Neurocognitive Functioning in Depressed Young People: A Systematic Review and Meta-Analysis.

Abstract

BACKGROUND:Depression is among the most common mental health problems for young people. In adults, depression is associated with neurocognitive deficits that reduce the effectiveness of treatment and impair educational and vocational functioning. Compared to adults, less is known about the neurocognitive functioning of young people with depression, and existing research has reported inconsistent findings. METHOD:This systematic review and meta-analysis synthesized the literature on neurocognitive functioning in currently depressed youth aged 12-25 years in comparison to healthy controls. RESULTS:Following a systematic review of the literature, 23 studies were included in the meta-analysis. Poorer performance in the domains of attention (SMD: .50, 95% CI: .18-.83, p = .002), verbal memory (SMD: .78, 95% CI: .50-1.0, p < .001), visual memory (SMD: .65, 95% CI: .30-.99, p < .001), verbal reasoning/knowledge (SMD: .46; 95% CI: .14-.79; p < 0.001) and IQ (SMD: .32; 95% CI: .08-.56; p = 0.01) were identified in depressed youth. Relative weaknesses in processing speed/reaction time and verbal learning were also evident, however, these findings disappeared when the quality of studies was controlled for. Moderator analysis showed a tendency for poorer set-shifting ability in younger depressed participants relative to controls (although non-significant; p = .05). Moderator analysis of medication status showed taking medication was associated with poorer attentional functioning compared to those not taking medication. CONCLUSION:The findings suggest that currently depressed young people display a range of neurocognitive weaknesses which may impact treatment engagement and outcome. The findings support the need to consider neurocognitive functioning when treating youth with depression.