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Table 3 Neuropsychological studies evaluating the five functional domains in young people (12–30 yrs) with a mood and/or anxiety disorder

From: The underlying neurobiology of key functional domains in young people with mood and anxiety disorders: a systematic review

Outcome measure Study Age (mean ± SD) Sample (N) Aims Key measures Key findings
Social and economic participation [40] HC: 13.6 ± 2.1, HC (47M; 34F), Evaluate the clinical impact of executive function deficits in youth with BPD-I disorder. NΨ: Executive function deficits (CPT, CVLT-C, RCF, SCWT, WCST, WAIS-III- FFD) BPD-I: ↓ executive function ~ ↓ social and economic participation
HC-EFD: 13.9 ± 2.3, HC-EFD (12M; 5F),
BPD-I: 13.7 ± 2.1, BPD-I (52M; 24F),
BPD-I-EFD: 12.8 ± 2.4 BPD-I-EFD (49M; 13F) Functional: GAF, WRAT-III, placement in special class
  [39]* SAD: 23.9 ± 6.7; SAD (20M; 10F) Assess the neuropsychological function of SAD without co-morbidity NΨ: Executive function (CPT, TMT-B, WCST), Processing speed (TMT-A), Verbal learning & memory (AVLT) SAD: ↓ executive function ~ ↓ social and economic participation (and ↑ SAD severity)
HC: 25.6 ± 5.6 HC (20M; 10F)
Functional: GAF
  [29] MDD: 18.9 ± 2.0, MDD (4M; 12F), Investigate the association between cognitive performance and MDD. NΨ: Executive function (SCWT, TMT-B), Verbal learning & memory (WMS-SR, LLT, RCF-3min), General intellect (WAIS-III-S & V), Attention (WAIS-III- DS, BD & DSp) MDD: No significant ~ NΨ
HC: 16.9 ± 1.9 HC (11M; 14F) MDD: ↓ social and economic participation
Functional: GAF
   FED: 22.00 ± 4.9 FED (8M; 12F) Assess the effectiveness of CR in patients with a first-episode of either major depression or psychosis NΨ: Executive function (CANTAB-IED; -FAS, TMT-B), Processing speed (TMT-A, category fluency), Attention and working memory (LDSF, LDSB, CANTAB-SSP;-RVP, mental control), Immediate learning and memory (Logical Memory I, RAVLT- tot, CANTAB-PAL), Delayed learning and memory (LM-Ret, RCF-3min, RAVLT-Ret) FED & FEP: CR ~ ↑ immediate learning and memory, and ↑ social and economic participation (mediated by ↑ delayed learning and memory)
FEP: 23.30 ± 3.9 FEP (20M; 13F)
Functional: SFS
  [24] MHP: 21.6 ± 4.5 MDD (34) Identify cognitive markers that predict later socio-occupational functioning. NΨ : Executive function (CANTAB-IED, TMT-B), Processing speed (TMT-A, CANTAB-FAS), Attention and working memory (CANTAB-RVP), Verbal learning & memory (LM-Ret, RAVLT-ret), Visual learning & memory (CANTAB- SSP;- PAL) MHP: ↑ BL general NΨ ~ ↑ social and economic participation at FUP
BPD (29)
PSD (30)
(of the total 93, 52 % were male)
Functional: SOFAS
Suicide and self-harm [31] SA: 15.5 ± 1.4 SA (10M; 30F) Examine decision-making processes in suicide attempters and never-suicidal comparison subjects NΨ: Decision making (IGT) SA: ↓ decision making ~ suicide attempt history
PC: 15.6 ± 1.4 PC (10M; 30F) Functional: CSHF, PSIS
  [32] SA: 18.31 ± 0.63 SA (1M; 12F) Examine whether cognitive inflexibility can differentially and prospectively predict suicidal ideation. NΨ: Executive function (WCST; perseverative errors) SA: ↓ BL cognitive inflexibility ~ ↑ suicide ideation at 6-month FUP.
