Neurocognitive dysfunction in adolescents with recent onset MDD - a cross-sectional comparative study

Abstract

Objectives The aim of this study was to examine the neurocognitive deficits associated with recent onset major depressive disorder (ROD) in adolescents as compared to adult patients. Methods Cross-sectional neurocognitive data from the baseline assessments of the PRONIA study with N = 650 (55.31% females) were analyzed. We built an overall neurocognitive performance (NP) score based on a battery of eleven neurocognitive tests. We examined mean score differences in NP between the groups of healthy controls (HC) and ROD and between adolescents (15–21 years) and adults (22–40 years) within a GLM approach for unbalanced data with focus on interaction effects while controlling for effects of medication and educational years. Results We found lower NP for the ROD as compared to the HC group (d=-0.29, p = .046) and lower NP for the adolescent group as compared to the adult group (d=-0.29; p < .039). We did not find an interaction between these two group effects (F = 1.11; p = .29). Educational years explained most of the variance in the model. An aggregated score of two subtests was highly correlated with the overall score of NP (r = 0.82) Discussion Our findings suggest that the detrimental effect of ROD on neurocognitive functioning is comparable in adolescent and adult patients, since lower scores in adolescent patients are explained by effects of age and education. This has theoretical, diagnostic and treatment implications for both age groups. Conclusion Neurocognitive impairment should be seen as an important factor in ROD, however, the implications of this has so far been under addressed in clinical treatment guidelines for adolescent MDD. Neurocognitive impairment should be considered an important diagnostic issue in adolescent mental health care. Our data further suggests that efficient monitoring of neurocognitive impairment could be implemented in clinical practice by using a subset of two short tests.