1
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Cheng CM, Jeng JS. Psychiatric rehabilitation and cognitive deficit for treatment-resistant depression. PROGRESS IN BRAIN RESEARCH 2023; 281:91-113. [PMID: 37806718 DOI: 10.1016/bs.pbr.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
Patients with TRD often experience persistent impairment of affective, psychosocial, and cognitive function, which impedes their recovery. The continuation of pharmacotherapy for patients with TRD remains the cornerstone of functional recovery. Cognitive dysfunction is prevalent in patients with MDD and may make patients' depressive symptoms and psychosocial functioning worse, even in the remitted stage of illness. Deficits can manifest not only in specific cognitive domains but also in global cognitive function, which may reflect underlying persistent pathophysiological changes. Compared with nontreatment-resistant patients with MDD, patients with TRD exhibit greater subjective and objective cognitive impairment, which possibly contributes to a greater adverse impact on daily functioning. Cognitive and psychosocial remission should be a goal in treating MDD. How to appropriately and individualized perform pharmacological intervention, psychotherapy, neuromodulation, cognitive remediation or other rehabilitation treatment programs is a critical step to achieve our goal. Integrating multiple interventions that engage multiple physiological systems with a multidisciplinary team warrants increased attention, and personalized therapeutic programs may facilitate the complete restoration of patients' everyday functioning.
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Affiliation(s)
- Chih-Ming Cheng
- Attending Psychiatrist, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Lecturer, Division of Psychiatry, College of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.
| | - Jia-Shyun Jeng
- Attending Psychiatrist, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
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2
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Armand S, Ozenne B, Svart N, Frøkjaer VG, Knudsen GM, Fisher PM, Stenbaek DS. Brain serotonin transporter is associated with cognitive-affective biases in healthy individuals. Hum Brain Mapp 2022; 43:4174-4184. [PMID: 35607850 PMCID: PMC9374883 DOI: 10.1002/hbm.25946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/21/2022] [Accepted: 05/02/2022] [Indexed: 12/26/2022] Open
Abstract
Cognitive affective biases describe the tendency to process negative information or positive information over the other. These biases can be modulated by changing extracellular serotonin (5-HT) levels in the brain, for example, by pharmacologically blocking and downregulating the 5-HT transporter (5-HTT), which remediates negative affective bias. This suggests that higher levels of 5-HTT are linked to a priority of negative information over positive, but this link remains to be tested in vivo in healthy individuals. We, therefore, evaluated the association between 5-HTT levels, as measured with [11 C]DASB positron emission tomography (PET), and affective biases, hypothesising that higher 5-HTT levels are associated with a more negative bias. We included 98 healthy individuals with measures of [11 C]DASB binding potential (BPND ) and affective biases using The Emotional Faces Identification Task by subtracting the per cent hit rate for happy from that of sad faces (EFITAB ). We evaluated the association between [11 C]DASB BPND and EFITAB in a linear latent variable model, with the latent variable (5-HTTLV ) modelled from [11 C]DASB BPND in the fronto-striatal and fronto-limbic networks implicated in affective cognition. We observed an inverse association between 5-HTTLV and EFITAB (β = -8% EFITAB per unit 5-HTTLV , CI = -14% to -3%, p = .002). These findings show that higher 5-HTT levels are linked to a more negative bias in healthy individuals. High 5-HTT supposedly leads to high clearance of 5-HT, and thus, a negative bias could result from low extracellular 5-HT. Future studies must reveal if a similar inverse association exists in individuals with affective disorders.