NSA: 18.31 ± 0.78 NSA (9M; 23F)
Functional: BSS, SBS, SHBQ
  [35] SIB: 15.5 ± 1.3 SIB (99) Investigate the neuropsychological differences between psychiatric patients with and without SIB. NΨ: Executive function (SCWT, WCST) Null findings
NSIB: 15.1 ± 1.4 NSIB (77)
Functional: Clinical interview
  [33] HC: 15.8 ± 1.5 HC (11M; 46F) Assess decision making and problem solving ability in adolescents with current or past self-harm NΨ: Decision making (IGT, MEPS) DSH: ↓ decision making ~ current, but not past DSH
PC: 15.7 + 1.3 PC (2M; 20F) Functional: Clinical interview
DSH: 15.8 + 1.5 DSH (5M; 49F)
  [34]* SA: 16.20 ± 0.78 SA (4M; 11F) Measure neural activity during performance on the IGT in adolescents. NΨ: Decision making (IGT-mod) SA: ↑ decision making ~ suicide attempt history
PC: 15.79 ± 1.58 PC (7M; 7F) Functional: C-CASA, CSHF, SIQ, SIS
HC: 15.15 ± 1.46 HC (8M; 5F)
Alcohol and substance use [164] CU: 16.2 (13.5 – 18.4) CU (28M; 42F) Investigate the non-acute relationship between cannabis use and cognitive function NΨ: Intelligence (WASI), Executive function (CANTAB-IED), (CANTAB-MS), Attention and working memory (CANTAB-RVP;-SWM; -SSP, DS, SDMT), Immediate learning and memory (RAVLT, CANTAB-PAL) CU: ↓ attention, spatial working memory and learning.
CU: was independent predictor of performance on the working memory and strategy measures
Functional: TLFB
  [165] HC-NB: 22.9 ± 3.1 HC-NB (7M; 14F) Compare the cognition in binge drinkers with depression to those with depression alone or binge drinking alone. NΨ: Intelligence (WTAR), Psychomotor speed (TMT-A) Executive function (TMT-B), Verbal learning and memory (RAVLT), Attention (CANTAB- RVP), working memory (CANTAB-SSP, Visuospatial learning and memory (CANTAB-PAL) MDD-B: ↓ visual learning & memory and overall pattern of ↓ NΨ functioning.
HC-B: 23.0 ± 2.5; HC-B (13M; 11F)
MDD-NB: 21.7 ± 3.2 MDD-NB (16M; 32F)
MDD-B: 21.8 ± 3.4 MDD-B (24M; 19F)
Functional: AUDIT
Clinical syndrome [50] OCD: 13.84 ± 2.78 OCD (18M; 17F) Investigate the influence of clinical variables treatment on cognitive performance in OCD patients NΨ: Intelligence (WISC-R: Vo), Visual organisation (WISC-R:-BD), Attention (WISC-R: -DS;-Co), Verbal learning and memory (WMS-III- LM1 & 2, RAVLT), Visual learning and memory (WMS-III: VR 1 & 2, RCFT), Processing speed (TMT-A), Cognitive flexibility (TMT-B, WCST, SCWT), Verbal fluency (COWAT) OCD: ↓ verbal and visual memory and velocity. (Neuropsychological impairment was not related to obsessive-compulsive severity)
HC: 13.81 ± 2.74 HC (18M; 17F)
Clinical: CDI, Y-BOCS
  [51] OCD: 13.46 ± 2.83 OCD (16M; 13F) Explore the evolution of cognitive dysfunction in children and adolescents with OCD after treatment NΨ: Intelligence (WISC-R: Vo), Visual organisation (WISC-R:-BD), Attention (WISC-R: -DS;-Co), Verbal learning and memory (WMS-III- LM1 & 2, RAVLT), Visual learning and memory (WMS-III: VR 1 & 2, RCFT), Processing speed (TMT-A), Cognitive flexibility (TMT-B, WCST, SCWT), Verbal fluency (COWAT) OCD: ↓ memory, speed of information processing and cognitive flexibility. (After treatment the cognitive profile of the OCD group was normalized)
HC: 13.06 ± 2.84 HC (12M; 10F)
Clinical: Y-BOCS
  [53] OCD: 29.70 ± 10.74 OCD (12M; 8F) Examine the impact of depression on executive function deficits in OCD NΨ: VCAT, Verbal Fluency (COWAT), Processing speed (TMT-A), Cognitive flexibility (TMT-B, WCST) OCD: cognitive flexibility deficits ~ co-morbid depression severity
HC: 30.06 ± 10.06 HC (11M; 21F)
Clinical: MMPI-D
  [47] HC: 12.5 ± 2.4 HC (11M; 10F) Compare impulsivity at the neuropsychological and behavioural level in young depressed patients and healthy controls. NΨ: Cognitive style (MFFT), Verbal fluency (VFT), Decision making (WDWT), cognitive flexibility (SCWT), Impulsivity (CPT) DD: ↑ symptom severity ~ ↑ reaction time, ↓ in commission errors.
