Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/62604
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Type: Journal article
Title: The depression-executive dysfunction (DED) syndrome and response to antidepressants: a meta-analytic review
Author: McLennan, S.
Mathias, J.
Citation: International Journal of Geriatric Psychiatry, 2010; 25(10):933-944
Publisher: John Wiley & Sons Ltd
Issue Date: 2010
ISSN: 0885-6230
1099-1166
Statement of
Responsibility: 
Skye N. McLennan and Jane L. Mathias
Abstract: BACKGROUND: The depression-executive dysfunction (DED) model predicts that cognitive impairment, particularly executive dysfunction, is associated with poor response to antidepressant medication. A meta-analysis was undertaken to assess the evidence for this hypothesis. METHODS: The PsycInfo and PubMed databases were searched to identify studies that examined response to antidepressant treatment in relation to pre-treatment cognitive performance. Systematic screening yielded 17 eligible publications, providing data for 1269 individuals. Ninety cognitive tests and subtests were used by these studies; 30 were used by more than one study. Weighted mean Cohen's d effect sizes, 95% confidence intervals and Fail Safe Ns were calculated for these 30 tests. RESULTS: Five cognitive tests provided good discrimination (d(w) > 0.5) between patients who ultimately responded to antidepressant medication and those who failed to respond. One was a test of executive function but the remainder assessed other cognitive domains. Due to the small number of studies the influence of methodological factors, such as participant age and treatment duration, could not be statistically examined. However, a supplementary analysis restricted to nine studies where SSRIs were the only class of antidepressant revealed a similar pattern of results. CONCLUSIONS: Performance on selected tests of executive function and non-executive cognitive functions is associated with response to anti-depressant medication in some populations. The available evidence does not provide strong support for the DED model.
Keywords: depression; antidepressants; cognition; neuropsychological tests; prefrontal cortex; executive function
Rights: Copyright Copyright 2010 John Wiley & Sons, Ltd.
RMID: 0020101189
DOI: 10.1002/gps.2431
Appears in Collections:Psychology publications

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