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Affiliation(s)
- Sophia Armand
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark.,BrainDrugs, Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Nanna Svart
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Vibe G Frøkjaer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Psychiatric Center Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Dea S Stenbaek
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark.,BrainDrugs, Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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3
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van Sprang ED, Maciejewski DF, Milaneschi Y, Kullberg ML, Hu MX, Elzinga BM, van Hemert AM, Hartman CA, Penninx BWJH. Familial resemblance in mental health symptoms, social and cognitive vulnerability, and personality: A study of patients with depressive and anxiety disorders and their siblings. J Affect Disord 2021; 294:420-429. [PMID: 34320449 DOI: 10.1016/j.jad.2021.06.072] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/03/2021] [Accepted: 06/25/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Investigating siblings of probands with affective disorders enables the identification of psychopathology-related risk features. Leveraging data from an older adult sample, as compared to most previous sibling studies, enabled us to study more definitive clinical profiling across the lifespan. We examined prevalence of depressive/anxiety disorders in siblings, proband-sibling resemblance in psychopathology-related features, and whether unaffected siblings showed higher levels of these features than healthy controls. METHODS The sample (N=929; Mage=50.6) consisted of 256 probands with lifetime depressive and/or anxiety disorders, their 380 siblings, and 293 healthy controls without affected relatives. Fifteen psychopathology-related features were investigated across four domains: mental health symptoms, social vulnerabilities, cognitive vulnerabilities, and personality. RESULTS Lifetime disorders were present in 50.3% of siblings. Prevalence was 2-3 times higher than Dutch population frequencies. We found small to medium probandsibling resemblance across psychopathology-related features (ρ=0.10-0.32). Unaffected siblings reported poorer interpersonal functioning and more negative life events, childhood trauma, and rumination than healthy controls. LIMITATIONS Due to the cross-sectional study design, the directionality of effects cannot be determined. No inferences can be made about potential differences in familial resemblance in psychopathology-related features between high- and low-risk families. CONCLUSIONS Siblings of probands with affective disorders are at higher risk for depressive/anxiety disorders. Even when unaffected, still show higher psychosocial vulnerability than healthy controls. Nevertheless, the only modest proband-sibling resemblance across psychopathology-related features suggests that individual mechanisms differentiate clinical trajectories across the lifespan. Identification of these mechanisms is crucial to improve resilience in subjects with familial risk.
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Affiliation(s)
- Eleonore D van Sprang
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, Amsterdam, The Netherlands.
| | - Dominique F Maciejewski
- Department of Developmental Psychopathology, Behavioral Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Yuri Milaneschi
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | | | - Mandy X Hu
- 113 Zelfmoordpreventie, Amsterdam, The Netherlands
| | - Bernet M Elzinga
- Institute of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Albert M van Hemert
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Catharina A Hartman
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, Groningen, The Netherlands
| | - Brenda W J H Penninx
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, Amsterdam, The Netherlands
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4
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Dell'Acqua C, Dal Bò E, Messerotti Benvenuti S, Ambrosini E, Vallesi A, Palomba D. Depressed mood, brooding rumination and affective interference: The moderating role of heart rate variability. Int J Psychophysiol 2021; 165:47-55. [PMID: 33838165 DOI: 10.1016/j.ijpsycho.2021.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/21/2021] [Accepted: 03/29/2021] [Indexed: 02/07/2023]
Abstract
Facilitated processing of negative information might contribute to the etiopathogenesis and maintenance of depressive symptoms. Cardiac vagal tone, indexed by heart rate variability (HRV), is believed to represent a proxy of the functional integrity of the neural networks implicated in brooding rumination, affective interference and depression. The present study examined whether HRV may moderate the relation between brooding rumination, affective interference and depressive symptoms in a sample of healthy individuals (n = 68) with different degrees of depressed mood. Self-report measures of depression and brooding were collected, whereas the emotional Stroop task was employed to measure affective interference. Three-minute resting-state electrocardiogram was recorded to obtain time- and frequency-domain vagally mediated HRV parameters. Stepwise linear regression analyses revealed that HRV was a significant moderator of the positive association between depression and brooding rumination, but not of the association between depression and affective interference. An integrated model is supported, in which vagally mediated HRV appeared to potentiate the positive link between depressive symptoms and brooding rumination. Considering that HRV and brooding rumination were found to have an interacting role in determining the severity of depressive symptoms, they may represent potential clinical targets in the prevention and treatment of depressive symptoms.