DD: 11.7 ± 2.3 DD (11M; 10)
DD: ↑ conservative response styles & attention problems, ↓ reaction times & response initiation
Clinical: HDRS, CDI, CPRS-R:L
  [166] HC: 28.2 ± 7.9 HC (20M; 28F) Investigate the effect of syndrome state or course on executive dysfunction NΨ: Intelligence (NAART), Cognitive flexibility (WCST) EUT: ↑ cognitive flexibility than MEM. Performed similarly to FEM
EUT: 30.0 ± 7.2 EUT (11M; 14F)
FEM: 25.7 ± 9.2 FEM (11M; 10F) Clinical: YMRS, HDRS
MEM: 28.2 8.6 MEM (16M; 18F)
  [39]* SAD: 23.9 ± 6.7; SAD (20M; 10F) Assess the neuropsychological function of SAD without co-morbidity NΨ: Executive function (CPT, TMT-B, WCST), Processing speed (TMT-A), Verbal learning & memory (AVLT) SAD: ↓ executive function ~ ↑ SAD severity
HC: 25.6 ± 5.6 HC (20M; 10F)
Clinical: GAF
  [44] HC: 12.8 ± 2.5 HC (15M; 18F) Examine basic performance neuropsychological performance in children and adolescents with anxiety disorder or depressive disorder and in healthy subjects under drug-free condition NΨ: Intelligence (WISC-III), Verbal learning and memory (RAVLT), Attention (go-no go task) DD: ↓ verbal learning and memory compared to HC and ANX.
ANX: 12.4 ± 2.3 ANX (19M; 15F)
DD: 13.5 ± 2.6 DD (17M; 14F)
Clinical: CDI
  [48] HC: 17.46 ± 1.59, MDD: 17.32 ± 1.59 HC (14M, 16F) MDD (12M, 19F) Investigate whether major depression in adolescence is characterized by neurocognitive deficits in attention, affective decision making, and cognitive control of emotion processing NΨ: Inhibitory control (CPT, go-no go task), Attention (ANT), Decision making (IGT), Verbal learning and memory (RAVLT), Attention (go-no go task) MDD: ↑ depression symptom severity ~ ↓ cognitive control of emotion processing
Clinical: BDI
  [167]* OCD: 27 ± 9.8 OCD (15M; 16F) Characterize the cognitive functions of the patients with OCD by utilizing ERPs and neuropsychological tests NΨ: cognitive flexibility (SCWT, TMT-B), Processing speed (TMT-A), Design fluency test, Verbal fluency (CWAT) Null findings for neuropsychological tests.
