtests of the Korean-Wechsler Adult Intelligence scale (K-WAIS), Stroop test, the word/design fluency tests were administered to assess cognition. Results The LD and HD groups did not differ in any of cognitive measures but anxiety level. Namely, the HD group obtained significantly higher scores on the state (U = 29.50, p < 0.01) and trait (U = 28.50, p < 0.001) anxiety scales than the LD group. A significant interaction effect between trait anxiety and depression severity was observed on the picture arrangement subtest of the K-WAIS [F (1, 27) = 5.09, p < 0.05]. Conclusions Cognitive deficits observed in patients with major depressive disorder may be related to other factors rather than current symptom severity. Trait anxiety possibly moderates the effect of current symptom severity on social judgment in these patients.

Keywords

References

  1. Grant MM, Thase ME, Sweeney JA. Cognitive disturbance in outpatient depressed younger adults: evidence of modest impairment. Biol Psychiatry 2001;50:35-43. https://doi.org/10.1016/S0006-3223(00)01072-6
  2. Burt T, Prudic J, Peyser S, Clark J, Sackeim HA. Learning and memory in bipolar and unipolar major depression: effects of aging. Neuropsychiatry Neuropsychol Behav Neurol 2000;13:246-253.
  3. Naismith SL, Longley WA, Scott EM, Hickie IB. Disability in major depression related to self-rated and objectively-measured cognitive deficits: a preliminary study. BMC Psychiatry 2007;7:32. https://doi.org/10.1186/1471-244X-7-32
  4. Farrin L, Hull L, Unwin C, Wykes T, David A. Effects of depressed mood on objective and subjective measures of attention. J Neuropsychiatry Clin Neurosci 2003;15:98-104. https://doi.org/10.1176/jnp.15.1.98
  5. Kiosses DN, Klimstra S, Murphy C, Alexopoulos GS. Executive dysfunction and disability in elderly patients with major depression. Am J Geriatr Psychiatry 2001;9:269-274. https://doi.org/10.1097/00019442-200108000-00011
  6. Stordal KI, Lundervold AJ, Egeland J, Mykletun A, Asbjornsen A, Landro NI, et al. Impairment across executive functions in recurrent major depression. Nord J Psychiatry 2004;58:41-47. https://doi.org/10.1080/08039480310000789
  7. Biringer E, Lundervold A, Stordal K, Mykletun A, Egeland J, Bottlender R, et al. Executive function improvement upon remission of recurrent unipolar depression. Eur Arch Psychiatry Clin Neurosci 2005;255:373-380. https://doi.org/10.1007/s00406-005-0577-7
  8. Castaneda AE, Tuulio-Henriksson A, Marttunen M, Suvisaari J, Lonnqvist J. A review on cognitive impairments in depressive and anxiety disorders with a focus on young adults. J Affect Disord 2008; 106:1-27. https://doi.org/10.1016/j.jad.2007.06.006
  9. Wang CE, Halvorsen M, Sundet K, Steffensen AL, Holte A, Waterloo K. Verbal memory performance of mildly to moderately depressed outpatient younger adults. J Affect Disord 2006;92:283-286. https://doi.org/10.1016/j.jad.2006.02.008
  10. Fossati P, Coyette F, Ergis AM, Allilaire JF. Influence of age and executive functioning on verbal memory of inpatients with depression. J Affect Disord 2002;68:261-271. https://doi.org/10.1016/S0165-0327(00)00362-1
  11. Austin MP, Mitchell P, Goodwin GM. Cognitive deficits in depression: possible implications for functional neuropathology. Br J Psychiatry 2001;178:200-206. https://doi.org/10.1192/bjp.178.3.200
  12. McClintock SM, Husain MM, Greer TL, Cullum CM. Association between depression severity and neurocognitive function in major depressive disorder: a review and synthesis. Neuropsychology 2010; 24:9-34. https://doi.org/10.1037/a0017336
  13. Yoon SY, Lim JH, Han C. Rating scales for measurement-based clinical practice of depression. Korean J Psychopharmacol 2012;23:136-146.
  14. Moller HJ. Outcome criteria in antidepressant drug trials: self-rating versus observer-rating scales. Pharmacopsychiatry 1991;24:71-75. https://doi.org/10.1055/s-2007-1014442