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Affiliation(s)
- Carola Dell'Acqua
- Department of General Psychology, University of Padua, Via Venezia 8, 35131 Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B, 35131 Padua, Italy.
| | - Elisa Dal Bò
- Department of General Psychology, University of Padua, Via Venezia 8, 35131 Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B, 35131 Padua, Italy
| | - Simone Messerotti Benvenuti
- Department of General Psychology, University of Padua, Via Venezia 8, 35131 Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B, 35131 Padua, Italy
| | - Ettore Ambrosini
- Department of General Psychology, University of Padua, Via Venezia 8, 35131 Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B, 35131 Padua, Italy; Department of Neuroscience, University of Padua, Via Giustiniani 5, 35128 Padua, Italy
| | - Antonino Vallesi
- Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B, 35131 Padua, Italy; Department of Neuroscience, University of Padua, Via Giustiniani 5, 35128 Padua, Italy; Brain Imaging & Neural Dynamics Research Group, IRCCS San Camillo Hospital, Venice, Italy
| | - Daniela Palomba
- Department of General Psychology, University of Padua, Via Venezia 8, 35131 Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B, 35131 Padua, Italy
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5
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Attention control and its emotion-specific association with cognitive emotion regulation in depression. Brain Imaging Behav 2019; 13:1766-1779. [DOI: 10.1007/s11682-019-00174-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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6
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MacKenzie LE, Uher R, Pavlova B. Cognitive Performance in First-Degree Relatives of Individuals With vs Without Major Depressive Disorder: A Meta-analysis. JAMA Psychiatry 2019; 76:297-305. [PMID: 30586133 PMCID: PMC6439825 DOI: 10.1001/jamapsychiatry.2018.3672] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
IMPORTANCE Findings of cognitive impairment in major depressive disorder (MDD), including remitted MDD, raise the question whether impaired cognition is part of preexisting vulnerability rather than a consequence of MDD or its treatment. To our knowledge, no meta-analyses have been published on cognitive impairment in first-degree relatives of individuals with MDD. OBJECTIVE To compare cognitive performance between individuals with and without family history of MDD. DATA SOURCES Medline/PubMed, PsycINFO, and Embase using combinations of search terms for depression, first-degree relatives, and cognition from January 1, 1980, to July 15, 2018. STUDY SELECTION Original articles that reported data on cognition in first-degree relatives of individuals with MDD compared with controls with no family history of major mental illness. DATA EXTRACTION AND SYNTHESIS Means and SDs were extracted, and standardized mean differences (SMD) between relatives and controls were calculated for each measure of cognitive performance. The relative-control differences in overall cognition and in specific cognitive domains were synthesized in random-effects meta-analyses with robust variance estimation that allows including multiple correlated measures of cognition within each study. Heterogeneity was quantified with τ2. Publication bias was assessed with funnel plots and Egger intercept. MAIN OUTCOMES AND MEASURES Performance on cognitive tests. RESULTS Across 284 measures of cognition in 54 nonoverlapping samples including 3246 relatives of people with MDD (mean age 15.38 years, 57.68% females) and 5222 controls (mean age 14.70 years, 55.93% females), relatives of people with MDD performed worse than controls across all measures of cognition (SMD = -0.19; 95% CI, -0.27 to -0.11; P < .001). Domain-specific meta-analyses showed similar size of relative-control difference in most domains of cognition, including Full-Scale IQ (SMD = -0.19), verbal intelligence (SMD = -0.29), perceptual intelligence (SMD = -0.23), memory (SMD = -0.20), academic performance (SMD = -0.40), and language (SMD = -0.29). Study characteristics were not significantly associated with observed between-group differences. There was no evidence of publication bias. CONCLUSIONS AND RELEVANCE A general impairment in cognition is a feature of familial disposition for MDD. Cognition may contribute to early identification of risk for depression and may be examined as potential target for early intervention.
