A Correlational Study On Executive Functioning And Clinical Features Of Patients With Major Depression Disorder

Objective The purposes of the study include:1.Using CANTAB as a much moresensible tool to discuss the features and correlations of the patients’ executive functioningimpairment with major depression disorder (MDD), providing evidence for specificcognitive deficits of depressive patients.2.To discuss the correlations of patients’ conditionof executive functioning and severity, HAMD-17factor scores, course of disease, age ofthe first episode etc., providing neuropsychological evidence for heterogeneity of thedisorder, thus certain clues for illustrating the etiology better and diagnosing and treatingmore correctly shall be revealed.Methods31MDD patients on first episode were included in the patient groupaccording to the DSM-IV criteria. And31healthy volunteers with similar ratio of gender,age and educating duration were also included.All subjects were assessed by HAMD-17scale, and accepted an interview on personaland/or clinical information. Five tests of Cambridge Neuropsychological Test AutomatedBattery (CANTAB), which were Motor Screening(MOT), One Touch Stocking(OTS),Spatial Working Memory(SWM), Delayed Matching to Sample(DMS) and Rapid VisualInformation Processing(RVP), were selected due to their sensitivity on minor prefrontallobe dysfunction and were administered on all subjects. The scores from the patient groupand the control group were compared with t test. The correlation between CANTAB scoresof the patient group and severity, HAMD-17factor scores, course of disorder, age of thefirst episode etc. were analyzed.Results1.The difference between patients and the controls:(1)The patients’ scorewere significantly higher than the controls on multiple OTS Mean latencies, SWM Meantime to last response(8boxes), DMS Mean latency(simultaneous) and RVP Mean latency,with significance of P<0.05.(2)The patients’ scores were higher than the controls on SWMBetween errors and Total errors, DMS Mean choice to correct(all delays,12000ms delay)and RVP Total misses, with a significance of P<0.05. The patients’ scores were lower than the controls on DMS Total correct and percent correct(12000ms de lay), DMS Meanchoice to correct, RVP Total hits, with a significance of P<0.05.(3)The patients’ RVP A’,RVP Prob of hits, RVP Total correct rejection are significantly higher than thecontrols(P<0.05).2. The correlations of MDD patients’ executive functioning:(1) Patients’ familystructure was negatively correlated to DMS Mean choice to correct (12000ms delay).Patients’ age was positively correlated to OTS Mean latencies, and was negativelycorrelated to SWM Double errors (8boxes). Patients’ duration of education was negativelycorrelated to OTS Mean latencies, SWM Mean time to first response, DMS Prob errorgiven correct and DMS Mean choice to correct(12000ms delay), and was positivelycorrelated with DMS Percent correct(mean,12000ms delay), DMS Total correct, RVP A’and RVP Prob of hits. All the coefficients were of significance (P<0.05).(2)Patients’ age offirst episode was negatively correlated to MOT Mean errors, OTS Mean latency to correct(2moves), SWM Strategy and RVP A’, and was positively correlated with RVP Totalmisses. The patients’ course of disorder was positively correlated with MOT Mean errors,OTS Mean latency to correct (2moves), SWM Strategy and RVP A’, and was negativelycorrelated with RVP Total misses. Patients’ HAMD-17total scores negatively correlatedwith SWM Double errors and SWM Within errors. Anxiety factor scores of the patientsnegatively correlate with RVP Mean latency. Weight factor scores positively correlatedwith OTS Mean latency to first choice correct, OTS Mean latency to correct (4moves) andRVP Mean latency. Cognition factor scores positively correlated with RVP Mean latency.Retardation factor negatively correlated with MOT Mean errors, and positively correlateswith SWM Mean time to first response (8boxes) and RVP Total misses. Sleep factorpositively correlated with DMS A’ and DMS Percent correct (12000ms delay), andnegatively correlates with DMS Prob error given correct. All the coefficients were ofsignificance (P<0.05).Conclusions1.The first onset MDD patients’ executive functioning havesignificant deficits, presenting working memory dysfunction, arouse threshold of attentionelevating, attention bias inhibiting disorder, difficulty in planning, decision making andadministrating dysfunction.2. The first onset MDD patients’ age and duration of education are correlated withexecutive functioning. The elder enjoy stronger administrating and planning functions. The patients who have accepted longer education remain more working memory functioning,with a worse control over emotions and inhibition of attention bias.3. The first onset MDD patients’ onset age and course of disease correlate withexecutive functioning. Early onset and long course of the disorders indicate more obviousadministrating deficit, worse inhibition to attention bias, higher arouse threshold ofattention and worse impairment of remaining/recalling of working memory.4. The first onset MDD patients’ severity correlate with executive functioning. Severesymptoms indicate worse damage of working memory. Obvious retardation in first onsetMDD patients implies less accuracy, worse administrating dysfunctioning and higherarouse threshold of attention.6. Bad quality of sleep in first onset MDD patients impliesmore obvious deficits on inhibition of attention and remaining of working memoryfunction.