Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-02T23:06:02.621Z Has data issue: false hasContentIssue false

The effect of psychiatric co-morbidity on cognitive functioning in a population-based sample of depressed young adults

Published online by Cambridge University Press:  05 May 2009

A. E. Castaneda*
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland Department of Psychology, University of Helsinki, Helsinki, Finland
M. Marttunen
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland Department of Psychiatry, University of Helsinki, Helsinki, Finland
J. Suvisaari
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland Department of Social Psychiatry, Tampere School of Public Health, University of Tampere, Tampere, Finland
J. Perälä
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
S. I. Saarni
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland Department of Psychiatry, University of Helsinki, Helsinki, Finland
T. Aalto-Setälä
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland Department of Child Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
H. Aro
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
J. Lönnqvist
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland Department of Psychiatry, University of Helsinki, Helsinki, Finland
A. Tuulio-Henriksson
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland Department of Psychology, University of Helsinki, Helsinki, Finland
*
*Address for correspondence: Mrs A. E. Castaneda, National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166, 00300Helsinki, Finland. (Email: [email protected])

Abstract

Background

Psychiatric co-morbidity is often inadequately controlled for in studies on cognitive functioning in depression. Our recent study established no major deficits in cognition among young adults with a history of pure unipolar depression. The present study extends our previous work by examining the effects of psychiatric co-morbidity and other disorder characteristics on depression-related cognitive functioning.

Method

Performance in verbal and visual short-term memory, verbal long-term memory and learning, attention, processing speed, and executive functioning was compared between a population-based sample aged 21–35 years with a lifetime history of unipolar depressive disorders (n=126) and a random sample of healthy controls derived from the same population (n=71). Cognitive functioning was also compared between the subgroups of pure (n=69) and co-morbid (n=57) depression.

Results

The subgroups of pure and co-morbid depression did not differ in any of the cognitive measures assessed. Only mildly compromised verbal learning was found among depressed young adults in total, but no other cognitive deficits occurred. Received treatment was associated with more impaired verbal memory and executive functioning, and younger age at first disorder onset with more impaired executive functioning.

