Academic Child Psychiatry Unit, Department of Paediatrics, University of Melbourne.
Developmental Neuropsychiatry Program, Royal Children's Hospital.
J Affect Disord. 2021 Jan 1;278:470-476. doi: 10.1016/j.jad.2020.09.093. Epub 2020 Sep 29.
Spatial working memory (SWM) is known to be impaired in children with Major depressive disorder (MDD), and, separately, Dysthymic disorder (DD) (DSM V persistent depressive disorder equivalent). Yet, it remains unclear whether MDD or DD is associated with worse SWM impairment, whether DD adds to the SWM impairments evident in MDD and whether these findings are evident in children as well as adolescents with MDD and DD.
The association of SWM and its strategy and spatial span components is explored in carefully defined children and adolescents (age 6-16 years) with MDD alone (N = 29), MDD and DD (N = 130), DD alone (N = 154) compared to healthy typically developing participants (N = 107), controlling for age, gender, full scale IQ and social adversity status. The relationship between SWM and its strategy and span components and anxious/depressed and inattentive symptoms were also examined.
MDD was associated with worse SWM impairment than DD and there was no evidence of an additive effect of MDD and DD on SWM, strategy and spatial span deficits. Further, these findings were age-independent.
The data presented are cross sectional and limited to SWM deficits in MDD and/or DD.
This study concurs with and extends current influential models about the cognitive effects of MDD and DD. Clinical implications and future research directions are discussed.
空间工作记忆 (SWM) 已知在患有重性抑郁症 (MDD) 的儿童中受损,并且,心境恶劣障碍 (DD)(DSM V 持续性抑郁障碍等效)也是如此。然而,目前尚不清楚 MDD 或 DD 是否与更严重的 SWM 损伤相关,DD 是否会增加 MDD 中明显的 SWM 损伤,以及这些发现是否在患有 MDD 和 DD 的儿童和青少年中也是如此。
在仔细定义的患有 MDD (N=29)、MDD 和 DD (N=130)、DD (N=154)的儿童和青少年(6-16 岁)中,探索 SWM 及其策略和空间跨度成分的相关性,同时控制年龄、性别、全量表智商和社会逆境状况。还检查了 SWM 及其策略和跨度成分与焦虑/抑郁和注意力不集中症状之间的关系。
MDD 与 SWM 损伤比 DD 更严重,并且没有证据表明 MDD 和 DD 对 SWM、策略和空间跨度缺陷有累加效应。此外,这些发现与年龄无关。
目前提出的数据是横断面的,仅限于 MDD 和/或 DD 中的 SWM 缺陷。
本研究与当前关于 MDD 和 DD 的认知影响的有影响力的模型一致并加以扩展。讨论了临床意义和未来的研究方向。