Journal of the Korean Academy of Child and Adolescent Psychiatry

Korean Academy of Child and Adolescent Psychiatry (대한소아청소년정신의학회)
권호 표지
DOI QR코드

DOI QR Code

Standardized Treatment and Shortened Depression Course can Reduce Cognitive Impairment in Adolescents With Depression

  • Penghui Cao (Institute of Neuropsychiatry, The Affiliated Brain Hospital of Guangzhou Medical University) ;
  • Junjie Tan (Department of Nephrology and Immunohematology, Qingyuan Maternal and Child Health Hospital of Guangdong Province) ;
  • Xuezhen Liao (Department of Neurology, The Affiliated Brain Hospital of Guangzhou Medical University) ;
  • Jinwei Wang (Department of Neurology, The Affiliated Brain Hospital of Guangzhou Medical University) ;
  • Lihuan Chen (Department of Neurology, The Affiliated Brain Hospital of Guangzhou Medical University) ;
  • Ziyan Fang (Institute of Neuropsychiatry, The Affiliated Brain Hospital of Guangzhou Medical University) ;
  • Nannan Pan (Department of Neurology, The Affiliated Brain Hospital of Guangzhou Medical University)
  • Received : 2023.08.04
  • Accepted : 2023.10.30
  • Published : 2024.01.01
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: This study aimed to explore the influence of depression severity, disease course, treatment status, and other factors on cognitive function in adolescents with depressive disorders. Methods: Participants who met the inclusion criteria were enrolled in the study. Sociodemographic data of each participant were recorded, including age, sex, and family history of mental disorders. Zung's Self-Rating Depression Scale was used to assess depression status in adolescents. Moreover, P300 and mismatch negativity (MMN) were used to objectively evaluate the participants' cognitive function. Results: Only 26.8% of the adolescents with depression received standard antidepressant treatment. The latencies of N2 (267.80±23.34 ms), P3 (357.71±32.09 ms), and MMN (212.10±15.61 ms) in the adolescent depression group were longer than those in the healthy control group (p<0.01). Further analysis revealed that the latency of MMN was extended with increased levels of depression in adolescents. The MMN latency was short in participants with depression receiving standardized treatment. Furthermore, the latency of MMN was positively correlated with the severity and duration of depression (correlation coefficients were 0.465 and 0.479, respectively) (p<0.01). Conclusion: Receiving standardized treatment and shortening the course of depression can reduce cognitive impairment in adolescents with depression.

Keywords

Acknowledgement

We are grateful to all the patients and their families for their collaboration and physicians for their contribution to this study. Moreover, we acknowledge the efforts of the research staff that worked on clinical and data collection.