Conclusions

Psychiatric co-morbidity may not aggravate cognitive functioning among depressed young adults. Regardless of co-morbidity, treatment seeking is associated with cognitive deficits, suggesting that these deficits relate to more distress.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aalto-Setälä, T, Marttunen, M, Tuulio-Henriksson, A, Poikolainen, K, Lönnqvist, J (2001). One-month prevalence of depression and other DSM-IV disorders among young adults. Psychological Medicine 31, 791801.CrossRefGoogle ScholarPubMed
Aalto-Setälä, T, Marttunen, M, Tuulio-Henriksson, A, Poikolainen, K, Lönnqvist, J (2002). Psychiatric treatment seeking and psychosocial impairment among young adults with depression. Journal of Affective Disorders 70, 3547.CrossRefGoogle ScholarPubMed
Airaksinen, E, Larsson, M, Lundberg, I, Forsell, Y (2004). Cognitive functions in depressive disorders: evidence from a population-based study. Psychological Medicine 34, 8391.CrossRefGoogle ScholarPubMed
Airaksinen, E, Wahlin, Å, Larsson, M, Forsell, Y (2006). Cognitive and social functioning in recovery from depression: results from a population-based three-year follow-up. Journal of Affective Disorders 96, 107110.CrossRefGoogle ScholarPubMed
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Aromaa, A, Koskinen, S (eds) (2004). Health and Functional Capacity in Finland. Baseline Results of the Health 2000 Health Examination Survey. Publications of the National Public Health Institute, B12, Helsinki, Finland (available in English at:www.ktl.fi/terveys2000/index.uk.html). Accessed 6 May 2008.Google Scholar
Austin, M-P, Mitchell, P, Goodwin, GM (2001). Cognitive deficits in depression. Possible implications for functional neuropathology. British Journal of Psychiatry 178, 200206.CrossRefGoogle ScholarPubMed
Basso, MR, Bornstein, RA (1999). Relative memory deficits in recurrent versus first-episode major depression on a word-list learning task. Neuropsychology 13, 557563.CrossRefGoogle ScholarPubMed
Basso, MR, Lowery, N, Ghormley, C, Combs, D, Purdie, R, Neel, J, Davis, M, Bornstein, R (2007). Comorbid anxiety corresponds with neuropsychological dysfunction in unipolar depression. Cognitive Neuropsychiatry 12, 437456.CrossRefGoogle ScholarPubMed
Berndt, ER, Koran, LM, Finkelstein, SN, Gelenberg, AJ, Kornstein, SG, Miller, IM, Thase, ME, Trapp, GA, Keller, MB (2000). Lost human capital from early-onset chronic depression. American Journal of Psychiatry 157, 940947.CrossRefGoogle ScholarPubMed
Burcusa, SL, Iacono, WG (2007). Risk for recurrence in depression. Clinical Psychology Review 27, 959985.CrossRefGoogle ScholarPubMed
Castaneda, AE, Suvisaari, J, Marttunen, M, Perälä, J, Saarni, SI, Aalto-Setälä, T, Aro, H, Koskinen, S, Lönnqvist, J, Tuulio-Henriksson, A (2008 b). Cognitive functioning in a population-based sample of young adults with a history of non-psychotic unipolar depressive disorders without psychiatric comorbidity. Journal of Affective Disorders 110, 3645.CrossRefGoogle Scholar
Castaneda, AE, Tuulio-Henriksson, A, Marttunen, M, Suvisaari, J, Lönnqvist, J (2008 a). A review on cognitive impairments in depressive and anxiety disorders with a focus on young adults. Journal of Affective Disorders 106, 127.CrossRefGoogle ScholarPubMed
de Graaf, R, Bijl, RV, Smit, F, Vollebergh, WAM, Spijker, J (2002). Risk factors for 12-month comorbidity of mood, anxiety, and substance use disorders: findings from the Netherlands Mental Health Survey and Incidence Study. American Journal of Psychiatry 159, 620629.CrossRefGoogle ScholarPubMed
Delis, DC, Kramer, JH, Kaplan, E, Ober, BA (1987). California Verbal Learning Test: Adult Version. The Psychological Corporation: San Antonio, TX.Google Scholar
DeLuca, AK, Lenze, EJ, Mulsant, BH, Butters, MA, Karp, JF, Dew, MA, Pollock, BG, Shear, MK, Houck, PR, Reynolds, CF 3rd (2005). Comorbid anxiety disorder in late life depression: association with memory decline over four years. International Journal of Geriatric Psychiatry 20, 848854.CrossRefGoogle ScholarPubMed
Egeland, J, Rund, BR, Sundet, K, Landrø, NI, Asbjørnsen, A, Lund, A, Roness, A, Stordal, KI, Hugdahl, K (2003). Attention profile in schizophrenia compared with depression: differential effects of processing speed, selective attention and vigilance. Acta Psychiatrica Scandinavica 108, 276284.CrossRefGoogle ScholarPubMed
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (2001). Structured Clinical Interview for DSM-IV-TR Axis I Disorders – Patient Edition (SCID I/P, 2/2001 Revision). Biometrics Research Department, New York State Psychiatry Institute: New York, NY.Google Scholar
Fossati, P, Amar, G, Raoux, N, Ergis, AM, Allilaire, JF (1999). Executive functioning and verbal memory in young patients with unipolar depression and schizophrenia. Psychiatry Research 89, 171187.CrossRefGoogle ScholarPubMed
Fossati, P, Harvey, PO, Le Bastard, G, Ergis, AM, Jouvent, R, Allilaire, JF (2004). Verbal memory performance of patients with a first depressive episode and patients with unipolar and bipolar recurrent depression. Journal of Psychiatric Research 38, 137144.CrossRefGoogle ScholarPubMed
Gollan, J, Raffety, B, Gortner, E, Dobson, K (2005). Course profiles of early- and adult-onset depression. Journal of Affective Disorders 86, 8186.CrossRefGoogle ScholarPubMed
Grant, MM, Thase, ME, Sweeney, JA (2001). Cognitive disturbance in outpatient depressed younger adults: evidence of modest impairment. Biological Psychiatry 50, 3543.CrossRefGoogle ScholarPubMed
Haarasilta, L, Marttunen, M, Kaprio, J, Aro, H (2003). Major depressive episode and health care use among adolescents and young adults. Social Psychiatry and Psychiatric Epidemiology 38, 366372.CrossRefGoogle ScholarPubMed
