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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by SLS on October 21, 2010, at 7:13:16
Depression - Cognitive and Memory Impairments
Link:
http://www.ncbi.nlm.nih.gov/pubmed/19835870
---------------------------------------------
Abstract:
Eur J Pharmacol. 2010 Jan 10;626(1):83-6. Epub 2009 Oct 14.
Cognitive impairment in major depression.Marazziti D, Consoli G, Picchetti M, Carlini M, Faravelli L.
Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, University of Pisa, via Roma, 67, I-56100 Pisa, Italy. dmarazzi@psico.med.unipi.it
AbstractIn the past decade, a growing bulk of evidence has accumulated to suggest that patients suffering from major depression (MD) present some cognitive disturbances, such as impairment in attention, working memory, and executive function, including cognitive inhibition, problem- and task-planning. If the results of short-term memory assessment in depressed patients are equivocal, a general consensus exists that memory problems are secondary to attentional dysfunctions, and reflect the inability to concentrate. Moreover, both unipolar and bipolar patients show evidence of impaired verbal learning that has been commonly interpreted as reflecting an inability to transfer information from short-term to long-term storage. According to some authors, there would be a gender-related as well age-related specificity of some disturbances. Depressed patients also show impairments of executive functions and their recent exploration through brain imaging techniques has recently permitted to formulate some general hypotheses on the possible involvement of different brain areas in MD.
PMID: 19835870 [PubMed - indexed for MEDLINE]
Posted by maxime on October 21, 2010, at 8:40:06
In reply to Depression - Cognitive and Memory Impairments, posted by SLS on October 21, 2010, at 7:13:16
Excellent find Scott! Well, it is something we knew about from experience, but it's interesting to read about it as well.
Scott, have you ever thought of writing your own article on depression. You have been through so much and you know a lot as well. I think you could write something that people would really want to read and who would gain some knowledge and enlightment as well. I know you aren't feeling well these days, but you could do it a little at a time.
Posted by Phillipa on October 21, 2010, at 10:30:23
In reply to Re: Depression - Cognitive and Memory Impairments » SLS, posted by maxime on October 21, 2010, at 8:40:06
In all seriousness and may have asked this before what's your personal definition of MDD? Seriously as see so much conflicting stuff? Phillipa
Posted by SLS on October 21, 2010, at 11:29:37
In reply to Re: Depression - Cognitive and Memory Impairments, posted by Phillipa on October 21, 2010, at 10:30:23
> In all seriousness and may have asked this before what's your personal definition of MDD? Seriously as see so much conflicting stuff? Phillipa
What conflicts have you seen in the definition of MDD?
- Scott
Posted by SLS on October 21, 2010, at 11:49:55
In reply to Re: Depression - Cognitive and Memory Impairments » Phillipa, posted by SLS on October 21, 2010, at 11:29:37
Major Depressive Disorder
Contents
* Diagnostic Criteria
* Essential Features
* Associated Features and Comorbidity
* Mortality
* Premorbid History
* Laboratory Findings
* Gender
* Prevalence
* Onset And Course
* Recurrence
* Recovery
* Poor Outcome
* Familial Pattern And Genetics
* Differential DiagnosisDiagnostic Criteria
1. At least one of the following three abnormal moods which significantly interfered with the person's life:
1. Abnormal depressed mood most of the day, nearly every day, for at least 2 weeks.2. Abnormal loss of all interest and pleasure most of the day, nearly every day, for at least 2 weeks.
3. If 18 or younger, abnormal irritable mood most of the day, nearly every day, for at least 2 weeks.
2. At least five of the following symptoms have been present during the same 2 week depressed period.
1. Abnormal depressed mood (or irritable mood if a child or adolescent) [as defined in criterion A].2. Abnormal loss of all interest and pleasure [as defined in criterion A2].
3. Appetite or weight disturbance, either:
* Abnormal weight loss (when not dieting) or decrease in appetite.
* Abnormal weight gain or increase in appetite.4. Sleep disturbance, either abnormal insomnia or abnormal hypersomnia.
