Austin M P, Mitchell P, Wilhelm K, Parker G, Hickie I, Brodaty H, Chan J, Eyers K, Milic M, Hadzi-Pavlovic D
Mood Disorders Unit, Prince Henry Hospital, Sydney, NSW, Australia.
Psychol Med. 1999 Jan;29(1):73-85. doi: 10.1017/s0033291798007788.
Although depressed patients demonstrate impaired performance on a range of neuropsychological tests, there is little research that examines either frontal cognitive deficits or possible differences in test performance between melancholic and non-melancholic subtypes.
Depressed subjects were administered a broad neuropsychological battery. In an overall analysis, 77 depressed subjects were compared with 28 controls. In a second set of analyses, the depressed sample was divided into melancholic and non-melancholic subsets according to DSM-III-R, the CORE system and the Newcastle scale. These depressed subsets were contrasted to controls and with each other using ANCOVA controlling for age, IQ, simple reaction time and Hamilton Depression scores where appropriate.
The total depressed sample was impaired on most mnemonic tasks, simple reaction time and Trails B. Similar findings applied to DSM-III-R melancholic and non-melancholic subjects. When defined by the CORE and Newcastle (narrower definitions of melancholia), melancholic patients were additionally impaired on WCST (perseverative response) and (for Newcastle) digit symbol substitution. In contrast, the cognitive performance of the CORE and Newcastle-defined non-melancholic patients was largely unimpaired.
Using narrower definitions of melancholia, i.e. CORE and (in particular) Newcastle, melancholic patients were impaired on mnemonic tasks and tasks of selective attention, and set-shifting while non-melancholic subjects were largely unimpaired in their cognitive performance. These differences may be due to impairment of specific neuroanatomical regions in narrowly defined melancholic patients, in particular the anterior cingulate.
尽管抑郁症患者在一系列神经心理学测试中表现受损，但很少有研究考察额叶认知缺陷或忧郁症与非忧郁症亚型在测试表现上的可能差异。
对抑郁症患者进行了广泛的神经心理测试。在总体分析中，将77名抑郁症患者与28名对照组进行比较。在第二组分析中，根据《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）、CORE系统和纽卡斯尔量表，将抑郁症样本分为忧郁症和非忧郁症亚组。使用协方差分析（ANCOVA）在适当情况下控制年龄、智商、简单反应时间和汉密尔顿抑郁评分，将这些抑郁症亚组与对照组进行对比，并相互对比。
总体抑郁症样本在大多数记忆任务、简单反应时间和连线测验B上表现受损。类似的发现也适用于DSM-III-R定义的忧郁症和非忧郁症患者。当根据CORE和纽卡斯尔标准（对忧郁症的更狭义定义）定义时，忧郁症患者在威斯康星卡片分类测验（WCST，持续性反应）和（根据纽卡斯尔标准）数字符号替换任务上表现更差。相比之下，CORE和纽卡斯尔标准定义的非忧郁症患者的认知表现基本未受损。
使用对忧郁症的更狭义定义，即CORE标准和（尤其是）纽卡斯尔标准，忧郁症患者在记忆任务、选择性注意任务和转换任务上表现受损，而非忧郁症患者的认知表现基本未受损。这些差异可能是由于狭义定义的忧郁症患者特定神经解剖区域受损，特别是前扣带回。
