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Neuropsychological impairments in unipolar depression: the influence of perceived failure on subsequent performance

Published online by Cambridge University Press:  09 July 2009

R. Elliott ,
B. J. Sahakian ,
A. P. McKay ,
J. J. Herrod ,
T. W. Robbins  and
E. S. Paykel
R. Elliott
Affiliation:
Department of Experimental Psychology and the Department of Psychiatry, University of Cambridge
B. J. Sahakian*
Affiliation:
Department of Experimental Psychology and the Department of Psychiatry, University of Cambridge
A. P. McKay
Affiliation:
Department of Experimental Psychology and the Department of Psychiatry, University of Cambridge
J. J. Herrod
Affiliation:
Department of Experimental Psychology and the Department of Psychiatry, University of Cambridge
T. W. Robbins
Affiliation:
Department of Experimental Psychology and the Department of Psychiatry, University of Cambridge
E. S. Paykel
Affiliation:
Department of Experimental Psychology and the Department of Psychiatry, University of Cambridge
*
1Address for correspondence: Dr Barbara J. Sahakian Department of PsychiatryUniversity of Cambridge School of Clinical Medicine. Addenbrooke's HospitalHills RoadCambridge CB2 2QQ.
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Synopsis

The CANTAB battery of neuropsychological tests was used to compare the performance of 28 patients with unipolar depression with that of 22 age and IQ matched controls. The patients were impaired on almost all tests studied with deficits in pattern and spatial recognition memory, matching to sample, spatial span, spatial working memory and planning. Most of the patients showed at least some impairment and deficits were seen across cognitive domains. An important finding was the detrimental effect of failure on subsequent performance; having solved one problem incorrectly, patients were far more likely than controls to fail the subsequent problem. Superimposed on the general deficits, there were also specific deficits in executive tasks characteristic of frontostriatal dysfunction and deficits in mnemonic tasks characteristic of temporal lobe dysfunction. This combination of a specific form of motivational deficit, resulting in oversensitivity to negative feedback, and superimposed specific neuropsychological deficits were correlated with severity of depression. The most significant correlations were seen between mnemonic deficits and clinical rating scores. Comparisons of the deficits seen in the depressed patients in this study with other patient groups assessed with the CANTAB neuropsychological battery, showed that one of the hypotheses of the neuropsychological deficits in depression, that of ‘frontosubcortical’ or ‘frontostriatal’ dysfunction, was not supported. These findings are discussed in relation to the likely neural substrates of depression.

Information

Type
Original Articles
Information
Psychological Medicine , Volume 26 , Issue 5 , September 1996 , pp. 975 - 989
Copyright
Copyright © Cambridge University Press 1996