Hill, SK, Keshavan, MS, Thase, ME, Sweeney, JA (2004). Neuropsychological dysfunction in antipsychotic-naive first-episode unipolar psychotic depression. American Journal of Psychiatry 161, 996–1003.CrossRefGoogle ScholarPubMed
Kessler, RC, Andrews, G, Colpe, LJ, Hiripi, E, Mroczek, DK, Normand, S-LT, Walters, EE, Zaslavsky, AM (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine 32, 959976.CrossRefGoogle ScholarPubMed
Kessler, RC, Barker, PR, Colpe, LJ, Epstein, JF, Gfroerer, JC, Hiripi, E, Howes, MJ, Normand, SL, Manderscheid, RW, Walters, EE, Zaslavsky, AM (2003). Screening for serious mental illness in the general population. Archives of General Psychiatry 60, 184189.CrossRefGoogle ScholarPubMed
Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 593602.CrossRefGoogle ScholarPubMed
Kizilbash, AH, Vanderploeg, RD, Curtiss, G (2002). The effects of depression and anxiety on memory performance. Archives of Clinical Neuropsychology 17, 5767.CrossRefGoogle ScholarPubMed
Klein, DN, Schatzberg, AF, McCullough, JP, Dowling, F, Goodman, D, Howland, RH, Markowitz, JC, Smith, C, Thase, ME, Rush, AJ, LaVange, L, Harrison, WM, Keller, MB (1999). Age of onset in chronic major depression: relation to demographic and clinical variables, family history, and treatment response. Journal of Affective Disorders 55, 149157.CrossRefGoogle ScholarPubMed
Koskinen, S, Kestilä, L, Martelin, T, Aromaa, A (eds) (2005). Baseline Results of the Health 2000 Study on the Health of 18–29-Year-Olds and the Factors Associated with It [in Finnish]. National Public Health Institute: Helsinki, Finland.Google Scholar
Lezak, MD, Howieson, DB, Loring, DW (2004). Neuropsychological Assessment, 4th edn. Oxford University Press: New York, NY.Google Scholar
Mahurin, RK, Velligan, DI, Hazleton, B, Davis, JM, Eckert, S, Miller, AL (2006). Trail making test errors and executive function in schizophrenia and depression. The Clinical Neuropsychologist 20, 271288.CrossRefGoogle ScholarPubMed
Merriam, EP, Thase, ME, Haas, GL, Keshavan, MS, Sweeney, JA (1999). Prefrontal cortical dysfunction in depression determined by Wisconsin Card Sorting Test performance. American Journal of Psychiatry 156, 780782.CrossRefGoogle ScholarPubMed
Narrow, WE, Rae, DS, Robins, LN, Regier, DA (2002). Revised prevalence estimates of mental disorders in the United States. Using a clinical significance criterion to reconcile 2 surveys' estimates. Archives of General Psychiatry 59, 115123.CrossRefGoogle ScholarPubMed
Newman, DL, Moffitt, TE, Caspi, A, Magdol, L, Silva, PA, Stanton, WR (1996). Psychiatric disorder in a birth cohort of young adults: prevalence, comorbidity, clinical significance, and new case incidence from ages 11 to 21. Journal of Consulting and Clinical Psychology 64, 552562.CrossRefGoogle Scholar
Parker, G, Roy, K, Hadzi-Pavlovic, D, Mitchell, P, Wilhelm, K (2003). Distinguishing early and late onset non-melancholic unipolar depression. Journal of Affective Disorders 74, 131138.CrossRefGoogle ScholarPubMed
Reitan, RM, Wolfson, D (1993). The Halstead–Reitan Neuropsychological Test Battery: Theory and Clinical Interpretation. Neuropsychology Press: Tucson, AZ.Google Scholar
Rohde, P, Lewinsoh, PM, Seeley, JR (1991). Comorbidity of unipolar depression: II. Comorbidity with other mental disorders in adolescents and young adults. Journal of Abnormal Psychology 100, 214222.CrossRefGoogle Scholar
Rohde, P, Lewinsohn, PM, Seeley, JR (1994). Are adolescents changed by an episode of major depression? Journal of the American Academy of Child and Adolescent Psychiatry 33, 12891298.CrossRefGoogle ScholarPubMed
Smith, DJ, Muir, WJ, Blackwood, DHR (2006). Neurocognitive impairment in euthymic young adults with bipolar spectrum disorder and recurrent major depressive disorder. Bipolar Disorders 8, 4046.CrossRefGoogle ScholarPubMed
SPSS Inc. (2007). SPSS 16.0 for Windows. SPSS Inc.: Chicago, IL.Google Scholar
Stordal, KI, Lundervold, AJ, Egeland, J, Mykletun, A, Asbjørnsen, A, Landrø, NI, Roness, A, Rund, BR, Sundet, K, Oedegaard, KJ, Lund, A (2004). Impairment across executive functions in recurrent major depression. Nordic Journal of Psychiatry 58, 4147.CrossRefGoogle ScholarPubMed
Suvisaari, J, Aalto-Setälä, T, Tuulio-Henriksson, A, Härkänen, T, Saarni, SI, Perälä, J, Schreck, M, Castaneda, A, Hintikka, J, Kestilä, L, Lähteenmäki, S, Latvala, A, Koskinen, S, Marttunen, M, Aro, H, Lönnqvist, J (2009). Mental disorders in young adulthood. Psychological Medicine 39, 287300.CrossRefGoogle ScholarPubMed
Wang, CE, Halvorsen, M, Sundet, K, Steffensen, AL, Holte, A, Waterloo, K (2006). Verbal memory performance of mildly to moderately depressed outpatient younger adults. Journal of Affective Disorders 92, 283286.CrossRefGoogle ScholarPubMed
Wang, PS, Aguilar-Gaxiola, S, Alonso, J, Angermeyer, MC, Borges, G, Bromet, EJ, Bruffaerts, R, de Girolamo, G, de Graaf, R, Gureje, O, Haro, JM, Karam, EG, Kessler, RC, Kovess, V, Lane, MC, Lee, S, Levinson, D, Ono, Y, Petukhova, M, Posada-Villa, J, Seedat, S, Wells, JE (2007). Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. Lancet 370, 841850.CrossRefGoogle ScholarPubMed
Wechsler, D (1981). Wechsler Adult Intelligence Scale, Revised. The Psychological Corporation: San Antonio, TX.Google Scholar
Wechsler, D (1987). Wechsler Memory Scale, Revised. The Psychological Corporation: San Antonio, TX.Google Scholar
Wechsler, D (1997). Wechsler Adult Intelligence Scale, Third Edition. The Psychological Corporation: San Antonio, TX.Google Scholar
Supplementary material: File

Castaneda supplementary material

Appendix.doc

Download Castaneda supplementary material(File)
File 96.3 KB