5. Activity disturbance, either abnormal agitation or abnormal slowing (observable by others).
6. Abnormal fatigue or loss of energy.
7. Abnormal self-reproach or inappropriate guilt.
8. Abnormal poor concentration or indecisiveness.
9. Abnormal morbid thoughts of death (not just fear of dying) or suicide.
3. The symptoms are not due to a mood-incongruent psychosis.
4. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode.
5. The symptoms are not due to physical illness, alcohol, medication, or street drugs.
6. The symptoms are not due to normal bereavement.
Essential Features
By definition, Major Depressive Disorder cannot be due to:
* Physical illness, alcohol, medication, or street drug use.
* Normal bereavement.
* Bipolar Disorder
* Mood-incongruent psychosis (e.g., Schizoaffective Disorder, Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified).Major Depressive Disorder causes the following mood symptoms:
* Abnormal depressed mood:
o Sadness is usually a normal reaction to loss. However, in Major Depressive Disorder, sadness is abnormal because it:
+ Persists continuously for at least 2 weeks.
+ Causes marked functional impairment.
+ Causes disabling physical symptoms (e.g., disturbances in sleep, appetite, weight, energy, and psychomotor activity).
+ Causes disabling psychological symptoms (e.g., apathy, morbid preoccupation with worthlessness, suicidal ideation, or psychotic symptoms).
o The sadness in this disorder is often described as a depressed, hopeless, discouraged, "down in the dumps," "blah," or empty. This sadness may be denied at first. Many complain of bodily aches and pains, rather than admitting to their true feelings of sadness.* Abnormal loss of interest and pleasure mood:
o The loss of interest and pleasure in this disorder is a reduced capacity to experience pleasure which in its most extreme form is called anhedonia.
o The resulting lack of motivation can be quite crippling.* Abnormal irritable mood:
o This disorder may present primarily with irritable, rather than depressed or apathetic mood. This is not officially recognized yet for adults, but it is recognized for children and adolescents.
o Unfortunately, irritable depressed individuals often alienate their loved ones with their cranky mood and constant criticisms.Major Depressive Disorder causes the following physical symptoms:
* Abnormal appetite:
o Most depressed patients experience loss of appetite and weight loss. The opposite, excessive eating and weight gain, occurs in a minority of depressed patients. Changes in weight can be significant.* Abnormal sleep:
o Most depressed patients experience difficulty falling asleep, frequent awakenings during the night or very early morning awakening. The opposite, excessive sleeping, occurs in a minority of depressed patients.* Fatigue or loss of energy:
o Profound fatigue and lack of energy usually is very prominent and disabling.* Agitation or slowing:
o Psychomotor retardation (an actual physical slowing of speech, movement and thinking) or psychomotor agitation (observable pacing and physical restlessness) often are present in severe Major Depressive Disorder.Major Depressive Disorder causes the following cognitive symptoms:
* Abnormal self-reproach or inappropriate guilt:
o This disorder usually causes a marked lowering of self-esteem and self-confidence with increased thoughts of pessimism, hopelessness, and helplessness. In the extreme, the person may feel excessively and unreasonably guilty.
o The "negative thinking" caused by depression can become extremely dangerous as it can eventually lead to extremely self-defeating or suicidal behavior.* Abnormal poor concentration or indecisiveness:
o Poor concentration is often an early symptom of this disorder. The depressed person quickly becomes mentally fatigued when asked to read, study, or solve complicated problems.
o Marked forgetfulness often accompanies this disorder. As it worsens, this memory loss can be easily mistaken for early senility (dementia).* Abnormal morbid thoughts of death (not just fear of dying) or suicide:
o The symptom most highly correlated with suicidal behavior in depression is hopelessness.Associated Features and Comorbidity
* Anxiety:
o 80 to 90% of individuals with Major Depressive Disorder also have anxiety symptoms (e.g., anxiety, obsessive preoccupations, panic attacks, phobias, and excessive health concerns).
