Major Depressive Disorder is Associated with Broad Impairments on Neuropsychological Measures of Executive Function: A Meta-Analysis and Review

By Hannah R. Snyder. Psychological bulletin, 2012

1,569 citations recorded by the source corpus.

Cognitive impairments are now widely acknowledged as an important aspect of major depressive disorder (MDD), and it has been proposed that executive function (EF) may be particularly impaired in patients with MDD. However, the existence and nature of EF impairments associated with depression remain strongly debated. While many studies have found significant deficits associated with MDD on neuropsychological measures of EF, others have not, potentially due to low statistical power, task impurity, and diverse patient samples, and there have been no recent, comprehensive, meta-analyses investigating EF in patients with MDD. The current meta-analysis uses random effects models to synthesize 113 previous research studies that compared participants with MDD to healthy control participants on at least one neuropsychological measure of EF. Results of the meta-analysis demonstrate that MDD is reliably associated with impaired performance on neuropsychological measures of EF, with effect sizes ranging from d = 0.32–0.97. While patients with MDD also have slower processing speed, motor slowing alone cannot account for these results. In addition, some evidence suggests that deficits on neuropsychological measures of EF are greater in patients with more severe current depression symptoms, and those taking psychotropic medications, while evidence for effects of age was weaker. The results are consistent with the theory that MDD is associated with broad impairment in multiple aspects of EF. Implications for treatment of MDD and theories of EF are discussed. Future research is needed to establish the specificity and causal link between MDD and EF impairments.

Subfields: Cognitive Neuroscience, Pharmacology, Psychiatry and Mental health

View Paper: https://www.semanticscholar.org/paper/685fc8c2496a14230c4cc788f36194b8ce5788fd

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Citations in the corpus

Depression: A cognitive perspective. (2019, result): “Several reviews suggest that depression is associated with deficits in working memory (e.g., Zakzanis et al., 1998), a conclusion that has been supported by the results of meta-analyses (Christensen, Griffiths, MacKinnon, & Jacomb, 1997; Snyder, 2013).”
Developmental dyslexia: emotional impact and consequences (2018, background): “Depression and anxiety are also known to exert a negative impact on executive functioning (Airaksinen, Larsson, & Forsell, 2005; Snyder, 2013).”
Reduced default mode network functional connectivity in patients with recurrent major depressive disorder (2019, neutral): “The reduced FC of the SMN with the VN and DMN may be interpreted as the neural underpinnings of the pervasive influence of psychomotor retardation on attentional processes, as revealed by previous studies (34).”
The Objective Benefits of Subjective Well-Being (2013, background): “Snyder (2012) reviewed extensive evidence showing that depressed people suffer substantially from broad impairments in executive functions, such as planning, with strong effect sizes varying from 0.32 to 0.97.”
Clinical Practice of Forensic Neuropsychology: An Evidence-Based Approach (2012, background): “In contrast, equivalent effect sizes for executive functions were noted for studies that did and did not exclude patients with a comorbid Axis I disorder (Snyder, 2013).”
COGNITIVE DEFICITS AND FUNCTIONAL OUTCOMES IN MAJOR DEPRESSIVE DISORDER: DETERMINANTS, SUBSTRATES, AND TREATMENT INTERVENTIONS (2013, background): “[27] The presence of cognitive deficits during the first MDE as part of MDD indicates that cognitive performance represents a target for early identification, measurement, and intervention.[27, 35] Taken together, there are multiple determinants of cognitive outcome in MDD: heterogeneity of sample c”
Cognitive impairment in depression: a systematic review and meta-analysis (2013, result): “Consistent with this, several systematic reviews have demonstrated cognitive deficits in patients suffering from depression (Burt et al. 1995; Veiel, 1997; Zakzanis et al. 1998; Stefanopoulou et al. 2009; Snyder 2013), including first-episode patients (Lee et al.”
Cognitive Control in Generalized Anxiety Disorder: Relation of Inhibition Impairments to Worry and Anxiety Severity (2017, background): “This decision was considered important for interpretability because MDD has been independently associated with neuropsychological deficits, with some studies finding these impairments to be more pronounced at severe levels (Snyder 2013).”
A systematic review of the relationship between rigidity/flexibility and transdiagnostic cognitive and behavioral processes that maintain psychopathology (2018, background): “A range of EF can be impaired in certain client groups, but it is still important to establish whether this is the case and not to conflate impairments arising from different EFs (Snyder, 2013; Snyder, Kaiser, Warren, & Heller, 2014).”