HC: 27.4 ± 9.1 HC (14M; 16F)
Clinical: HDRS
  [49] MDD: 15.3 ± 1.6 MDD (5M; 17F) Investigate verbal fluency, cognitive speed, motor speed, and executive functions in adolescents with unipolar depression. NΨ: Verbal fluency (COWAT), Processing speed (Inspection time task), Working memory (Serial choice reaction time task), Set shifting (Local-global task) Clinical: DD: ↓ WM & VF. MDD: ↓WM & processing speed
DD: 15.6 ± 1.5 DD (6M; 6F)
HC: 15.8 ± 1.2 HC (9M; 24F)
  [52] OCD: 24.06 ± 5 OCD (21M; 9F) Assess the relationship between cognitive dysfunction, clinical status and severity in OCD. NΨ: Intelligence (WAIS-BD; -S), Cognitive flexibility (WCST) Results showed a defective visuospatial recognition, which worsens with chronicity, deteriorated set-shifting abilities, overfocused attention to irrelevant stimuli and delayed selective attention to relevant tasks. Mild cases showed better selective attention than severe cases. Obsessive cases had a defective visual memory, while compulsive cases had delayed perception of task relevant stimuli. Mixed cases showed disturbed information-processing both early and late.
HC: Matched HC (21M; 9F)
Clinical: YBOCS
  [55] HC: 12.4 ± 3.3, HC (15M; 9F) Examine the treatment impact of lamotrigine on the neurocognitive profile of patients with pediatric bipolar disorder NΨ: Attention (TMT-A, CPT), cognitive flexibility (TMT-B), Verbal fluency (COWT), Working memory (WMS; DS, SS), Verbal memory (CVLT) BPD: ↑ Working memory and verbal memory following treatment (to levels similar to HC)
BPD: 13 ± 3.1 BPD (18M; 16F)
Clinical: YMRS
  [168] MDD: 26.93 ± 5.33 MDD (14M; 14F) Assess the association between executive function and relapse NΨ: cognitive flexibility (CWIT, TMT-B), Verbal fluency (VFT), Processing speed (TMT-A), MDD: Poor BL inhibition and switching ~ ↑ relapse at FU
HC: 26.93 ± 5.18 HC (14M; 14F)
Clinical: MADRS
  [45] CS: 28 ± 7.9 CS (642) Examine whether cognitive deficits predict current and/or follow-up (sub)clinical depressive symptoms in the general population NΨ: Information processing (SCWT, CST, LDST), Episodic memory (AVLT) CS: Poor BL episodic memory ~ ↑ depressive symptoms at FUP
Clinical: SCL-90
  [169] BD: 22.2 ± 3.9 BD (23M; 22F) Determine whether neuropsychological impairments are present in clinically stable patients with bipolar disorder shortly after resolution of their first manic episode NΨ: Intelligence (NAART), Visual spatial reasoning (K-BIT), Attention/processing speed (TMT-A, CANTAB-RVP, CVLT), Learning and memory (CVLT- recall, CANTAB-SRM;-PRM;-PAL), cognitive flexibility (TMT-B, CANTAB-IED;-SWM), Verbal fluency (COWT), BPD: ↓ learning/memory, spatial/nonverbal reasoning, executive function, and some aspects of attention
HC: 22.5 ± 4.8 HC (12M; 13F)
  [56] MDD: 16.2 ± 1.1 MDD (7M; 11F) Investigate the neurocognitive outcome in adolescents who were treated with TMS NΨ: Verbal learning and memory (CAVLT), Cognitive flexibility (D-KEFS, TMT) MDD: ↓ Depressive symptoms were associated with ↑ in immediate and delayed verbal memory.