o Separation anxiety may be prominent in children.
o About one third of individuals with Major Depressive Disorder also have a full-blown anxiety disorder (usually either Panic Disorder, Obsessive-Compulsive Disorder, or Social Phobia).
o Anxiety in a person with major depression leads to a poorer response to treatment, poorer social and work function, greater likelihood of chronicity and an increased risk of suicidal behavior.* Eating Disorders:
o Individuals with Anorexia Nervosa and Bulimia Nervosa often develop Major Depressive Disorder.* Psychosis:
o Mood congruent delusions or hallucinations may accompany severe Major Depressive Disorder.* Substance Abuse:
o The combination of Major Depressive Disorder and substance abuse is common (especially Alcohol and Cocaine).
o Alcohol or street drugs are often mistakenly used as a remedy for depression. However, this abuse of alcohol or street drugs actually worsens Major Depressive Disorder.
o Depression may also be a consequence of drug or alcohol withdrawal and is commonly seen after cocaine and amphetamine use.* Medical Illness:
o 25% of individuals with severe, chronic medical illness (e.g., diabetes, myocardial infarction, carcinomas, stroke) develop depression.
o About 5% of individuals initially diagnosed as having Major Depressive Disorder subsequently are found to have another medical illness which was the cause of their depression.
o Medical conditions often causing depression are:
+ Endocrine disorders: hypothyroidism, hyperparathyroidism, Cushing's disease, and diabetes mellitus.
+ Neurological disorders: multiple sclerosis, Parkinson's disease, migraine, various forms of epilepsy, encephalitis, brain tumors.
+ Medications: many medications can cause depression, especially antihypertensive agents such as calcium channel blockers, beta blockers, analgesics and some anti-migraine medications.Mortality
Up to 15% of patients with severe Major Depressive Disorder die by suicide. Over age 55, there is a fourfold increase in death rate.
Premorbid History
10-25% of patients with Major Depressive Disorder have preexisting Dysthymic Disorder. These "double depressions" (i.e., Dysthymia + Major Depressive Disorder) have a poorer prognosis.
Laboratory Findings
There are no laboratory findings that are diagnostic for this disorder.
Gender
Males and females are equally affected by Major Depressive Disorder prior to puberty. After puberty, this disorder is twice as common in females as in males. The highest rates for this disorder are in the 25- to 44-year-old age group.
Prevalence
The lifetime risk for Major Depressive Disorder is 10% to 25% for women and from 5% to 12% for men. At any point in time, 5% to 9% of women and 2% to 3% of men suffer from this disorder. Prevalence is unrelated to ethnicity, education, income, or marital status.
Onset And Course
* Onset:
o Average age at onset is 25, but this disorder may begin at any age.* Psychological stress:
o Stress appears to play a prominent role in triggering the first 1-2 episodes of this disorder, but not in subsequent episodes.* Duration:
o An average episode lasts about 9 months.* Course:
o Course is variable. Some people have isolated episodes that are separated by many years, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older.
o About 20% of individuals with this disorder have a chronic course.Recurrence
* The risk of recurrence is about 70% at 5 year follow up and at least 80% at 8 year follow-up.
* After the first episode of Major Depressive Disorder, there is a 50%-60% chance of having a second episode, and a 5-10% chance of having a Manic Episode (i.e., developing Bipolar I Disorder). After the second episode, there is a 70% chance of having a third. After the third episode, there a 90% chance of having a fourth.
* The greater number of previous episodes is an important risk factor for recurrence.
Recovery
For patients with severe Major Depressive Disorder, 76% on antidepressant therapy recover, whereas only 18% on placebo recover. For these severely depressed patients, significantly more recover on antidepressant therapy than on interpersonal psychotherapy. For these same patients, cognitive therapy has been shown to be no more effective than placebo.