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References

Abas, M. A., Sahakian, B. J. & Levy, R. (1990). Neuropsychological deficits and CT scan changes in elderly depressives. Psychological Medicine 20, 507–520.CrossRefGoogle ScholarPubMed
Albert, M. L., Feldman, R. G. & Willis, A. L. (1974). The ‘subcortical dementia’ of progressive supranuclear palsy. Journal of Neurology, Neurosurgery and Psychiatry 37, 121–130.Google Scholar
Alexander, G. E., De Long, M. R. & Strick, P. L. (1986). Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annual Renew of Neuroscience 9, 357–381.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders (DSM-III). APA: Washington, DC.Google Scholar
Austin, M. P., Ross, M., Murray, C., O'Carroll, R. E., Ebmeier, K. P. & Goodwin, G. M. (1992). Cognitive function in major depression. Journal of Affective Disorders 25, 21–30.CrossRefGoogle ScholarPubMed
Baker, S. C., Rogers, R. D., Owen, A. M., Frith, C. D., Dolan, R. J., Frackowiak, R. S. J. & Robbins, T. W. (1996). Neural systems engaged by planning: a PET study of the Tower of London task. Neuropsychologia 34, 515–526.CrossRefGoogle ScholarPubMed
Beats, B. C., Sahakian, B. J. & Levy, R. (1996). Cognitive performance in tests sensitive to frontal lobe dysfunction in the elderly depressed. Psychological Medicine 26, 591–603.CrossRefGoogle ScholarPubMed
Beck, A. T. (1967). Depression: Clinical, Experimental and Theoretical Aspects. Harper and Row: New York.Google Scholar
Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. International Universities Press: New York.Google Scholar
Beck, A. T. (1979). Cognitive Therapy of Depression. J. Wiley & Sons: New York.Google Scholar
Bench, C. J., Friston, K. J., Brown, R. G., Scott, L. C., Frackowiak, R. S. J. & Doln, R. J. (1992). The anatomy of melancholia – focal abnormalities of cerebral blood flow in major depression. Psychological Medicine 22, 607–615.CrossRefGoogle ScholarPubMed
Bench, C. J., Friston, K. J., Brown, R. G., Frackowiak, R. S. J. & Dolan, R. J. (1993). Regional cerebral blood flow in depression measured by positron emission tomography: the relationship with clinical dimensions. Psychological Medicine 23, 579–590.CrossRefGoogle ScholarPubMed
Benton, A. L. (1968). Differential behavioural effects in frontal lobe disease. Neuropsychologia 6, 53–60.Google Scholar
Brown, R. G. & Marsden, C. D. (1988). ‘Subcortical dementia’: the neuropsychological evidence. Neuroscience 25, 363–387.Google Scholar
Cummings, J. L. (1986). Subcortical dementia: neuropsychology, neuropsychiatry and pathophysiology. British Journal of Psychiatry 149, 682–697.CrossRefGoogle ScholarPubMed
Dolan, R. J., Bench, C. J., Friston, K. J., Brown, R., Scott, L. & Frackowiak, R. S. J. (1992). Regional cerebral blood flow abnormalities in depressed patients with cognitive impairment. Journal of Neurology, Neurosurgery and Psychiatry 55, 768–773.CrossRefGoogle ScholarPubMed
Dolan, R. J., Bench, C. J., Brown, R. G., Scott, L. C. & Frackowiak, R. S. J. (1994). Neuropsychological dysfunction in depression: the relationship to regional cerebral blood flow. Psychological Medicine 24, 849–857.Google Scholar
Downes, J. J., Roberts, A. C., Sahakian, B. J., Evenden, J. L. & Robbins, T. W. (1989). Impaired extra-dimensional shift performance in medicated and unmedicated Parkinson's disease: evidence for a specific attentional deficit. Neuropsychologia 27, 1329–1343.Google Scholar
Drevets, W. C., Videen, T. O., Price, J. L., Preskorn, S. H., Carmichael, S. T. & Raichle, M. E. (1992). A functional anatomical study of unipolar depression. Journal of Neuroscience 12, 3628–3641.CrossRefGoogle ScholarPubMed
Elliott, R., McKenna, P. J., Robbins, T. W. & Sahakian, B. J. (1995). Neuropsychological evidence for frontostriatal dysfunction in schizophrenia. Psychological Medicine 25, 619–630.CrossRefGoogle ScholarPubMed
Elliott, R., Sahakian, B. J., Herrod, J. J., Robbins, T. W. & Paykel, E. S. (1996). Oversensitivity to perceived failure in unipolar depression: evidence for a diagnosis-specific impairment. (Submitted.)Google Scholar
Folstein, F. E., Peyser, C. E., Starkstein, S. E. & Folstein, M. F. (1991). Subcortical triad of Huntington's disease – a model for a neuropathology of depression, dementia and dyskinesia. In Psychopathology and the Brain (ed. Carroll, B. J., B., and Barrett, J. E.), pp. 65–75. Raven: New York.Google Scholar
Golinkoff, M. & Sweeney, J. A. (1989). Cognitive impairments in depression. Journal of Affective Disorders 17, 105–112.CrossRefGoogle ScholarPubMed
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 56–62.CrossRefGoogle ScholarPubMed
Lange, K. W., Sahakian, B. J., Quinn, N. P. & Marsden, C. D. (1995). Comparison of executive and visuospatial memory in Huntington's disease and dementia of the Alzheimer type matched for degree of dementia. Journal of Neurology, Neurosurgery and Psychiatry 58, 598–606.CrossRefGoogle ScholarPubMed
Lawrence, A. D., Sahakian, B. J., Hodges, J. R., Rosser, A. E., Lange, K. W. & Robbins, T. W. (1996). Executive and mnemonic function in early Huntington's disease. Brain (in the press).Google Scholar
Lewinsohn, P. M., Youngren, M. A. & Grosscup, S. J. (1979). Reinforcement and depression. In The Psychobiology of the Depressive Disorders: Implications for the Effects of Stress. (ed. Depue, R. A.), pp. 291–316. Academic Press: New York.Google Scholar
Milner, B. (1971). Interhemispheric difference in the localization of psychological processes in man. British Medical Bulletin 27, 272–277.CrossRefGoogle ScholarPubMed
