Neuropsychological Assessments of Cognitive Impairment in Major Depressive Disorder: A Systematic Review and Meta-Analysis with Meta-Regression

荟萃分析 心理学 神经心理学 临床心理学 科克伦图书馆 心理信息 剑桥神经心理学测试自动电池 认知 重性抑郁障碍 萧条(经济学) 严格标准化平均差 置信区间 精神科 梅德林 医学 工作记忆 空间记忆 内科学 法学 政治学 宏观经济学 经济
作者
Taeho Greg Rhee,Sung Ryul Shim,Kevin J. Manning,Howard Tennen,Tyler S. Kaster,Giacomo d’Andrea,Brent P. Forester,Andrew A. Nierenberg,Roger S. McIntyre,David C. Steffens
出处
期刊:Psychotherapy and Psychosomatics [Karger Publishers]
卷期号:93 (1): 8-23 被引量:18
标识
DOI:10.1159/000535665
摘要

<b><i>Introduction:</i></b> Cognitive dysfunction or deficits are common in patients with major depressive disorder (MDD). The current study systematically reviews and meta-analyzes multiple domains of cognitive impairment in patients with MDD. <b><i>Methods:</i></b> PubMed/MEDLINE, PsycINFO, Cochrane Library, Embase, Web of Science, and Google Scholar were searched from inception through May 17, 2023, with no language limits. Studies with the following inclusion criteria were included: (1) patients with a diagnosis of MDD using standardized diagnostic criteria; (2) healthy controls (i.e., those without MDD); (3) neuropsychological assessments of cognitive impairment using Cambridge Neuropsychological Test Automated Battery (CANTAB); and (4) reports of sufficient data to quantify standardized effect sizes. Hedges’ <i>g</i> standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs) were used to quantify effect sizes of cognitive impairments in MDD. SMDs were estimated using a fixed- or random-effects models. <b><i>Results:</i></b> Overall, 33 studies consisting of 2,596 subjects (<i>n</i> = 1,337 for patients with MDD and <i>n</i> = 1,259 for healthy controls) were included. Patients with MDD, when compared to healthy controls, had moderate cognitive deficits (SMD, −0.39 [95% CI, −0.47 to −0.31]). In our subgroup analyses, patients with treatment-resistant depression (SMD, −0.56 [95% CI, −0.78 to −0.34]) and older adults with MDD (SMD, −0.51 [95% CI, −0.66 to −0.36]) had greater cognitive deficits than healthy controls. The effect size was small among unmedicated patients with MDD (SMD, −0.19 [95% CI, −0.37 to −0.00]), and we did not find any statistical difference among children. Cognitive deficits were consistently found in all domains, except the reaction time. No publication bias was reported. <b><i>Conclusion:</i></b> Because cognitive impairment in MDD can persist in remission or increase the risk of major neurodegenerative disorders, remediation of cognitive impairment in addition to alleviation of depressive symptoms should be an important goal when treating patients with MDD.
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