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Affiliation(s)
- Lynn E. MacKenzie
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Rudolf Uher
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada,Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada,Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Barbara Pavlova
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada,Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
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7
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Ruhe HG, Mocking RJT, Figueroa CA, Seeverens PWJ, Ikani N, Tyborowska A, Browning M, Vrijsen JN, Harmer CJ, Schene AH. Emotional Biases and Recurrence in Major Depressive Disorder. Results of 2.5 Years Follow-Up of Drug-Free Cohort Vulnerable for Recurrence. Front Psychiatry 2019; 10:145. [PMID: 30984039 PMCID: PMC6447719 DOI: 10.3389/fpsyt.2019.00145] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 02/27/2019] [Indexed: 12/24/2022] Open
Abstract
An interesting factor explaining recurrence risk in Major Depressive Disorder (MDD) may be neuropsychological functioning, i.e., processing of emotional stimuli/information. Negatively biased processing of emotional stimuli/information has been found in both acute and (inconclusively) remitted states of MDD, and may be causally related to recurrence of depression. We aimed to investigate self-referent, memory and interpretation biases in recurrently depressed patients in remission and relate these biases to recurrence. We included 69 remitted recurrent MDD-patients (rrMDD-patients), 35-65 years, with ≥2 episodes, voluntarily free of antidepressant maintenance therapy for at least 4 weeks. We tested self-referent biases with an emotional categorization task, bias in emotional memory by free recall of the emotion categorization task 15 min after completing it, and interpretation bias with a facial expression recognition task. We compared these participants with 43 never-depressed controls matched for age, sex and intelligence. We followed the rrMDD-patients for 2.5 years and assessed recurrent depressive episodes by structured interview. The rrMDD-patients showed biases toward emotionally negative stimuli, faster responses to negative self-relevant characteristics in the emotional categorization, better recognition of sad faces, worse recognition of neutral faces with more misclassifications as angry or disgusting faces and less misclassifications as neutral faces (0.001 < p < 0.05). Of these, the number of misclassifications as angry and the overall performance in the emotional memory task were significantly associated with the time to recurrence (p ≤ 0.04), independent of residual symptoms and number of previous episodes. In a support vector machine data-driven model, prediction of recurrence-status could best be achieved (relative to observed recurrence-rate) with demographic and childhood adversity parameters (accuracy 78.1%; 1-sided p = 0.002); neuropsychological tests could not improve this prediction. Our data suggests a persisting (mood-incongruent) emotional bias when patients with recurrent depression are in remission. Moreover, these persisting biases might be mechanistically important for recurrence and prevention thereof.
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Affiliation(s)
- Henricus G Ruhe
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Psychiatry, Location Academic Medical Center, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Roel J T Mocking
- Department of Psychiatry, Location Academic Medical Center, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Caroline A Figueroa
- Department of Psychiatry, Location Academic Medical Center, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.,Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Paulien W J Seeverens
- Department of Psychiatry, Location Academic Medical Center, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Nessa Ikani
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, Netherlands.,ProPersona Mental Health Care, Depression Expertise Center, Nijmegen, Netherlands.,Department of Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Anna Tyborowska
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Michael Browning
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Janna N Vrijsen
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands.,ProPersona Mental Health Care, Depression Expertise Center, Nijmegen, Netherlands
| | | | - Aart H Schene
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
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8
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Differences of biased recall memory for emotional information among children and adolescents of mothers with MDD, children and adolescents with MDD, and normal controls. Psychiatry Res 2015; 228:223-7. [PMID: 25998002 DOI: 10.1016/j.psychres.2015.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 03/30/2015] [Accepted: 04/01/2015] [Indexed: 11/23/2022]
Abstract
This study examines explicit memory bias for emotional information in children and adolescents with major depressive disorder (MDD). Participants were a convenient sample of 28 children and adolescents of mothers with MDD, 28 children and adolescents with MDD, and 29 healthy controls. Their age range was 11-17 years old. The groups were matched for gender ratio, mean age, and the years of educational level. They were assessed by the Recall Task. Emotional stimuli consisted of three sets of words namely sad, happy, and neutral words. Children and adolescents of mothers with MDD similar to children and adolescents with MDD recalled more sadness stimuli in comparison with the controls. In other words, they showed an explicit memory bias towards sad stimuli. Also, healthy children significantly recalled more happy words than the other two groups. There was no significant difference among the three groups for the recall of neutral stimuli. Current findings support that there is a recall memory bias for emotional information in children with MDD. These children more than healthy children recall sad words. Moreover, healthy children recall happy words more than children with MDD.
