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：系统回顾和荟萃回归分析。


简介 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重度抑郁症患者认知障碍的多个领域。方法 PubMed/MEDLINE、PsycINFO、Cochrane Library、Embase、Web of Science 和 Google Scholar 的检索时间自创建之日起至 2023 年 5 月 17 日，没有语言限制。纳入以下纳入标准的研究：（1）使用标准化诊断标准诊断为MDD的患者； (2) 健康对照（即无MDD的人）； (3) 使用剑桥神经心理学测试自动电池组 (CANTAB) 对认知障碍进行神经心理学评估； (4) 报告足够的数据来量化标准化效应大小。 Hedges 的 g 标准化平均差 (SMD) 和相应的 95% 置信区间 (CI) 用于量化 MDD 认知障碍的影响大小。 SMD 使用固定效应或随机效应模型进行估计。结果 总体而言，纳入了 33 项研究，涉及 2,596 名受试者（重度抑郁症患者 n = 1,337 名，健康对照者 n = 1,259 名）。与健康对照相比，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]）和患有 MDD 的老年人（SMD，-0.51 [95% CI，-0.66 至 -0.36]）与健康对照组相比，他们有更大的认知缺陷。在未接受药物治疗的 MDD 患者中，效果较小（SMD，-0.19 [95% CI，-0.37 至 -0.00]），并且我们没有发现儿童之间存在任何统计学差异。除反应时间外，所有领域均存在认知缺陷。没有报道发表偏倚。 结论 由于 MDD 中的认知障碍可能会在缓解后持续存在，或增加主要神经退行性疾病的风险，因此，除了缓解抑郁症状之外，治疗 MDD 患者时，纠正认知障碍也应该是一个重要目标。