Kyte Zoë A, Goodyer Ian M, Sahakian Barbara J
Developmental Psychiatry Section, Department of Psychiatry, University of Cambridge, UK.
J Child Psychol Psychiatry. 2005 Sep;46(9):995-1005. doi: 10.1111/j.1469-7610.2004.00400.x.
To investigate whether recent first episode major depression in adolescence is characterised by selected executive difficulties in attentional flexibility, behavioural inhibition and decision-making.
Selected executive functions were compared in adolescents with recent (past year) first episode major depression (n = 30) and community controls (n = 49). Three computerised tests within the CANTAB battery were completed by all subjects (the Intra-Dimensional, Extra-Dimensional Set-Shifting task, the Affective Go, No-Go task, and the Decision-Making task).
Compared with controls, recently depressed cases displayed a bias towards negative stimuli with fewer errors on sad words as well as being more accurate in their responses to sad targets on the Affective Go, No-Go task. Cases also made faster decisions in the context of betting more of their available points compared to controls, as indexed by the Decision-Making task. These results were not influenced by age, gender, IQ, recent mood, severity of depression, medication or comorbidity.
Adolescents with recent first episode major depression show greater attention towards sad stimuli and more impulsive behaviour when making decisions. They were able to switch attentional set to neutral stimuli. This study demonstrates that computerised tests for measuring executive functions can be successfully deployed in adolescents, and suggests that specific patterns of neuropsychological functions may be relatively compromised in first episode major depression. These, together with their underlying neural substrates, deserve further investigation within this age range.
探讨青少年近期首次发作的重度抑郁症是否具有注意力灵活性、行为抑制和决策方面特定的执行功能困难特征。
对近期（过去一年）首次发作重度抑郁症的青少年（n = 30）和社区对照组（n = 49）的特定执行功能进行比较。所有受试者均完成了剑桥神经心理测试自动化成套系统（CANTAB）中的三项计算机化测试（维度内、维度间转换任务，情感性Go/No-Go任务和决策任务）。
与对照组相比，近期患抑郁症的患者对负面刺激存在偏向，在悲伤词汇上的错误较少，并且在情感性Go/No-Go任务中对悲伤目标的反应更准确。根据决策任务指标，与对照组相比，这些患者在押注更多可用分数的情况下做出决策的速度也更快。这些结果不受年龄、性别、智商、近期情绪、抑郁严重程度、药物治疗或共病的影响。
近期首次发作重度抑郁症的青少年对悲伤刺激表现出更高的关注度，并且在做决策时行为更冲动。他们能够将注意力转向中性刺激。本研究表明，用于测量执行功能的计算机化测试可成功应用于青少年，并表明在首次发作的重度抑郁症中，特定的神经心理功能模式可能相对受损。这些以及其潜在的神经基质，在这个年龄范围内值得进一步研究。
