Executive function in adolescent patients with major depressive episode with psychotic symptoms and childhood trauma

Abstract

BackgroundThere are differences in executive function between major depressive episode patients with or without psychotic symptoms， and childhood trauma may affect the executive function of patients with major depressive episode. Previous research studies predominantly focused on adult patients with major depressive episode， with a lack of studies specifically focusing on adolescent patients with major depressive episode.ObjectiveTo investigate the differences in executive function among adolescent patients with major depressive episode， with or without psychotic symptoms and childhood trauma.MethodsA total of 112 hospitalized adolescent patients with major depressive episode who met the criteria of the International Classification of Diseases， tenth edition （ICD-10） were included in the study. The participants were recruited from the Department of Child and Adolescent Psychiatry， Shenzhen Kangning Hospital during the period from August 2020 to November 2021. Additionally， 27 healthy controls were recruited through public advertisements. The Cambridge Neuropsychological Test Automated Battery （CANTAB） was used to assess executive function through the administration of the Motor Screening Task （MOT）， Spatial Working Memory（SWM） and Rapid Visual Information Processing （RVP） modules. Childhood Trauma Questionnaire-Short Form （CTQ-SF） was used to assess the trauma type.ResultsCompared with healthy controls， adolescent patients with major depressive episode had a longer mean delay （Z=-3.407， P=0.001） in the MOT task. In the SWM task， the patients had a higher total number of intergroup error responses （Z=-3.291， P=0.001）， a higher total number of intragroup error responses （Z=-3.461， P=0.001）， more total number of double error responses （Z=-3.218， P=0.001）， a higher total error responses （Z=-3.312， P=0.001）， higher strategy scores （Z=-2.437， P=0.015） and longer average delay time （Z=-2.055， P=0.040）. In the RVP task， the patients had fewer hits （Z=-3.196， P=0.001）， more misses （Z=-3.179， P=0.001）， fewer rejections （Z=-2.772， P=0.006）， lower hit probability （Z=-3.187， P=0.001） and lower A´ scores （Z=-3.070， P=0.002）.Compared with adolescent patients with major depressive episode without psychotic symptoms， those with psychotic symptoms had a lower total number of double error responses （Z=-2.566， P=0.010） in SWM task. Compared with adolescent patients with major depressive episode who did not experience emotional neglect， those who experienced emotional neglect had longer average delay time （Z=-3.183， P=0.001） in MOT task， fewer total hits （Z=-2.445， P=0.014）， more total missed reports （Z=-2.467， P=0.014）， lower hit probability （Z=-2.445， P=0.014） and lower A´scores （Z=-2.089， P=0.037） in RVP task. Adolescent patients with major depressive episode who had experienced emotional abuse had longer average delay time in MOT task than those who had not experienced emotional abuse （Z=-2.552， P=0.011）.ConclusionAdolescent patients with major depressive episode exhibit abnormalities in a majority of executive function domains. Specifically， those without psychotic symptoms and with childhood trauma demonstrate significantly impaired executive function. ［Funded by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties （number， SZGS013）， Basic and Applied Basic Research Fund of Guangdong Province （number， 2019A1515110047）， Shenzhen Science and Technology Planning Project （number， JCYJ20190809155019338）］

Keywords

• adolescents
• major depressive episode
• psychotic symptoms
• childhood trauma
• executive function