Moffoot, A. P. R., O'Carroll, R. E., Bennie, J., Carroll, S., Dicj, H., Ebmeier, K. P. & Goodwin, G. M. (1994). Diurnal variation of mood and neuropsychological function in major depression with melancholia. Journal of Affective Disorders 32, 257–269.Google Scholar
Montgomery, S. A. & Åsberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry 134, 382–389.Google Scholar
Nelson, H. E. (1982). National Adult Reading Test (NART): Test Manual. NFER-Nelson: Windsor.Google Scholar
Nie, N. H., Hadlai Hull, C., Jenkins, J. G., Steinbrenner, K. & Bent, D. H. (1970). Statistical Package for the Social Sciences. McGraw Hill: New York.Google Scholar
Owen, A. M., Downes, J. J., Sahakian, B. J., Polkey, C. E. & Robbins, T. W. (1990). Planning and spatial working memory following lobe lesions in man. Neuropsychologica 28, 1021–1034.Google Scholar
Owen, A. M., Roberts, A. C., Polkey, C. E., Sahakian, B. J. & Robbins, T. W. (1991). Extradimensional versus intradimensional set-shifting performance following frontal lobe excisions, temporal lobe excisions or amygdalo-hippocampectomy in man. Neuropsychologia 29, 993–1006.Google Scholar
Owen, A. M., James, M., Leigh, P. N., Summers, B. A., Quinn, N. P., Sahakian, B. J. & Robbins, T. W. (1992). Fronto-striatal cognitive deficits at different stages of Parkinson's disease. Brain 115, 1727–1751.CrossRefGoogle ScholarPubMed
Owen, A. M., Roberts, A. C., Hodges, J. R., Summers, B. A., Polkey, C. E. & Robbins, T. W. (1993). Contrasting mechanisms of attentional set-shifting in patients with frontal lobe damage or Parkinson's disease. Brain 116, 1159–1175.Google Scholar
Owen, A. M., Sahakian, B. J., Hodges, J. R., Summers, B. A., Polkey, C. E. & Robbins, T. W. (1995 a). Dopamine-dependent frontostriatal planning deficits in early Parkinson's disease. Neuropsychology 9, 126–140.CrossRefGoogle Scholar
Owen, A. M., Sahakian, B. J., Semple, J., Polkey, C. E. & Robbins, T. W. (1995 b). Visuo-spatial short-term recognition memory and learning after temporal lobe excisions, frontal lobe excisions or amygdalo-hippocampectomy in man. Neuropsychologia 33, 1–24.CrossRefGoogle ScholarPubMed
Paykel, E. S. (1985). The Clinical Interview for Depression: development, reliability and validity. Journal of Affective Disorders 9, 85–96.CrossRefGoogle ScholarPubMed
Robbins, T. W., Joyce, E. M. & Sahakian, B. J. (1992 a). Neuropsychology and neuroimaging of affective disorders. In Handbook of Affective Disorders (ed. Paykel, E. S.), pp. 289–309. Churchill Livingstone: London.Google Scholar
Robbins, T. W., James, M., Lange, K. W., Owen, A. M., Quinn, M. P. & Marsden, C. D. (1992 b). Cognitive performance in multiple system atrophy. Brain 115, 271–291.CrossRefGoogle ScholarPubMed
Robbins, T. W., James, M., Owen, A. M., Sahakian, B. J., McInnes, L. & Rabbitt, P. (1994). Cambridge neuropsychological test automated battery (CANTAB): a factor analytic study of a large sample of normal elderly volunteers. Dementia 5, 266–281.Google ScholarPubMed
Rogers, D., Lees, A. J., Smith, E., Trimble, M. & Stern, G. M. (1987). Bradyphrenia in Parkinson's disease and psychomotor retardation in depressive illness. An experimental study. Brain 110, 761–776.CrossRefGoogle ScholarPubMed
Sahakian, B. J. & Owen, A. M. (1992). Computerised assessment in neuropsychiatry using CANTAB. Journal of the Royal Society of Medicine 85, 399–402.Google Scholar
Sahakian, B. J., Morris, R. G., Evenden, J. L., Heald, A., Levy, R., Philpot, M. & Robbins, T. W. (1988). A comparative study of visuospatial memory and learning in Alzheimer-type dementia and Parkinson's disease. Brain 111, 695–718.CrossRefGoogle ScholarPubMed
Sahakian, B. J., Downes, J. J., Eagger, S., Evenden, J. L., Levy, R., Philpot, M. P., Roberts, A. C. & Robbins, T. W. (1990). Sparing of attentional relative to mnemonic function in a subgroup of patients with dementia of the Alzheimer type. Neuropsychologica 28, 1197–1213.Google Scholar
Sahgal, A., Lloyd, S., Wray, C., Galloway, P., Robbins, T. W., Sahakian, B. J., McKeith, I. G., Cook, J. H., Disley, J. C. A. & Edwardson, J. A. (1992). Does visuospatial memory in Alzheimer's disease depend on the severity of the disorder? International Journal of Geriatric Psychiatry 7, 427–436.Google Scholar
Shallice, T. (1982). Specific impairments of planning. Philosophical Transactions of the Royal Society of London 298, 199–209.Google ScholarPubMed
Silberman, E. K., Weingarnter, H. & Post, R. M. (1983). Thinking of disorder in depression. Archives of General Psychiatry 42, 775–780.Google Scholar
Swerdlow, N. R. & Koob, G. F. (1987). Dopamine, schizophrenia, mania and depression: towards a unified hypothesis of cortico–striato–pallido–thalamic function. Behavioural Brain Science 10, 197–245.Google Scholar
Watts, F. N., MacLeod, A. K. & Morris, L. (1988). Associations between phenomenal and object aspects of concentration problems in depressed patients. British Journal of Psychology 79, 241–250.CrossRefGoogle Scholar
Watts, F. M., Dalgleish, T., Bourke, P. & Healy, D. (1990). Memory deficit in clinical depression: processing resources and structure of materials. Psychological Medicine 20, 345–349.Google Scholar
Weingartner, H., Cohen, R. M., Murphy, D. L., Martello, J. & Gerdt, C. (1981). Cognitive processes in depression. Archives of General Psychiatry 38, 42–47.Google Scholar
Winer, B. J. (1971). Statistical Principles in Experimental Design, 2nd edn.McGraw-Hill: New York.Google Scholar