Poor Outcome
Poor outcome or chronicity in Major Depressive Disorder is associated with the following:
* Inadequate treatment
* Severe initial symptoms
* Early age of onset
* Greater number of previous episodes
* Only partial recovery after one year
* Having another severe mental disorder (e.g. Alcohol Dependency, Cocaine Dependency)
* Severe chronic medical illness
* Family dysfunctionFamilial Pattern And Genetics
There is strong evidence that major depression is, in part, a genetic disorder:
* Individuals who have parents or siblings with Major Depressive Disorder have a 1.5-3 times higher risk of developing this disorder.
* The concordance for major depression in monozygotic twins is substantially higher than it is in dizygotic twins. However, the concordance in monozygotic twins is in the order of about 50%, suggesting that factors other than genetic factors are also involved.
* Children adopted away at birth from biological parents who have a depressive illness carry the same high risk as a child not adopted away, even if they are raised in a family where no depressive illness exists.
* Interestingly, families having Major Depressive Disorder have an increased risk of developing Alcoholism and Attention-Deficit Hyperactivity Disorder.
Differential Diagnosis
1. Exclude depressions due to physical illness, medications, or street drug use:
* If due to physical illness, diagnose: Mood Disorder Due to a General Medical Condition.
* If due to alcohol, diagnose: Alcohol-Induced Mood Disorder.
* If due to other substance use, diagnose: Other Substance-Induced Mood Disorder.Organic Causes Of Severe Depression
Illnesses:
Organic Mood Syndromes caused by: Acquired Immune Deficiency Syndrome (AIDS), Adrenal (Cushing's or Addison's Diseases), Cancer (especially pancreatic and other GI), Cardiopulmonary disease, Dementias (including Alzheimer's Disease); Epilepsy, Fahr's Syndrome, Huntington's Disease, Hydrocephalus, Hyperaldosteronism, Infections (including HIV and neurosyphilis), Migraines, Mononucleosis, Multiple Sclerosis, Narcolepsy, Neoplasms, Parathyroid Disorders (hyper- and hypo-), Parkinson's Disease, Pneumonia (viral and bacterial), Porphyria, Postpartum, Premenstrual Syndrome, Progressive Supranuclear Palsy, Rheumatoid Arthritis, Sjogren's Arteritis, Sleep Apnea, Stroke, Systemic Lupus Erythematosus, Temporal Arteritis, Trauma, Thyroid Disorders (hypothyroid and "apathetic" hyperthyroidism), Tuberculosis, Uremia (and other renal diseases), Vitamin Deficiencies (B12, C, folate, niacin, thiamine), Wilson's Disease.Drugs:
Acetazolamine, Alphamethyldopa, Amantadine, Amphetamines, Ampicillin, Azathioprine (AZT), 6-Azauridine, Baclofen, Beta Blockers, Bethanidine, Bleomycin, Bromocriptine, C-Asparaginase, Carbamazepine, Choline, Cimetidine, Clonidine, Clycloserin, Cocaine, Corticosteroids (including ACTH), Cyproheptadine, Danazol, Digitalis, Diphenoxylate, Disulfiram, Ethionamide, Fenfluramine, Griseofulvin, Guanethidine, Hydralazine, Ibuprofen, Indomethacin, Lidocaine, Levodopa, Methoserpidine, Methysergide, Metronidazole, Nalidixic Acid, Neuroleptics (butyrophenones, phenothiazines, oxyindoles), Nitrofurantoin, Opiates, Oral Contraceptives, Phenacetin, Phenytoin, Prazosin, Prednisone, Procainamide, Procyclidine, Quanabenzacetate, Rescinnamine, Reserpine, Sedative/Hypnotics (barbiturates, benzodiazepines, chloral hydrate), Streptomycin, Sulfamethoxazole, Sulfonamides, Tetrabenazine, Tetracycline, Triamcinolone, Trimethoprim, Veratrum, Vincristine.2. Exclude depressions having a previous history of elevated, expansive, or euphoric mood:
* If previous history of a Manic Episode, diagnose: Bipolar I Disorder.
* If previous history of recurrent Major Depressive Episodes and at least one Hypomanic Episode, diagnose: Bipolar II Disorder.
