INTRODUCTION Cognitive dysfunction or deficits are common in patients with major depressive disorder (MDD). The current study systematically reviews and meta-analyzes multiple domains of cognitive impairment in patients with MDD. METHODS PubMed/MEDLINE, PsycINFO, Cochrane Library, Embase, Web of Science, and Google Scholar were searched from inception through May 17, 2023, with no language limits. Studies with the following inclusion criteria were included: (1) patients with a diagnosis of MDD using standardized diagnostic criteria; (2) healthy controls (i.e., those without MDD); (3) neuropsychological assessments of cognitive impairment using Cambridge Neuropsychological Test Automated Battery (CANTAB); and (4) reports of sufficient data to quantify standardized effect sizes. Hedges' g standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs) were used to quantify effect sizes of cognitive impairments in MDD. SMDs were estimated using a fixed- or random-effects models. RESULTS Overall, 33 studies consisting of 2,596 subjects (n = 1,337 for patients with MDD and n = 1,259 for healthy controls) were included. Patients with MDD, when compared to healthy controls, had moderate cognitive deficits (SMD, -0.39 [95% CI, -0.47 to -0.31]). In our subgroup analyses, patients with treatment-resistant depression (SMD, -0.56 [95% CI, -0.78 to -0.34]) and older adults with MDD (SMD, -0.51 [95% CI, -0.66 to -0.36]) had greater cognitive deficits than healthy controls. The effect size was small among unmedicated patients with MDD (SMD, -0.19 [95% CI, -0.37 to -0.00]), and we did not find any statistical difference among children. Cognitive deficits were consistently found in all domains, except the reaction time. No publication bias was reported. CONCLUSION Because cognitive impairment in MDD can persist in remission or increase the risk of major neurodegenerative disorders, remediation of cognitive impairment in addition to alleviation of depressive symptoms should be an important goal when treating patients with MDD.

中文翻译：

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重度抑郁症认知障碍的神经心理学评估：具有 Meta 回归的系统评价和荟萃分析。


引言 认知功能障碍或缺陷在重度抑郁症 （MDD） 患者中很常见。目前的研究系统地回顾和荟萃分析了 MDD 患者认知障碍的多个领域。方法 检索了从建库到 2023 年 5 月 17 日的 PubMed/MEDLINE、PsycINFO、Cochrane Library、Embase、Web of Science 和 Google Scholar，没有语言限制。纳入纳入标准的研究：（1） 使用标准化诊断标准诊断为 MDD 的患者;（2） 健康对照（即没有 MDD 的对照）;（3） 使用剑桥神经心理学测试自动电池 （CANTAB） 对认知障碍进行神经心理学评估;（4） 报告了足够的数据来量化标准化效应大小。Hedges 的 g 标准化均数差 （SMD） 和相应的 95% 置信区间 （CIs） 用于量化 MDD 中认知障碍的效应大小。使用固定或随机效应模型估计 SMD。结果 总体而言，共纳入 33 项研究，涉及 2,596 名受试者 （MDD 患者 n = 1,337 名，健康对照者 n = 1,259 名）。与健康对照组相比，MDD 患者有中度认知缺陷 （SMD，-0.39 [95% CI，-0.47 至 -0.31]）。在我们的亚组分析中，难治性抑郁症患者 （SMD，-0.56 [95% CI，-0.78 至 -0.34]）和老年 MDD 患者 （SMD，-0.51 [95% CI，-0.66 至 -0.36]）比健康对照组有更大的认知缺陷。未用药的 MDD 患者的效应量较小 （SMD，-0.19 [95% CI，-0.37 至 -0.00]），我们未发现儿童之间有任何统计学差异。认知缺陷在所有领域中都一致存在，除了反应时间。没有报告发表偏倚。 结论 由于 MDD 患者的认知障碍可以持续缓解或增加重度神经退行性疾病的风险，因此在治疗 MDD 患者时，除了缓解抑郁症状外，补救认知障碍应是一个重要目标。