Learning and memory in bipolar and unipolar major depression: effects of aging.
ABSTRACT The goal of this study was to examine the effects of aging on neuropsychological functions in bipolar and unipolar major depression.
Earlier studies suggested that neurocognitive deficits in mood disorder patients correlate with duration and severity of illness and also that bipolar disorder has a more virulent course than unipolar disorder. We hypothesized that elderly patients with bipolar disorder will demonstrate greater neurocognitive dysfunction than young patients with bipolar disorder and elderly patients with unipolar disorder.
A battery of tests of general intelligence and learning and memory was administered to 79 inpatients with major depression referred for electroconvulsive therapy. With patients 60 years of age and older defined as elderly, there were 29 young and 24 elderly unipolar patients and 13 young and 13 elderly bipolar patients.
Unipolar and bipolar patients did not differ in measures of general intelligence or global cognitive status. Generally, across tests of memory, young bipolar patients exhibited the best performance and elderly bipolar patients exhibited the poorest performance.
The results suggest that over the course of their illness, patients with bipolar disorder experience greater deterioration in memory functions than patients with unipolar disorder. Longitudinal studies are required to support the preliminary findings of this cross-sectional study.
SourceAvailable from: Eva Biringer
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ABSTRACT: Cognitive dysfunction is of clinical significance and exerts longstanding implication on patients׳ function. Pharmacological and non-pharmacological treatments of cognitive dysfunction are emerging. This review evaluates pharmacological and non-pharmacological treatments of cognitive impairment primarily in the domains of memory, attention, processing speed and executive function in clinical depression. A total of 35 studies were retrieved from Pubmed, PsycInfo and Scopus after applying inclusion and exclusion criteria. Results show that various classes of antidepressants exert improving effects on cognitive function across several cognitive domains. Specifically, studies suggest that SSRIs, the SSRE tianeptine, the SNRI duloxetine, vortioxetine and other antidepressants such as bupropion and moclobemide may exert certain improving effects on cognitive function in depression, such as in learning and memory and executive function. Class-specific cognitive domains or specific dose–response relationships were not identified yet. The few non-pharmacological studies conducted employing cognitive orientated treatments and cognitive remediation therapy show promising results for the improvement of cognitive impairment in depression. However, several methodological constraints of studies limit generalizability of the results and caution the interpretation. Future direction should consider the development of a neuropsychological consensus cognitive battery to support the discovery, clinical assessment, comparison of studies and registration of new agents in clinical depression.Psychiatry Research 09/2014; 219(1):25–50. DOI:10.1016/j.psychres.2014.05.013 · 2.68 Impact Factor
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ABSTRACT: While neuropsychological dysfunction is a contributor to major depressive disorder (MDD) in adult MDD, little is known about neuropsychological function in MDD during adolescence and early adulthood. The aim of this review is to evaluate literature on neuropsychological function in this young age group. A database search of Medline, the Cochrane database and PsycInfo was conducted. Inclusion/exclusion criteria yielded seven case-control studies on neuropsychological functioning in MDD (12–25 years of age) published since 1995. Effect sizes were calculated. Results show a broader range of statistically significant neuropsychological deficits in MDD compared to controls in the cognitive domains of executive function (EF), working memory (WM), psychomotor and processing speed (PPS), verbal fluency (VF) and visual (-spatial) memory (VM). Most convincingly, three out of four studies investigating WM and three out of four studies investigating PPS found statistically significant impairments in MDD with varying effect sizes. EF deficits were reported only in three out of seven studies with small, medium and large effect sizes. While some evidence was found for impaired VM and VF, no evidence was observed for attention and verbal learning and memory; however, these domains have been less extensively studied. Further research is required to broaden the study base.Psychiatry Research 08/2014; 218(3):261–271. DOI:10.1016/j.psychres.2014.04.052 · 2.68 Impact Factor