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Sensitivity of cognitive tests in four cognitive domains in discriminating MDD patients from healthy controls: a meta-analysis

Published online by Cambridge University Press:  03 June 2013

JaeHyoung Lim ,
In Kyung Oh ,
Changsu Han ,
Yu Jeong Huh ,
In-Kwa Jung ,
Ashwin A. Patkar ,
David C. Steffens  and
Bo-Hyoung Jang
JaeHyoung Lim
Affiliation:
Department of Psychiatry, Korea University Ansan Hospital, Ansan-shi, Gyeonggi-do, Republic of Korea
In Kyung Oh
Affiliation:
Department of Psychiatry, Korea University Ansan Hospital, Ansan-shi, Gyeonggi-do, Republic of Korea
Changsu Han*
Affiliation:
Department of Psychiatry, Korea University Ansan Hospital, Ansan-shi, Gyeonggi-do, Republic of Korea
Yu Jeong Huh
Affiliation:
Department of Psychiatry, Korea University Ansan Hospital, Ansan-shi, Gyeonggi-do, Republic of Korea
In-Kwa Jung
Affiliation:
Department of Psychiatry, Korea University Guro Hospital, Guro-gu, Seoul-shi, Republic of Korea
Ashwin A. Patkar
Affiliation:
Department of Psychiatry, Duke University Medical Center, Durham, North Carolina, USA
David C. Steffens
Affiliation:
Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut, USA
Bo-Hyoung Jang
Affiliation:
College of Korean Medicine, Kyung Hee University, Healthcare Collaborating Agency, Jongno-gu, Republic of Korea
*
Correspondence should be addressed to: Dr. Changsu Han, MD, PhD, MHS, Department of Psychiatry, Korea University Ansan Hospital, 516, Gojan-dong, Danwon-gu, Ansan-shi, Gyeonggi-do 425-707, Republic of Korea. Phone: +82-31-412-5140; Fax: +82-2-6442-5008. Email: [email protected].
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Abstract

Background: We performed a meta-analysis in order to determine which neuropsychological domains and tasks would be most sensitive for discriminating between patients with major depressive disorder (MDD) and healthy controls.

Methods: Relevant articles were identified through a literature search of the PubMed and Cochrane Library databases for the period between January 1997 and May 2011. A meta-analysis was conducted using the standardized means of individual cognitive tests in each domain. The heterogeneity was assessed, and subgroup analyses according to age and medication status were performed to explore the sources of heterogeneity.

Results: A total of 22 trials involving 955 MDD patients and 7,664 healthy participants were selected for our meta-analysis. MDD patients showed significantly impaired results compared with healthy participants on the Digit Span and Continuous Performance Test in the attention domain; the Trail Making Test A (TMT-A) and the Digit Symbol Test in the processing speed domain; the Stroop Test, the Wisconsin Card Sorting Test, and Verbal Fluency in the executive function domain; and immediate verbal memory in the memory domain. The Finger Tapping Task, TMT-B, delayed verbal memory, and immediate and delayed visual memory failed to separate MDD patients from healthy controls. The results of subgroup analysis showed that performance of Verbal Fluency was significantly impaired in younger depressed patients (<60 years), and immediate visual memory was significantly reduced in depressed patients using antidepressants.

Conclusions: Our findings have inevitable limitations arising from methodological issues inherent in the meta-analysis and we could not explain high heterogeneity between studies. Despite such limitations, current study has the strength of being the first meta-analysis which tried to specify cognitive function of depressed patients compared with healthy participants. And our findings may provide clinicians with further evidences that some cognitive tests in specific cognitive domains have sensitivity to discriminate MDD patients from healthy controls.

Keywords

major depressive disordercognitive functionmeta-analysis
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 9 , September 2013 , pp. 1543 - 1557
Copyright
Copyright © International Psychogeriatric Association 2013 

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