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9
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Abstract
Insufficient outcomes amongst adults with major depressive disorder (MDD) provide the impetus to identify and refine therapeutic targets that are most critical to outcome from patient, provider, and societal perspectives. Towards this aim, a pivotal shift towards the transnosological domain, cognition, is occurring in the study of MDD and other brain disorders. This paper aims to provide a framework for conceptualizing and prioritizing cognitive function amongst adults with MDD with a particular view to provide a conceptual framework for research and clinical priorities. We also summarize extant data pertaining to psychotropic effects, notably antidepressants, on the cognitive dimension/domain. This narrative review was based on articles identified through a PubMed/MEDLINE search of all English-language articles published between January 1966 and October 2014. The search words were major depressive disorder, depression, unipolar depression, cognition, cognitive dysfunction, cognitive deficit, and cognitive function. The search was supplemented with a manual review of relevant references. The selection of articles for inclusion in this review was based on overall methodological quality as well as on their pertinence to informing the framework described herein. Cognitive dysfunction in MDD is a discrete domain subserved by discrete yet overlapping substrates. There is a need to provide a glossary of terms commonly employed in the cognition literature for consensus as to the appropriate screening, measurement, and monitoring tools. The guiding principle of measurement-based care should include systematic assessment and measurement of cognition in subpopulations with MDD, as a tactic to improve outcome. Relatively few treatment strategies have demonstrated efficacy specifically for the cognitive domain in MDD. The antidepressant vortioxetine has replicated evidence of specific pro-cognitive effects in adults with MDD across multiple subdomains of cognitive function. Vortioxetine is a novel antidepressant that is hypothesized to act through a combination of direct effects on receptor activity and serotonin receptor inhibition, as well as other systems. Pro-cognitive effects for other US FDA-approved agents are suggested, but pseudospecificity has not been excluded as a possible explanation of their beneficial effects on cognitive function. A disparate assortment of other agents are currently under investigation for possible benefit in mitigating cognitive deficits and improving cognitive performance (e.g., intranasal insulin, erythropoietin, anti-inflammatory agents). Non-pharmacological approaches including, but not limited to, cognitive remediation (CR), aerobic exercise, and neuromodulation are promising.
