Mayer Jutta S, Bernhard Anka, Fann Nikola, Boxhoorn Sara, Hartman Catharina A, Reif Andreas, Freitag Christine M
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528 Frankfurt am Main, Germany.
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528 Frankfurt am Main, Germany.
Neurosci Biobehav Rev. 2021 Feb;121:307-345. doi: 10.1016/j.neubiorev.2020.12.018. Epub 2021 Jan 7.
The risk for major depressive disorder (MDD) is considerably increased in young adults with attention-deficit/hyperactivity disorder (ADHD) but underlying mechanisms are poorly understood. This review explores ADHD-specific neurocognitive impairments as possible underlying mechanisms for ADHD-depression comorbidity. Two systematic literature searches were conducted in EBSCOhost, PubMED, and Cochrane Reviews databases according to PRISMA guidelines. The first search identified 18 meta-analyses of cross-sectional and longitudinal studies on cognitive dysfunctions in MDD across the lifespan. The second search identified six original studies on reaction time variability in MDD. During acute depression, children and adults showed cognitive deficits that overlapped with some of the ADHD-related impairments. Findings from remitted patients, high-risk individuals, and few prospective studies suggest that a subset of these shared impairments, specifically executive dysfunctions (selective attention, verbal fluency, working memory) and long-term memory problems, are candidate pre-existing risk markers of depression. We discuss if and how these specific neurocognitive mechanisms may mediate developmental pathways from ADHD to depression. If replicated by longitudinal studies, these findings may guide future prevention strategies.
患有注意力缺陷多动障碍（ADHD）的年轻人患重度抑郁症（MDD）的风险会大幅增加，但其中的潜在机制却知之甚少。本综述探讨了ADHD特有的神经认知障碍，将其作为ADHD与抑郁症共病的潜在机制。根据PRISMA指南，在EBSCOhost、PubMED和Cochrane Reviews数据库中进行了两次系统的文献检索。第一次检索确定了18项关于MDD患者一生中认知功能障碍的横断面和纵向研究的荟萃分析。第二次检索确定了6项关于MDD患者反应时间变异性的原始研究。在急性抑郁期间，儿童和成人表现出的认知缺陷与一些ADHD相关的损伤有重叠。缓解期患者、高危个体以及少数前瞻性研究的结果表明，这些共同损伤中的一部分，特别是执行功能障碍（选择性注意力、语言流畅性、工作记忆）和长期记忆问题，是抑郁症潜在的预先存在的风险标志物。我们讨论了这些特定的神经认知机制是否以及如何介导从ADHD到抑郁症的发展途径。如果纵向研究能够重复这些发现，那么这些结果可能会为未来的预防策略提供指导。
