Malekizadeh Hossein, Saed Omid, Rashtbari Alireza, Sajjadi Mozhdeh, Ahmadi Davoud, Ronold Eivind Haga
Department of Clinical Psychology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
Faculty of Psychology and Education, University of Tehran, Tehran, Iran.
Front Psychiatry. 2023 Oct 3;14:1225062. doi: 10.3389/fpsyt.2023.1225062. eCollection 2023.
Previous research has highlighted the executive function (EF) deficits present in depressed patients; however, conflicting results exist regarding the impact of depression severity on the size of these deficits. This study aimed to compare deficits in EF between antidepressant naïve inpatient and outpatient depressed, a group with subclinical depression symptoms, and a healthy control group while controlling for education, sex, and age.
In cross-sectional research, 245 antidepressant naive participants (46 inpatient, 68 outpatient, 65 subclinical, and 67 healthy control individuals) were recruited by convenience sampling. The Structured Clinical Interview for DSM-5 Disorders (SCID-5) and Beck Depression Inventory-II (BDI-II) were used to assess depression. EF was measured using several neuropsychological tests, including the Stroop Color-Word Test, the Wisconsin Card Sorting Test, and the N-back Test, which assessed the components of Inhibition, Shifting, and Updating, respectively. Multivariate analysis of covariance revealed a significant difference between the groups in EF components ( < 0.001). Pairwise comparisons further showed that inpatient and outpatient patients had more depressive symptoms and worse EF performance than subclinical and healthy control groups ( < 0.05).
In the analysis of EF measures, a significant difference was found among the four groups, with tests revealing variations in specific EF components. Overall, patients with more severe depressive symptoms show more deficits in EF. Additionally, correlations between clinical characteristics and EF measures varied across patient groups, but many correlations became non-significant after adjusting for the false discovery rate (FDR).
This study emphasizes the impact of depression severity on deficits in the EF of depressed patients and at-risk populations. Consequently, it is important to consider executive dysfunctions as an underlying vulnerability in the development and persistence of depressive disorder.
先前的研究强调了抑郁症患者存在的执行功能（EF）缺陷；然而，关于抑郁严重程度对这些缺陷程度的影响，存在相互矛盾的结果。本研究旨在比较未服用抗抑郁药的住院和门诊抑郁症患者、有亚临床抑郁症状的一组人群以及健康对照组在执行功能方面的缺陷，同时控制教育程度、性别和年龄因素。
在横断面研究中，通过便利抽样招募了245名未服用抗抑郁药的参与者（46名住院患者、68名门诊患者、65名亚临床患者和67名健康对照个体）。使用《精神疾病诊断与统计手册》第五版障碍的结构化临床访谈（SCID - 5）和贝克抑郁量表第二版（BDI - II）来评估抑郁情况。执行功能通过多项神经心理学测试进行测量，包括斯特鲁普颜色 - 文字测试、威斯康星卡片分类测试和n - 回溯测试，分别评估抑制、转换和更新成分。多变量协方差分析显示，各组在执行功能成分上存在显著差异（<0.001）。两两比较进一步表明，住院和门诊患者比亚临床和健康对照组有更多的抑郁症状和更差的执行功能表现（<0.05）。
在执行功能测量分析中，四组之间存在显著差异，检验揭示了特定执行功能成分的变化。总体而言，抑郁症状更严重的患者在执行功能方面表现出更多缺陷。此外，临床特征与执行功能测量之间的相关性在不同患者组中有所不同，但在调整错误发现率（FDR）后，许多相关性变得不显著。
本研究强调了抑郁严重程度对抑郁症患者及高危人群执行功能缺陷的影响。因此，将执行功能障碍视为抑郁症发展和持续存在的潜在易感性因素很重要。