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10
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Miskowiak KW, Glerup L, Vestbo C, Harmer CJ, Reinecke A, Macoveanu J, Siebner HR, Kessing LV, Vinberg M. Different neural and cognitive response to emotional faces in healthy monozygotic twins at risk of depression. Psychol Med 2015; 45:1447-1458. [PMID: 25382193 DOI: 10.1017/s0033291714002542] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Negative cognitive bias and aberrant neural processing of emotional faces are trait-marks of depression. Yet it is unclear whether these changes constitute an endophenotype for depression and are also present in healthy individuals with hereditary risk for depression. METHOD Thirty healthy, never-depressed monozygotic (MZ) twins with a co-twin history of depression (high risk group: n = 13) or without co-twin history of depression (low-risk group: n = 17) were enrolled in a functional magnetic resonance imaging (fMRI) study. During fMRI, participants viewed fearful and happy faces while performing a gender discrimination task. After the scan, they were given a faces dot-probe task, a facial expression recognition task and questionnaires assessing mood, personality traits and coping strategies. RESULTS High-risk twins showed increased neural response to happy and fearful faces in dorsal anterior cingulate cortex (ACC), dorsomedial prefrontal cortex (dmPFC), pre-supplementary motor area and occipito-parietal regions compared to low-risk twins. They also displayed stronger negative coupling between amygdala and pregenual ACC, dmPFC and temporo-parietal regions during emotional face processing. These task-related changes in neural responses in high-risk twins were accompanied by impaired gender discrimination performance during face processing. They also displayed increased attention vigilance for fearful faces and were slower at recognizing facial expressions relative to low-risk controls. These effects occurred in the absence of differences between groups in mood, subjective state or coping. CONCLUSIONS Different neural response and functional connectivity within fronto-limbic and occipito-parietal regions during emotional face processing and enhanced fear vigilance may be key endophenotypes for depression.
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Affiliation(s)
- K W Miskowiak
- Psychiatric Centre Copenhagen,Copenhagen University Hospital,Rigshospitalet,Denmark
| | - L Glerup
- Psychiatric Centre Copenhagen,Copenhagen University Hospital,Rigshospitalet,Denmark
| | - C Vestbo
- Psychiatric Centre Copenhagen,Copenhagen University Hospital,Rigshospitalet,Denmark
| | - C J Harmer
- Department of Psychiatry,University of Oxford,Oxford,UK
| | - A Reinecke
- Department of Psychiatry,University of Oxford,Oxford,UK
| | - J Macoveanu
- Danish Research Centre for Magnetic Resonance,Copenhagen University Hospital Hvidovre,Denmark
| | - H R Siebner
- Danish Research Centre for Magnetic Resonance,Copenhagen University Hospital Hvidovre,Denmark
| | - L V Kessing
- Psychiatric Centre Copenhagen,Copenhagen University Hospital,Rigshospitalet,Denmark
| | - M Vinberg
- Psychiatric Centre Copenhagen,Copenhagen University Hospital,Rigshospitalet,Denmark
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11
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Vrijsen JN, Becker ES, Arias-Vásquez A, van Dijk MK, Speckens A, Oostrom IV. What is the contribution of different cognitive biases and stressful childhood events to the presence and number of previous depressive episodes? Psychiatry Res 2014; 217:134-42. [PMID: 24726815 DOI: 10.1016/j.psychres.2014.02.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 02/20/2014] [Accepted: 02/24/2014] [Indexed: 12/22/2022]
Abstract
Negative cognitive biases as well as stressful childhood events are well-known risk factors for depression. Few studies have compared the association of different types of biases and events with depression. The current study examined whether different cognitive biases and stressful childhood events variables were associated with depression and recurrence. Three types of childhood events were assessed in 83 never-depressed and 337 formerly depressed individuals: trauma within the family, trauma outside the family, and adverse events. Furthermore, after a sad mood induction procedure, participants executed a Dot Probe task (selective attentional bias), an Emotional Stroop task (attentional interference bias) and an incidental learning task (memory bias). The association of these measures with case status and recurrence status (one or multiple past episodes) was examined. Negative memory bias and traumatic childhood events within the family were associated with case status, whereas none of the bias measures or childhood events variables were associated with recurrence status. The results indicate that memory bias as well as the experience of aggression and/or abuse within the family during childhood are independently associated with depression. Biases and stressful childhood events did not offer differentiation between individuals with one or multiple past episodes.