References

  1. Zhao Y, Yu F, Wu Y, Zeng G, Peng K. Positive education interventions prevent depression in Chinese adolescents. Front Psychol 2019;10:1344. 
  2. Ahmed HU, Hossain MD, Aftab A, Soron TR, Alam MT, Chowdhury MWA, et al. Suicide and depression in the World Health Organization South-East Asia region: a systematic review. WHO South East Asia J Public Health 2017;6:60-66. 
  3. Millan MJ, Agid Y, Brune M, Bullmore ET, Carter CS, Clayton NS, et al. Cognitive dysfunction in psychiatric disorders: characteristics, causes and the quest for improved therapy. Nat Rev Drug Discov 2012;11:141-168. 
  4. Bissonnette JN, Francis AM, Hull KM, Leckey J, Pimer L, Berrigan LI, et al. MMN-indexed auditory change detection in major depressive disorder. Clin EEG Neurosci 2020;51:365-372. 
  5. Chakrabarty T, Hadjipavlou G, Lam RW. Cognitive dysfunction in major depressive disorder: assessment, impact, and management. Focus (Am Psychiatr Publ) 2016;14:194-206. 
  6. McIntyre RS, Cha DS, Soczynska JK, Woldeyohannes HO, Gallaugher LA, Kudlow P, et al. Cognitive deficits and functional outcomes in major depressive disorder: determinants, substrates, and treatment interventions. Depress Anxiety 2013;30:515-527. 
  7. Austin MP, Mitchell P, Goodwin GM. Cognitive deficits in depression: possible implications for functional neuropathology. Br J Psychiatry 2001;178:200-206. 
  8. Yamamoto T, Shimada H. Cognitive dysfunctions after recovery from major depressive episodes. Appl Neuropsychol Adult 2012;19:183-191. 
  9. Majer M, Ising M, Kunzel H, Binder EB, Holsboer F, Modell S, et al. Impaired divided attention predicts delayed response and risk to relapse in subjects with depressive disorders. Psychol Med 2004;34:1453-1463. 
  10. Paelecke-Habermann Y, Pohl J, Leplow B. Attention and executive functions in remitted major depression patients. J Affect Disord 2005;89:125-135. 
  11. Goodall J, Fisher C, Hetrick S, Phillips L, Parrish EM, Allott K. Neurocognitive functioning in depressed young people: a systematic review and meta-analysis. Neuropsychol Rev 2018;28:216-231. 
  12. Gorlyn M, Keilp J, Burke A, Oquendo M, Mann JJ, Grunebaum M. Treatment-related improvement in neuropsychological functioning in suicidal depressed patients: paroxetine vs. bupropion. Psychiatry Res 2015;225:407-412. 
  13. Mahableshwarkar AR, Zajecka J, Jacobson W, Chen Y, Keefe RS. A randomized, placebo-controlled, active-reference, double-blind, flexible-dose study of the efficacy of vortioxetine on cognitive function in major depressive disorder. Neuropsychopharmacology 2015;40:2025-2037. 
  14. Moreines JL, McClintock SM, Holtzheimer PE. Neuropsychologic effects of neuromodulation techniques for treatment-resistant depression: a review. Brain Stimul 2011;4:17-27. 
  15. UK ECT Review Group. Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet 2003;361:799-808. 
  16. Lam RW, Kennedy SH, Mclntyre RS, Khullar A. Cognitive dysfunction in major depressive disorder: effects on psychosocial functioning and implications for treatment. Can J Psychiatry 2014;59:649-654. 
  17. Lopez-Torres Hidalgo J; DEP-EXERCISE Group. Effectiveness of physical exercise in the treatment of depression in older adults as an alternative to antidepressant drugs in primary care. BMC Psychiatry 2019;19:21. 
  18. Zung WW. A self-rating depression scale. Arch Gen Psychiatry 1965;12:63-70. 
  19. Montoya-Pedron A, Ocana-Montoya CM, Bolano-Diaz GA. [P300 cognitive event-related potentials in the diagnosis and classification of possible Alzheimer-type neurocognitive disorders]. Rev Neurol 2020;71:11-18. Spanish 
  20. Naatanen R, Sussman ES, Salisbury D, Shafer VL. Mismatch negativity (MMN) as an index of cognitive dysfunction. Brain Topogr 2014;27:451-466. 
  21. Bress JN, Meyer A, Proudfit GH. The stability of the feedback negativity and its relationship with depression during childhood and adolescence. Dev Psychopathol 2015;27(4 Pt 1):1285-1294. 
  22. Levkovitz Y, Harel EV, Roth Y, Braw Y, Most D, Katz LN, et al. Deep transcranial magnetic stimulation over the prefrontal cortex: evaluation of antidepressant and cognitive effects in depressive patients. Brain Stimul 2009;2:188-200. 
  23. Croarkin PE, MacMaster FP. Transcranial magnetic stimulation for adolescent depression. Child Adolesc Psychiatr Clin N Am 2019;28:33-43. 
  24. Spirito A, Esposito-Smythers C, Wolff J, Uhl K. Cognitive-behavioral therapy for adolescent depression and suicidality. Child Adolesc Psychiatr Clin N Am 2011;20:191-204. 
  25. Dotson VM, McClintock SM, Verhaeghen P, Kim JU, Draheim AA, Syzmkowicz SM, et al. Depression and cognitive control across the lifespan: a systematic review and meta-analysis. Neuropsychol Rev 2020;30:461-476. 
  26. McDermott LM, Ebmeier KP. A meta-analysis of depression severity and cognitive function. J Affect Disord 2009;119:1-8. 
  27. Sheline YI, Barch DM, Garcia K, Gersing K, Pieper C, Welsh-Bohmer K, et al. Cognitive function in late life depression: relationships to depression severity, cerebrovascular risk factors and processing speed. Biol Psychiatry 2006;60:58-65. 
  28. Andrade C, Rao NS. How antidepressant drugs act: a primer on neuroplasticity as the eventual mediator of antidepressant efficacy. Indian J Psychiatry 2010;52:378-386. 
  29. Harmer CJ, Goodwin GM, Cowen PJ. Why do antidepressants take so long to work? A cognitive neuropsychological model of antidepressant drug action. Br J Psychiatry 2009;195:102-108.