Clinical: CDRS-R
  1. Note. Sample: ANX Anxiety disorder, BPD Bipolar Disorder, BPD-I Bipolar Disorder I, BPD-I-EFD Bipolar Disorder I with Executive Function Deficits, CS Community Sample, DD Depressive disorder, CU Cannabis user, DSH Deliberate Self-Harm, EUT euthymic, FED First-Episode depression, FEM first episode mania, FEP First-Episode Psychosis, HC Healthy Controls, HC-B Healthy Control Binge drinker, HC-EFD Healthy Control with Executive Function Deficits, HC-NB Healthy Control Non Binge drinker, MDD Major Depression Disorder, MDD-B Major Depression Disorder Binge drinker, MDD-NB Major Depression Disorder Non Binge drinker, MEM multiple episode mania, MHP Mental Health Patients (mixed diagnosis sample), NSA No Suicide Attempt, NSIB No Suicide Ideation Behaviour, OCD Obsessive Compulsive Disorder, PC Psychiatric Control (i.e. psychiatric diagnosis but no suicide attempt), PSD Psychotic Spectrum Disorder, SA Suicide Attempters, SAD Social Anxiety Disorder, SIB Suicide Ideation Behaviour
  2. Measures: ANT Attention network test, AUDIT Alcohol Use Disorder Identification Test, AVLT Auditory Verbal Learning Test, BDI Beck Depression Inventory, BPRS Brief psychiatric rating scale, BSS Beck Scale for Suicidal Ideation, CANTAB Cambridge Neuropsychological Test Automated Battery [subsets include: FAS Fluency and semantic test, IED Intra/Extra dimensional Set Shift Errors, MS Motor Screening, PAL Paired associates learning, PRM Pattern recognition memory, RVP Rapid Visual Processing hits score, SRM Spatial recognition memory, SSP Spatial span task, SWM Spatial working memory), C-CASA Columbia Classification Algorithm of Suicide Assessment, CDI Children’s Depression Inventory, COWAT Controlled Oral Word Association Task, CPRS-R:L Conners Parent Rating Scale- Revised: Long Version, CPT Continuous Performance Test, CSHF Colombia Suicide History Form, CST Concept shifting test, CVLT California Verbal Learning Test for Children, D-KEFS Delis–Kaplan Executive Function System, GAF Global Assessment of Functioning, HDRS Hamilton depression rating scale, IGT Iowa Gambling Task, K-BIT Kaufman Brief Intelligence Test, LDSB Longest Digit Span Backward, LDSF Longest Digit Span Forward, LDST letter digit substitution test, LM-Ret logical memory- percentage retention, MADRS Montgomery-Asberg Depression Rating Scale, MEPS means-ends problem-solving procedure, MFFT matching familiar figures test, MMPI-D Minnesota Multiphasic Personality Test, depression subscale, NAART North American Adult Reading Test, neuropsychological, PANSS positive and negative syndrome scale, PSIS pierce suicide intent scale, RAVLT rey auditory verbal learning test; total score; retention; and/or 20min score, RCF Rey-Osterrieth Complex Figure, SBS Suicide Behavior Screening, SCWT stroop colour and word test, SCL-90 symptom checklist, SCWT stroop colour and word test, SDMT symbol digit modality test, SFS social functioning scale, SHBQ self-harm behavior questionnaire, SIQ suicide ideation questionnaire, SIS suicide intent scale, SOFAS social and occupational functioning assessment scale, = time-line followback, TMT-A trail making test – part A, TMT-B trail making test – part B, VFT verbal fluency task, WAIS-III Wechsler Adult Intelligence Scale [subsets include: S similarities, V Vocabulary, DS Digit symbol, BD Block design, FFD freedom from distractibility], WASI Wechsler abbreviated scale of Intelligence, WISC Wechsler Intelligence Scale For Children, WCST Wisconsin Card Sorting Test, WDWT Walk don’t-walk test, WMS Wechsler Memory Scale [subsets include: DS Digit Span, LM logical memory 1 & 2, SR = story recall, LLT List Learning Test, SS Spatial span, VR Visual Reproduction], WRAT-III wide range achievement test – third edition, WTAR wechsler test of adult reading, Y-BOCS Yale–Brown obsessive-compulsive scale, YMRS young mania rating scale
  3. Findings: ↑ = Increased, Improved or Higher, ↓ = Decreased, Reduced or Lower, ~ = ‘is associated with’, FUP follow-up
  4. *indicates that the study features more than once in the data synthesis