儿童和青少年抑郁症患者的认知功能:系统评价和荟萃分析。

Cognitive functioning in children and adolescents with depression: A systematic review and meta-analysis.

机构信息

Neurosciences and Mental Health, Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada.

Neurosciences and Mental Health, Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada; Nutrition and Dietetics Program, Clinical Public Health Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.

出版信息

Eur Neuropsychopharmacol. 2024 Feb;79:49-58. doi: 10.1016/j.euroneuro.2023.11.005. Epub 2023 Dec 20.

Abstract

Although cognitive dysfunction is associated with depression in adults, the link in children and adolescents is unclear. This systematic review and meta-analysis quantifies the association between depression and cognitive function in children and adolescents. Systematic searches were conducted in six databases: Child Development and Adolescent Studies, Ovid MEDLINE, Ovid Embase, Ovid APA PsycINFO, EBSCO CINAHL Plus, Scopus (last search: April 2023). Studies including measures of cognitive outcomes (memory, attention, executive function, processing speed, language) among children (≤18 years) with depression were included. The Joanna Briggs Institute Critical Appraisal Tools were used to determine study risk of bias. Random-effects meta-analyses of study outcomes were performed. Seventeen studies were included (15 were cross-sectional, 1 prospective, 1 randomized control trial). Participants (N = 13,567) were 10 to 17 years old (mean 13.8 ± 2.2 years; 60 % female). Compared with healthy controls, depressed participants had lower performance on tests of working memory (g = -0.40; 95 % CI: -0.67, -0.13), long-term memory (g = -0.48; 95 % CI: -0.72, -0.25), attention (g = -0.15; 95 % CI: -0.26, -0.04), executive function (g = -0.16; 95 % CI: -0.24, -0.08), and language (g = -0.23; 95 % CI: -0.36, -0.09). No performance differences were observed on tests of short-term memory or processing speed. Children and adolescents with depression demonstrated lower performance on tests of working and long-term memory, attention, executive function and language. These findings emphasize the importance of considering cognitive functioning among children with depression, and greater understanding of the effect of treatment on these outcomes. PROSPERO (CRD42022332064).

摘要

虽然认知功能障碍与成年人的抑郁有关,但在儿童和青少年中的关联尚不清楚。本系统评价和荟萃分析量化了儿童和青少年抑郁与认知功能之间的关联。系统检索了六个数据库:儿童发展与青少年研究、Ovid MEDLINE、Ovid Embase、Ovid APA PsycINFO、EBSCO CINAHL Plus、Scopus(最后一次搜索:2023 年 4 月)。纳入了在患有抑郁的儿童(≤18 岁)中测量认知结果(记忆、注意力、执行功能、处理速度、语言)的研究。使用 Joanna Briggs 研究所批判性评估工具来确定研究的偏倚风险。对研究结果进行了随机效应荟萃分析。纳入了 17 项研究(15 项为横断面研究,1 项为前瞻性研究,1 项为随机对照试验)。参与者(N=13567)年龄为 10 至 17 岁(平均 13.8±2.2 岁;60%为女性)。与健康对照组相比,抑郁组参与者在工作记忆(g=-0.40;95%CI:-0.67,-0.13)、长时记忆(g=-0.48;95%CI:-0.72,-0.25)、注意力(g=-0.15;95%CI:-0.26,-0.04)、执行功能(g=-0.16;95%CI:-0.24,-0.08)和语言(g=-0.23;95%CI:-0.36,-0.09)测试中的表现较低。在短期记忆或处理速度测试中没有观察到表现差异。患有抑郁的儿童和青少年在工作和长时记忆、注意力、执行功能和语言测试中的表现较低。这些发现强调了在患有抑郁的儿童中考虑认知功能的重要性,以及更深入地了解治疗对这些结果的影响。PROSPERO(CRD42022332064)。

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