Major Depressive Disorder And Child Maltreatment Affect Adults’ Neurocognitive Function

Objective:1.Explore neurocognitive function of adults with major depressive disorder(MDD)or with child maltreatment;2.Explore the effects of MDD and child maltreatment on neurocognitive function.Methods:Subjects are divided into the healthy control and patients with MDD according MDD diagnostic criteria in Diagnostic and Statistical Manual of Mental Disorders Fourth Edition(DSM-Ⅳ)and Mini-International Neuropsychiatric Interview(M.I.N.I.); subjects are divided into people with and without child maltreatment according to Childhood Trauma Questionnaire-Short Form(CTQ-SF) scores. In a word subjects are divided into four groups, namely subjects without MDD and without child maltreatment, subjects without MDD and with child maltreatment, subjects with MDD and without child maltreatment, subjects with MDD and with child maltreatment. All subjects are collected general demographic information and assessed neurocognitive function and childhood maltreatment. MDD patients are also assessed the severity of depression with Hamilton Depression Scale(HAM-D17), evaluated the severity of anxiety with Hamilton Anxiety Scale(HAMA) and collected depressive episodes.All data is analyzed by SPSS19.0.Analyze subjects’ clinical features and characteristics of childhood maltreatment by analysis of variance or chi-square test; assess the extent of damage of subjects’ information processing speed, executive function, learning and memory, sustained attention and whole neurocognitive function with effect size(ES); explore the effects ofMDD and child maltreatment on adults’ neurocognitive function with factorial design;explore the effects of severity of MDD, severity of anxiety and depressive episodes on MDD neurocognitive function by multiple linear regression analysis.Results:1.Except for executive function(P = 0.024), information processing speed, learning and memory, sustained attention and whole neurocognitive function are no significant difference among four groups.2.There is no learning and memory dysfunction in subjects without MDD and with child maltreatment because of its effect size is 0.002, and the effect sizes of information processing speed, executive function, sustained attention, whole neurocognitive function are-0.337,-0.195,-0.349,-0.287, respectively. The effect sizes of learning and memory information processing speed, executive function, sustained attention, whole neurocognitive function are-0.296,-0.140,-0.267,-0.332,-0.327, respectively in subjects with MDD and without child maltreatment. The effect sizes of learning and memory, information processing speed, executive function, sustained attention, whole neurocognitive function are-0.429,-0.312,-0.625,-0.269,-0.493, respectively, in subjects with MDD and without child maltreatment.3.The main effect of MDD is found in executive function(P = 0.037). However, no main effect of child maltreatment is found in any cognitive domain. There is no interaction between MDD and child maltreatment also.4.Depressive scores, anxiety scores and depressive episodes as the independent variables, learning and memory, information processing speed, executive function,sustained attention and whole neurocognitive function, respectively, as the dependent variables, perform regression analysis. Eventually depressive scores are into the five regression equations, and partial regression coefficients of equations of learning and memory, information processing speed, executive function, sustained attention, whole neurocognitive function are-0.527,-0.746,-0.666,-0.523,-0.689, respectively. Exceptfor depressive scores, anxiety scores are also into the learning and memory regression equations, which partial regression coefficient is-0.320.Conclusion:1.Generally speaking, subjects with MDD and with child maltreatment show the heaviest and the widest neurocognitive impairment, followed by subjects with MDD and without child maltreatment, then subjects without MDD and with child maltreatment.2.The main effect of MDD is found in executive function. However, no main effect of child maltreatment is found in any cognitive domain. There is no interaction between MDD and child maltreatment also.3.More severe MDD is, the more severely neurocognitive function impair. Not only the severity of MDD, but also the severity of anxiety is significantly associated with sustained attention.