* If previous history of recurrent Hypomanic Episodes and brief, mild depressive episodes (milder than Major Depressive Episodes), diagnose: Cyclothymic Disorder.3. Exclude depressions that merely represent normal bereavement, instead diagnose: Uncomplicated Bereavement.
4. Exclude depressions associated with mood-incongruent psychosis:
* If previous history of at least 2 weeks of delusions or hallucinations occurring in the absence of prominent mood symptoms, diagnose either: Schizoaffective Disorder, Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.
5. Exclude mild depressions:
* If only mild depression present for most of past 2 years (or 1 year in children), diagnose: Dysthymic Disorder.
* If only brief mild depression clearly triggered by stress, diagnose: Adjustment Disorder with Depressed Mood, or Adjustment Disorder with Mixed Anxiety and Depressed Mood.
* If mild depression is clinically significant, but does not meet the criteria for any of the previously described disorders, diagnose: Depressive Disorder Not Otherwise Specified.6. In the elderly, it is often difficult to distinguish between early dementia or Major Depressive Disorder:
* If there is a premorbid history of declining cognitive function in the absence of severe depression, diagnose: Dementia.
* If there was a relatively normal premorbid state and somewhat abrupt cognitive decline associated with severe depression, diagnose: Major Depressive Disorder.Internet Mental Health (www.mentalhealth.com) copyright © 1995-2000 by Phillip W. Long, M.D.
Posted by bearfan on October 21, 2010, at 17:20:50
In reply to Depression - Cognitive and Memory Impairments, posted by SLS on October 21, 2010, at 7:13:16
Yes these are the classical symptoms. Although I think it also depends on the individual as some people don't have the cognitive problems at all.
Posted by SLS on October 21, 2010, at 17:30:39
In reply to Re: Depression - Cognitive and Memory Impairments, posted by bearfan on October 21, 2010, at 17:20:50
> Yes these are the classical symptoms. Although I think it also depends on the individual as some people don't have the cognitive problems at all.
Exactly.
Cognitive and memory impairments were cardinal symptoms of my depression since age 17. When I entered the research program at the NIH, I told them that I just wanted to be able to read, learn, and remember. I didn't care about the negative affect and anhedonia if they could just accomplish improving my cognitive resources.
- Scott
Posted by bleauberry on October 21, 2010, at 19:08:13
In reply to Depression - Cognitive and Memory Impairments, posted by SLS on October 21, 2010, at 7:13:16
Picture this scenario. There is an organism that burrows into human tissue. It leaves a telltale trail the immune system sees as a a danger. While the organism is safely hiding in its protective coating or in hard to reach areas of little blood supply, the trail markers are still on your tissue. Your immune system mistakenly attacks your own tissue. The result is inflammation and the release of toxic proteins. Meanwhile the organisms going about their daily routine are excreting their own toxins similar to acetyldehyde, alcohol metabolites, and such. Some of the tissues involved include the brain and the spinal cord. The toxins contaminate serotonin and dopamine. The toxins clog up receptors.
This patient feels several things. Depression obviously. Cognitive impairments and memory problems, obviously.
Fatigue, probably. Loss of interest, likely. Sleep distrubance and anxiety, hit or miss.This patient is diagnosed with depression.
This patient does not have depression.
This patient will get better not by increasing neurotransmitter levels, but by suppressing the unseen organism and by calming down a confused immune system. Serotonin doesn't need to be added....toxins need to be removed.
Could probably present a dozen other scenarios that play out in real life and maybe should write a book.
Just food for thought.
All too commonly we see a cluster of symptoms such as "depressed mood, cognitive impairment, loss of interest, fatigue, unexplained pain, etc" and we immediately put a label on it "depression". But it isn't. Depression is only a result of a biological insult. The symptoms didn't just happen for no reason. The explanations are not rocket science and are not things that we need to wait 100 years for science to figure out.
