青少年抑郁症患者认知功能的病例对照研究
江汉大学附属武汉市精神卫生中心, 湖北武汉 430012
| 摘 要： | 目的：探讨青少年抑郁症患者在执行功能（威斯康星卡片分类测验，WCST）及多项认知功能（THINC-it）上的损伤特征。方法：纳入52例健康青少年和51例符合DSM-5诊断标准的抑郁障碍住院患者，比较两组在威斯康星卡片分类测验（总错误数TE、持续性错误PE、完成分类数CC等）及THINC-it（符号数字替换测验DSST、连线测验B部分TMT-B、N-back任务及选择反应时间CRT）上的差异。结果：与对照组相比，抑郁组在WCST的TE（26.86±5.43 vs. 23.35±5.68, p<0.001, Cohen’s d=-0.63）和PE（17.57±6.73 vs. 14.75±5.34,p=0.02,d=-0.47）上显著更差；在THINC-it的PDQ-5（9.67 ± 4.19 vs 6.60 ± 2.86, p=0.01, d=0.83）、CRT（1880 vs. 2532.5, p=0.01）、NBack（664 vs. 998, p=0.01）、DSST（894.02±595.70 vs. 1151.62±543.17, p=0.02，d=0.45）、TMT（1699 vs. 2215.5, p<0.001）上均表现更差。两组在年龄、性别、BMI分布上无显著差异（p>0.05）。结论：青少年抑郁症患者存在明确的执行功能损伤以及信息加工速度、工作记忆、注意转换等多维度认知损害。 |
| 关 键 词： | 青少年抑郁症; 执行功能; 认知功能; 病例对照研究 |
| DOI： | 10.57237/j.mrf.2026.03.002 |
View:
Downloads:
收稿日期: 2026-06-04
接受日期: 2026-06-24
在线出版日期: 2026-07-28
A Case-control Study of Cognitive Function in Adolescents with Major Depressive Disorder
Wuhan Mental Health Center Affiliated to Jianghan University, Wuhan 430012, China
| Abstract: | Objective: To explore the characteristics of impairment in executive function (Wisconsin Card Sorting Test, WCST) and multiple cognitive functions (THINC-it) in adolescents with major depressive disorder. Methods: A total of 52 healthy adolescents and 51 inpatient adolescents meeting DSM-5 criteria for major depressive disorder were enrolled. Differences between the two groups were compared on the WCST (total errors, TE; perseverative errors, PE; completed categories, CC, etc.) and THINC-it subtests (Digit Symbol Substitution Test, DSST; Trail Making Test Part B, TMT‑B; N‑back task; and Choice Reaction Time, CRT). Results: Compared with the control group, the depression group performed significantly worse on WCST TE (26.86±5.43 vs. 23.35±5.68, p<0.001, Cohen’s d=-0.63) and PE (17.57±6.73 vs. 14.75±5.34, p=0.02, d= -0.47). On THINC-it, the depression group also showed significantly poorer performance on the subjective measure PDQ-5 (9.67±4.19 vs. 6.60±2.86, p=0.01, d=0.83) and on all four objective subtests: CRT (1880 vs. 2532.5, p=0.01), N-back (664 vs. 998, p=0.01), DSST (894.02±595.70 vs. 1151.62±543.17, p=0.02, d=0.45), and TMT-B (1699 vs. 2215.5, p<0.001). No significant differences were found between the two groups in age, sex, or BMI distribution (p>0.05). Conclusion: Adolescents with major depressive disorder exhibit clear executive function deficits as well as multi-domain cognitive impairments, including reduced information processing speed, working memory, and attentional set-shifting. |
| Keywords: | Adolescent Depression; Executive Function; Cognitive Function; Case-control Study |
基金
| 1. | 武汉市卫健委科研项目（WX23A97） |
参考文献
| [1] | Fontanella C A, et al. Antidepressant treatment quality of depressed youth: a national evaluation of Medicaid patients [J]. Journal of the American Academy of Child and Adolescent Psychiatry, 2026, 65(5): 685-696. https://doi.org/10.1016/j.jaac.2025.05.011 |
| [2] | Shorey S, Ng E D, Wong C H J. Global prevalence of depression and elevated depressive symptoms among adolescents: a systematic review and meta-analysis [J]. British Journal of Clinical Psychology, 2022, 61(2): 287-305. https://doi.org/10.1111/bjc.12333 |
| [3] | Urbańska-Grosz J, et al. Is there sufficient evidence for the association between executive dysfunction and academic performance in adolescents with major depressive disorder: a systematic review [J]. European Child & Adolescent Psychiatry, 2024, 33(7): 2129-2140. https://doi.org/10.1007/s00787-023-02275-9 |
| [4] | Fan X, et al. Sleep disturbance and suicidal ideation among youth with depression [J]. Journal of Affective Disorders, 2024, 354: 232-238. https://doi.org/10.1016/j.jad.2024.03.019 |
| [5] | Zhang Y, Boemo T, Qiao Z, et al. Distinct effects of anxiety and depression on updating emotional information in working memory [J]. International Journal of Environmental Research and Public Health, 2022, 19(9): 5444. https://doi.org/10.3390/ijerph20010544 |