  15. Carter JD, Frampton CM, Mulder RT, Luty SE, Joyce PR. The relationship of demographic, clinical, cognitive and personality variables to the discrepancy between self and clinician rated depression. J Affect Disord 2010;124:202-206. https://doi.org/10.1016/j.jad.2009.11.011
  16. Domken M, Scott J, Kelly P. What factors predict discrepancies between self and observer ratings of depression? J Affect Disord 1994; 31:253-259. https://doi.org/10.1016/0165-0327(94)90101-5
  17. Choi S, Choi SW. Comparison of cognitive function between unipolar depression and bipolar depression through meta-analysis: focus on verbal memory and frontal-executive function. Kor J Clin Psychol 2010;29:607-620. https://doi.org/10.15842/kjcp.2010.29.2.016
  18. Hur JW, Kim YK. Comparison of neuropsychological deficits between depressed episode and remission in first-onset patients with major depressive disorder. Korean J Biol Psychiatry 2008;15:92-100.
  19. Kang RH, Ham BJ, Cha JH, Lee MS. The comparison of the neurocognitive functions between dysthymic disorder and major depressive disorder. J Korean Soc Biol Psychiatry 2002;9:103-111.
  20. Lee KU, Cho SM, Park JI. Cognitive dysfunction and improvement after antidepressant treatment in patients with non-psychotic major depressive disorder in mild to moderate severity: a Prospective Study. Korean J Psychopharmacol 2008;19:283-292.
  21. First MB, Spitzer RL, Gibbon M, Williams JB. User's guide for the structured clinical interview for DSM-IV axis I disorders SCID-I. clinician version. Washington, DC: American Psychiatric Press;1997. p.132.
  22. Yum TH, Park YS, Oh KJ, Kim JK, Lee YH. Korean Wechsler Adult Intelligence Scale (K-WAIS) manual. Seoul: Hankook Guidance; 1992.
  23. Kim H. Kims Frontal-Executive Neuropsychological Test: Manual Daegu: Neuropsychology press;2001.
  24. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:56-62. https://doi.org/10.1136/jnnp.23.1.56
  25. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561-571. https://doi.org/10.1001/archpsyc.1961.01710120031004
  26. Spielberger CD. Manual for the State-trait anxiety inventory (Form Y). Palo Alto, CA: Consulting Psychologists Press;1983.
  27. Han DW, Lee CH, Tak JK. The validation of the Korean-version of Spielberger's STAI. J Stud Guidance 1993;10:214-222.
  28. Rush AJ, First MB, Blacker D; American Psychiatric Association. Task Force for the Handbook of Psychiatric Measures. Handbook of psychiatric measures. 2nd ed. Washington, DC: American Psychiatric Pub.;2008.
  29. Hill SK, Keshavan MS, Thase ME, Sweeney JA. Neuropsychological dysfunction in antipsychotic-naive first-episode unipolar psychotic depression. Am J Psychiatry 2004;161:996-1003. https://doi.org/10.1176/appi.ajp.161.6.996
  30. Cha SY, Hwang SH. Neuropsychological characteristics of elderly patients: a comparison of mild cognitive impairment with depressed mood, mild cognitive impairment without depressed mood and depression. Kor J Clin Psychol 2014;33:107-120. https://doi.org/10.15842/kjcp.2014.33.1.007
  31. Fossati P, Amar G, Raoux N, Ergis AM, Allilaire JF. Executive functioning and verbal memory in young patients with unipolar depression and schizophrenia. Psychiatry Res 1999;89:171-187. https://doi.org/10.1016/S0165-1781(99)00110-9
  32. Veiel HO. A preliminary profile of neuropsychological deficits associated with major depression. J Clin Exp Neuropsychol 1997;19:587-603. https://doi.org/10.1080/01688639708403745
  33. Trichard C, Martinot JL, Alagille M, Masure MC, Hardy P, Ginestet D, et al. Time course of prefrontal lobe dysfunction in severely depressed in-patients: a longitudinal neuropsychological study. Psychol Med 1995;25:79-85. https://doi.org/10.1017/S0033291700028105
  34. Purcell R, Maruff P, Kyrios M, Pantelis C. Neuropsychological function in young patients with unipolar major depression. Psychol Med 1997;27:1277-1285. https://doi.org/10.1017/S0033291797005448