It seems ironic how humans spend so much time, effort, and money attaching names to certain clusters of symptoms, when they basically remain impotent year after year, decade after decade, at doing anything significant to reverse those symptoms. Yet our clinicians barely do anything to figure out where those symptoms are coming from. It's considered a thorough exam to simply check thyroid, which usually doesn't even look at reverse T3 or thyroid antibodies. Oh well.
In any case, back to the original study of this thread, yes, I see it as no surprise that cognitive impairment and patterns in the brain are consistent with the presentation of depression.
What came first, the chicken or the egg? That's where I think science has got it all wrong when looking at depression.
But they are making strides. That's a good thing.
Posted by 49er on October 23, 2010, at 9:00:04
In reply to Depression - Cognitive and Memory Impairments, posted by SLS on October 21, 2010, at 7:13:16
> Depression - Cognitive and Memory Impairments
>
> Link:
>
> http://www.ncbi.nlm.nih.gov/pubmed/19835870
>
> ---------------------------------------------
>
> Abstract:
>
> Eur J Pharmacol. 2010 Jan 10;626(1):83-6. Epub 2009 Oct 14.
> Cognitive impairment in major depression.
>
> Marazziti D, Consoli G, Picchetti M, Carlini M, Faravelli L.
>
> Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, University of Pisa, via Roma, 67, I-56100 Pisa, Italy. dmarazzi@psico.med.unipi.it
> Abstract
>
> In the past decade, a growing bulk of evidence has accumulated to suggest that patients suffering from major depression (MD) present some cognitive disturbances, such as impairment in attention, working memory, and executive function, including cognitive inhibition, problem- and task-planning. If the results of short-term memory assessment in depressed patients are equivocal, a general consensus exists that memory problems are secondary to attentional dysfunctions, and reflect the inability to concentrate. Moreover, both unipolar and bipolar patients show evidence of impaired verbal learning that has been commonly interpreted as reflecting an inability to transfer information from short-term to long-term storage. According to some authors, there would be a gender-related as well age-related specificity of some disturbances. Depressed patients also show impairments of executive functions and their recent exploration through brain imaging techniques has recently permitted to formulate some general hypotheses on the possible involvement of different brain areas in MD.
>
> PMID: 19835870 [PubMed - indexed for MEDLINE]Scott,
As an aside, every time I am procrastinating and really should not be on the Internet, I always come upon one of your posts in which I have to respond:))
Anyway, the problem I have with a citation like this is without being able to access the whole text, we're really limited in making a judgment.
That goes both ways as an FYI.
The problem I have is that many researchers refuse to believe that meds can cause the same problems so of a course, a study will be set up to prove what you believe. Just so you think I am not a crazy conspiracy theorist, this is mentioned in the issue of the Atlantic regarding medical studies.
Of course, I don't know if it happened in this case or not but I am sure you understand my skepticism.
As I previously mentioned, I don't doubt that depression can cause cognitive issues. But the problem I have is if I were to complain to a psychiatrist about the brain fog I am experiencing as the result of the psych meds I was on, it would probably be attributed to depression when that isn't the case. Let me give you an example.
Last week, I went to an event which greatly encouraged me about my job prospects. It was the most hopeful I have ever been.
But when I got home, I literally couldn't focus on what I needed to do due to bleeping brain fog.
I think what I am saying is I feel researchers make alot of assumptions without asking specifics. It is like you guilty of experiencing depression until proven innocent which almost never happens.
Back to work:)
49er
Posted by SLS on October 23, 2010, at 9:51:57
In reply to Re: Depression - Cognitive and Memory Impairments » SLS, posted by 49er on October 23, 2010, at 9:00:04
Hi 49er.
The following study gives evidence that cognitive impairments are extant in people with depression who have never taken a psychotropic drug. That is to say that depression itself is responsible for cognitive and memory impairments.
I don't know to what degree doctors are reluctant to acknowledge the existance of long-term discontinuation phenomena from being exposed to antidepressants. I doubt it is taught in medical school yet.