| [6] | Miyake A, Friedman N P, Emerson M J, et al. The unity and diversity of executive functions and their contributions to complex "frontal lobe" tasks: a latent variable analysis [J]. Cognitive Psychology, 2000, 41(1): 49-100. https://doi.org/10.1006/cogp.1999.0734 |
| [7] | Acosta N L, De Jesus Y, Smith K E, et al. 89 Depression and executive function in a Mexican population [J]. Journal of the International Neuropsychological Society, 2023, 29(s1): 289-290. https://doi.org/10.1017/S1355617723004071 |
| [8] | Zhu N, et al. The THINC-it tool: temporal sensitivity to change over time [J]. BMC Psychiatry, 2024, 24(1): 749. https://doi.org/10.1186/s12888-024-06170-8 |
| [9] | Zhang W, et al. Reliability and validity of THINC-it in evaluating cognitive function of patients with bipolar depression [J]. Neuropsychiatric Disease and Treatment, 2020, 16: 2419-2428. https://doi.org/10.2147/NDT.S266642 |
| [10] | Zhu N, et al. Validation of the THINC-It tool for assessment of cognitive impairment in patients with bipolar depression [J]. Neuropsychiatric Disease and Treatment, 2023, 19: 443-452. https://doi.org/10.2147/NDT.S401095 |
| [11] | Wang Q, et al. Attention-dominated cognitive dysfunction may be a biological marker for distinguishing SA from SI in adolescents: a network analysis study based on adolescent depression [J]. Psychology Research and Behavior Management, 2024, 17: 945-956. https://doi.org/10.2147/PRBM.S448904 |
| [12] | LaCroix A N, et al. A verbal card sorting task to measure executive functions [J]. American Journal of Speech-Language Pathology, 2023, 32(4): 1698-1704. https://doi.org/10.1044/2023_AJSLP-23-00027 |
| [13] | Wirback T, et al. Social and sex differences in psychiatric comorbidity and psychosocial functioning among adolescents with depression [J]. Journal of Affective Disorders, 2021, 282: 1132-1142. https://doi.org/10.1016/j.jad.2020.12.179 |
| [14] | Wang Z, et al. Clinical characteristics and cognitive function in bipolar disorder patients with different onset symptom [J]. Frontiers in Psychiatry, 2023, 14: 1253088. https://doi.org/10.3389/fpsyt.2023.1253088 |
| [15] | Lu Z, et al. Neurocognition function of patients with bipolar depression, unipolar depression, and depression with bipolarity [J]. Frontiers in Psychiatry, 2021, 12: 696903. https://doi.org/10.3389/fpsyt.2021.696903 |
| [16] | Barceló F, Knight R T. Both random and perseverative errors underlie WCST deficits in prefrontal patients [J]. Neuropsychologia, 2002, 40(3): 349-356. https://doi.org/10.1016/s0028-3932(01)00110-5 |
| [17] | Zhang Z Q, et al. Increased prefrontal cortex connectivity associated with depression vulnerability and relapse [J]. Journal of Affective Disorders, 2022, 304: 133-141. https://doi.org/10.1016/j.jad.2022.02.059 |
| [18] | Tamura J K, Harangi D, Rodrigues N B, et al. The mediational role of cognitive function on occupational outcomes in persons with major depressive and bipolar disorder [J]. CNS Spectrums, 2024, 29(6): 697-704. https://doi.org/10.1017/S1092852924002293 |
| [19] | Zou T, Cao S, Liu W, et al. Is simple reaction time or choice reaction time an indicator of all-cause mortality or CVD mortality? [J]. Public Health, 2021, 199: 34-41. https://doi.org/10.1016/j.puhe.2021.07.045 |
| [20] | Pahor A, Seitz A R, Jaeggi S M. Near transfer to an unrelated N-back task mediates the effect of N-back working memory training on matrix reasoning [J]. Nature Human Behaviour, 2022, 6(9): 1243-1256. https://doi.org/10.1038/s41562-022-01384-w |
| [21] | Frikha M, Alsalman Z A, Chlif M. Motor and cognitive determinants of L2 handwriting fluency and legibility in 10-12-year-old girls: a cross-sectional study [J]. Frontiers in Psychology, 2026, 17: 1757652. https://doi.org/10.3389/fpsyg.2026.1757652 |
| [22] | Knight M J, Baune B T. Cognitive dysfunction in major depressive disorder [J]. Current Opinion in Psychiatry, 2018, 31(1): 26-31. https://doi.org/10.1097/YCO.0000000000000378 |