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Affiliation(s)
- Janna N Vrijsen
- Department of Psychiatry, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Eni S Becker
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Alejandro Arias-Vásquez
- Department of Psychiatry, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands; Department of Human Genetics, Radboud University, Medical Centre, Nijmegen, The Netherlands; Department of Epidemiology & Biostatistics, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Anne Speckens
- Department of Psychiatry, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Iris van Oostrom
- Department of Psychiatry, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands
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12
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Goldstein BL, Klein DN. A review of selected candidate endophenotypes for depression. Clin Psychol Rev 2014; 34:417-27. [PMID: 25006008 DOI: 10.1016/j.cpr.2014.06.003] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 06/08/2014] [Accepted: 06/12/2014] [Indexed: 12/13/2022]
Abstract
Endophenotypes are proposed to occupy an intermediate position in the pathway between genotype and phenotype in genetically complex disorders such as depression. To be considered an endophenotype, a construct must meet a set of criteria proposed by Gottesman and Gould (2003). In this qualitative review, we summarize evidence for each criterion for several putative endophenotypes for depression: neuroticism, morning cortisol, frontal asymmetry of cortical electrical activity, reward learning, and biases of attention and memory. Our review indicates that while there is strong support for some depression endophenotypes, other putative endophenotypes lack data or have inconsistent findings for core criteria.
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Vogel S, Gerritsen L, van Oostrom I, Arias-Vásquez A, Rijpkema M, Joëls M, Franke B, Tendolkar I, Fernández G. Linking genetic variants of the mineralocorticoid receptor and negative memory bias: interaction with prior life adversity. Psychoneuroendocrinology 2014; 40:181-90. [PMID: 24485490 DOI: 10.1016/j.psyneuen.2013.11.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 11/06/2013] [Accepted: 11/13/2013] [Indexed: 12/27/2022]
Abstract
Substantial research has been conducted investigating the association between life adversity and genetic vulnerability for depression, but clear mechanistic links are rarely identified and investigation often focused on single genetic variants. Complex phenotypes like depression, however, are likely determined by multiple variants in interaction with environmental factors. As variations in the mineralocorticoid receptor gene (NR3C2) have been related to a higher risk for depression, we investigated whether NR3C2 variance is related to negative memory bias, an established endophenotype for depression, in healthy participants. Furthermore, we explored the influence of life adversity on this association. We used a set-based analysis to simultaneously test all measured variation in NR3C2 for an association with negative memory bias in 483 participants and an interaction with life adversity. To further specify this interaction, we split the sample into low and high live adversity groups and repeated the analyses in both groups separately. NR3C2 variance was associated with negative memory bias, especially in the high life adversity group. Additionally, we identified a functional polymorphism (rs5534) related to negative memory bias and demonstrating a gene×life adversity interaction. Variations in NR3C2 are associated with negative memory bias and this relationship appears to be influenced by life adversity. As negative memory bias is implicated in the susceptibility to depression, our findings provide mechanistic support for the notion that variations in NR3C2 - which could compromise the proper function of this receptor - are a risk factor for the development of mood disorders.
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Affiliation(s)
- Susanne Vogel
- Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Department of Cognitive Neuroscience, Nijmegen, The Netherlands.
| | - Lotte Gerritsen
- Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Karolinska Institute, Department of Medical Epidemiology and Biostatistics, Solna, Sweden
| | - Iris van Oostrom
- Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Department of Psychiatry, Nijmegen, The Netherlands
| | - Alejandro Arias-Vásquez
- Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Department of Psychiatry, Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Department of Human Genetics, Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
| | - Mark Rijpkema
- Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Marian Joëls
- University Medical Centre Utrecht, Rudolf Magnus Institute of Neuroscience, The Netherlands
| | - Barbara Franke
- Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Department of Psychiatry, Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Department of Human Genetics, Nijmegen, The Netherlands
| | - Indira Tendolkar
- Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Department of Psychiatry, Nijmegen, The Netherlands; University of Duisburg-Essen, LVR Clinics of Psychiatry and Psychotherapy, Essen, Germany
| | - Guillén Fernández
- Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
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Hoffman KL. Role of murine models in psychiatric illness drug discovery: a dimensional view. Expert Opin Drug Discov 2013; 8:865-77. [DOI: 10.1517/17460441.2013.797959] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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