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儿童和青少年重性抑郁障碍认知功能的荟萃分析。

A meta-analysis of cognitive functions in children and adolescents with major depressive disorder.

机构信息

Department of Psychiatry and Psychotherapy, University Medical Centre Mainz, Untere Zahlbacher Str. 8, Mainz, Germany,

出版信息

Eur Child Adolesc Psychiatry. 2015 Jan;24(1):5-19. doi: 10.1007/s00787-014-0559-2. Epub 2014 May 29.

Abstract

The cumulative prevalence rates of major depressive disorders (MDD) in children and adolescents averages 9.5 %. The majority of adults with MDD suffer from significant cognitive deficits, but the available neuropsychological data on the cognitive performance of children and adolescents with MDD yielded mixed results. Meta-analytic methods were used to assess the severity of cognitive deficits in children and adolescents with MDD as compared to healthy children and adolescents. We identified 17 studies comparing the intelligence, executive functions, verbal memory and attention of 447 patients with DSM-IV MDD and 1,347 healthy children and adolescents. Children and adolescents with MDD performed 0.194-0.772 (p < 0.001) standard mean differences worse than healthy control subjects in neuropsychological test procedures. The most pronounced deficits of children and adolescents with MDD were seen in inhibition capacity (STD = 0.772; p = 0.002), phonemic verbal fluency (STD = 0.756; p = 0.0001), sustained attention (STD = 0.522; p = 0.000), verbal memory (STD = 0.516; p = 0.0009) and planning (STD = 0.513; p = 0.014). We revealed cognitive deficits of children and adolescents with MDD in various cognitive domains. Long-term studies should investigate how the cognitive deficits of depressed youth affect their academic and social functioning, and whether age, comorbidity and depression severity play a role in this process.

摘要

儿童和青少年重度抑郁症(MDD)的累积患病率平均为 9.5%。大多数患有 MDD 的成年人都存在明显的认知缺陷,但关于患有 MDD 的儿童和青少年认知表现的现有神经心理学数据得出的结果却不一致。本研究采用荟萃分析方法评估与健康儿童和青少年相比,患有 MDD 的儿童和青少年的认知缺陷严重程度。我们确定了 17 项研究,比较了 447 名符合 DSM-IV MDD 标准的患者和 1347 名健康儿童和青少年的智力、执行功能、言语记忆和注意力。在神经心理学测试程序中,患有 MDD 的儿童和青少年的表现比健康对照组差 0.194-0.772(p<0.001)个标准均数差。患有 MDD 的儿童和青少年最明显的缺陷是抑制能力(STD = 0.772;p = 0.002)、语音流畅性(STD = 0.756;p = 0.0001)、持续注意力(STD = 0.522;p = 0.000)、言语记忆(STD = 0.516;p = 0.0009)和计划能力(STD = 0.513;p = 0.014)。我们发现患有 MDD 的儿童和青少年在各个认知领域都存在认知缺陷。长期研究应调查抑郁青年的认知缺陷如何影响他们的学业和社交功能,以及年龄、共病和抑郁严重程度在这一过程中是否发挥作用。

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