Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC, 3052, Australia.
Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.
Neuropsychol Rev. 2018 Jun;28(2):216-231. doi: 10.1007/s11065-018-9373-9. Epub 2018 Apr 22.
Depression is among the most common mental health problems for young people. In adults, depression is associated with neurocognitive deficits that reduce the effectiveness of treatment and impair educational and vocational functioning. Compared to adults, less is known about the neurocognitive functioning of young people with depression, and existing research has reported inconsistent findings.
This systematic review and meta-analysis synthesized the literature on neurocognitive functioning in currently depressed youth aged 12-25 years in comparison to healthy controls.
Following a systematic review of the literature, 23 studies were included in the meta-analysis. Poorer performance in the domains of attention (SMD: .50, 95% CI: .18-.83, p = .002), verbal memory (SMD: .78, 95% CI: .50-1.0, p < .001), visual memory (SMD: .65, 95% CI: .30-.99, p < .001), verbal reasoning/knowledge (SMD: .46; 95% CI: .14-.79; p < 0.001) and IQ (SMD: .32; 95% CI: .08-.56; p = 0.01) were identified in depressed youth. Relative weaknesses in processing speed/reaction time and verbal learning were also evident, however, these findings disappeared when the quality of studies was controlled for. Moderator analysis showed a tendency for poorer set-shifting ability in younger depressed participants relative to controls (although non-significant; p = .05). Moderator analysis of medication status showed taking medication was associated with poorer attentional functioning compared to those not taking medication.
The findings suggest that currently depressed young people display a range of neurocognitive weaknesses which may impact treatment engagement and outcome. The findings support the need to consider neurocognitive functioning when treating youth with depression.
抑郁是年轻人最常见的心理健康问题之一。在成年人中,抑郁与神经认知缺陷有关,这些缺陷会降低治疗效果,并损害教育和职业功能。与成年人相比,人们对患有抑郁症的年轻人的神经认知功能了解较少,而且现有研究的结果也不一致。
本系统评价和荟萃分析综合了目前 12-25 岁患有抑郁症的年轻人与健康对照组的神经认知功能的文献。
经过文献系统评价,有 23 项研究纳入荟萃分析。在注意力(SMD:.50,95%CI:.18-.83,p = .002)、言语记忆(SMD:.78,95%CI:.50-1.0,p < .001)、视觉记忆(SMD:.65,95%CI:.30-.99,p < .001)、言语推理/知识(SMD:.46;95%CI:.14-.79;p < 0.001)和智商(SMD:.32;95%CI:.08-.56;p = 0.01)等领域的表现较差,在抑郁的年轻人中被发现。处理速度/反应时间和言语学习方面的相对弱点也很明显,但是,当控制研究质量时,这些发现就消失了。调节分析表明,与对照组相比,年轻抑郁参与者的转换能力较差(尽管不显著;p = .05)。对药物使用情况的调节分析表明,与未服用药物者相比,服用药物与注意力功能较差有关。
研究结果表明,目前患有抑郁症的年轻人表现出一系列神经认知弱点,这可能会影响治疗的参与和结果。这些结果支持在治疗患有抑郁症的年轻人时考虑神经认知功能的必要性。