- Scott
****************************************************J Child Psychol Psychiatry. 2009 Mar;50(3):307-16. Epub 2008 Oct 24.
Reduced activation in lateral prefrontal cortex and anterior cingulate during attention and cognitive control functions in medication-naïve adolescents with depression compared to controls.Halari R, Simic M, Pariante CM, Papadopoulos A, Cleare A, Brammer M, Fombonne E, Rubia K.
Child and Adolescent Psychiatry, Institute of Psychiatry, London, UK. r.halari@iop.kcl.ac.uk
AbstractBACKGROUND: There is increasing recognition of major depressive disorder (MDD) in adolescence. In adult MDD, abnormalities of fronto-striatal and fronto-cingulate circuitries mediating cognitive control functions have been implicated in the pathogenesis and been related to problems with controlling negative thoughts. No neuroimaging studies of cognitive control functions, however, exist in paediatric depression. This study investigated whether medication-naïve adolescents with MDD show abnormal brain activation of fronto-striatal and fronto-cingulate networks when performing tasks of attentional and cognitive control.
METHODS: Event-related functional magnetic resonance imaging was used to compare brain activation between 21 medication-naïve adolescents with a first-episode of MDD aged 14-17 years and 21 healthy adolescents, matched for handedness, age, sex, demographics and IQ. Activation paradigms were tasks of selective attention (Simon task), attentional switching (Switch task), and motor response inhibition and error detection (Stop task).
RESULTS: In all three tasks, adolescents with depression compared to healthy controls demonstrated reduced activation in task-relevant right dorsolateral (DLPFC), inferior prefrontal cortex (IFC) and anterior cingulate gyrus (ACG). Additional areas of relatively reduced activation were in the parietal lobes during the Stop and Switch tasks, putamen, insula and temporal lobes during the Switch task and precuneus during the Simon task.
CONCLUSIONS: This study shows first evidence that medication-naïve adolescents with MDD are characterised by abnormal function in ACG and right lateral prefrontal cortex during tasks of attention and performance monitoring, suggesting an early pathogenesis of these functional abnormalities attributed to MDD.
PMID: 19175815 [PubMed - indexed for MEDLINE]
Posted by 49er on October 23, 2010, at 10:18:34
In reply to Re: Depression - Cognitive and Memory Impairments » 49er, posted by SLS on October 23, 2010, at 9:51:57
>
> I don't know to what degree doctors are reluctant to acknowledge the existance of long-term discontinuation phenomena from being exposed to antidepressants. I doubt it is taught in medical school yet.That would be a great study. I am not optimistic it will ever happen.
49er
Posted by floatingbridge on October 25, 2010, at 2:28:31
In reply to Re: Depression - Cognitive and Memory Impairments » bearfan, posted by SLS on October 21, 2010, at 17:30:39
> Cognitive and memory impairments were cardinal symptoms of my depression since age 17. When I entered the research program at the NIH, I told them that I just wanted to be able to read, learn, and remember. I didn't care about the negative affect and anhedonia if they could just accomplish improving my cognitive resources.
>
>Scott, you must work very diligently on recovery. To me you seem incredibly intelligent and articulate, and if this makes sense, I therefore imagine the loss of cognitive function for you to be keenly and profoundly felt. I'm sorry.
Hugs.
(Hope you are still feeling a mild improvement in mood.)
Posted by huxley on October 26, 2010, at 23:29:05
In reply to Re: Depression - Cognitive and Memory Impairments » SLS, posted by floatingbridge on October 25, 2010, at 2:28:31
I can only speak for myself here,
Before I was on meds I never had a great memory was unorganised etc...
After being on Lactimal and Zyprexa my memory has been destroyed. Wiped out. First by Zyprexa and then finished off with Lactimal. I forget simple words mid sentance, I can't remember how to spell simple words, I forget peoples names that I have known for years.
I don't see how this would help med naieve people who already have memory problems.
Infact I think the results are disasterous.
Memory/cognative problems can already cause great stress to someone who is working.. cause them to be fired or to quit their job.
How does it help to drug someone out of a job, further ruin their self esteem and spend the rest of their life out of the workforce.
This is the end of the thread.
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