A further assessment of decision-making in anorexia nervosa

2015 ◽  
Vol 30 (1) ◽  
pp. 121-127 ◽  
Author(s):  
C. Adoue ◽  
I. Jaussent ◽  
E. Olié ◽  
S. Beziat ◽  
F. Van den Eynde ◽  
...  

AbstractObjective:Anorexia nervosa (AN) may be associated with impaired decision-making. Cognitive processes underlying this impairment remain unclear, mainly because previous assessments of this complex cognitive function were completed with a single test. Furthermore, clinical features such as mood status may impact this association. We aim to further explore the hypothesis of altered decision-making in AN.Method:Sixty-three adult women with AN and 49 female controls completed a clinical assessment and were assessed by three tasks related to decision-making [Iowa Gambling Task (IGT), Balloon Analogue Risk Task (BART), Probabilistic Reversal Learning Task (PRLT)].Results:People with AN had poorer performance on the IGT and made less risky choices on the BART, whereas performances were not different on PRLT. Notably, AN patients with a current major depressive disorder showed similar performance to those with no current major depressive disorder.Conclusion:These results tend to confirm an impaired decision making-process in people with AN and suggest that various cognitive processes such as inhibition to risk-taking or intolerance of uncertainty may underlie this condition Furthermore, these impairments seem unrelated to the potential co-occurent major depressive disorders.

2020 ◽  
pp. 000486742097685
Author(s):  
Syeda F Husain ◽  
Samantha K Ong ◽  
Liu Cuizhen ◽  
Bach Tran ◽  
Roger C Ho ◽  
...  

Objective: Patients with major depressive disorder tend to exhibit poorer decision-making capacity than the general population, but neurobiological evidence is lacking. Functional near-infrared spectroscopy monitors changes in oxy-haemoglobin concentration in the cerebral cortex. It may provide an objective assessment of neurophysiological responses during decision-making processes. Thus, this study investigated the effect of major depressive disorder diagnosis and severity on prefrontal cortex activity during the Iowa gambling task. Methods: Right-handed healthy controls ( n = 25) and patients with major depressive disorder ( n = 25) were matched for age, gender, ethnicity and years of education in this cross-sectional study. Functional near-infrared spectroscopy signals and the responses made during a computerised Iowa gambling task were recorded. In addition, demographics, clinical history and symptom severity were noted. Results: Compared to healthy controls, patients with major depressive disorder had reduced haemodynamic response in several cortical regions of the frontal lobe (Hedge’s g range from 0.71 to 1.52; p values range from ⩽0.001 to 0.041). Among patients, mean oxy-haemoglobin declined with major depressive disorder severity in the right orbitofrontal cortex (Pearson’s r = −0.423; p = 0.024). Conclusion: Haemodynamic dysfunction of the prefrontal cortex during decision-making processes is associated with major depressive disorder diagnosis and severity. These neurophysiological alterations may have a role in the decision-making capacity of patients with major depressive disorder.


2018 ◽  
Vol 12 (3) ◽  
pp. 250-255 ◽  
Author(s):  
Alaise Silva Santos de Siqueira ◽  
Mariana Kneese Flaks ◽  
Marina Maria Biella ◽  
Sivan Mauer ◽  
Marcus Kiiti Borges ◽  
...  

Abstract Major Depressive Disorder (MDD) can occur in parallel with cognitive impairment. The search for a neuropsychological profile of depression has been pursued in the last two decades. However, scant research has been done on executive functions and decision-making ability (DM). Objective: To perform a systematic review of the evidence of DM performance evaluated using the Iowa Gambling Task (IGT) in adults with MDD. Methods: A systematic search according to the PRISMA statement was performed on MEDLINE for studies in English using the following keywords: ‘depression’, ‘depressive’, ‘depressive symptoms’ AND ‘decision making’ OR ‘game task’. Results: Five articles that met the inclusion and exclusion criteria were identified. Three reported significant differences between depressed and non-depressed individuals. The results indicated that young adults with MDD exhibited lower performance on all or almost all stages of the IGT. One study that evaluated DM in older adults with MDD showed that depressed non-apathetic participants failed to adopt any advantageous strategy and continued to make risky decisions during the task. Conclusion: Results suggest that performance on the DM task by young and old adults with MDD differed in comparison to non-depressed participants. Given the small number of articles, further studies should be performed.


2021 ◽  
Vol 89 (9) ◽  
pp. S362
Author(s):  
Timothy McDermott ◽  
Namik Kirlic ◽  
Ryan Smith ◽  
Elisabeth Akeman ◽  
Jessica Santiago ◽  
...  

Author(s):  
James F. Boswell ◽  
Laren R. Conklin ◽  
Jennifer M. Oswald ◽  
Matteo Bugatti

Major depressive disorder (MDD) can be a chronic, debilitating condition that for many individuals waxes and wanes over time. In addition, MDD and other unipolar depressive disorders demonstrate a high level of comorbidity with anxiety disorders. This chapter describes the application of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) to MDD and other unipolar depressive disorders. We first review research supporting the association between depression and higher-order constructs such as neuroticism. Next, we present a clinical case that, combined with module-specific recommendations, further illustrates how UP principles and strategies are implemented in the treatment of primary depression. Finally, we offer recommendations for future work involving the UP for major depression and other depressive disorders.


Author(s):  
Kelly C. Cukrowicz ◽  
Erin K. Poindexter

Suicide is a significant concern for clinicians working with clients experiencing major depressive disorder (MDD). Previous research has indicated that MDD is the diagnosis more frequently associated with suicide, with approximately two-thirds of those who die by suicide suffering from depression at the time of death by suicide. This chapter reviews data regarding the prevalence of suicidal behavior among those with depressive disorders. It then reviews risk factors for suicide ideation, self-injury, and death by suicide. Finally, the chapter provides an empirical overview of treatment studies aimed at decreasing risk for suicide, as well as an overview of several recent treatment approaches showing promise in the reduction of suicidal behavior.


2017 ◽  
Vol 41 (S1) ◽  
pp. s777-s777 ◽  
Author(s):  
H. Kozhyna ◽  
V. Korostiy ◽  
S. Hmain ◽  
V. Mykhaylov

IntroductionAccording to studies done in recent years regarding the treatment of patients with melancholy in major depressive disorder, a shift of interest from studies evaluating the effectiveness of therapy to the study of remission is seen. Despite significant progress in the development of pharmacotherapy of depressive disorders, difficulty in achieving rapid reduction in depressive symptoms and stable remission in patients with melancholic depression necessitated the search for new approaches to the treatment of this pathology.AimsEvaluating the effectiveness of art therapy in treatment in patients with melancholy in major depressive disorder on the quality of remission.MethodsThe study involved 135 patients – 60 male and 75 female patients aged from 18 to 30 years old. The main group of patients apart the combined treatment also participated in group art therapy with the use of drawing techniques, while the control group – statutory standard therapy.ResultsThe results of the use of art therapy in complex treatment in patients with major depressive disorder is detected primarily in reducing of the level of anxiety at the early stages of treatment (60% of patients have noticed decreasing of melancholic state), as well as improving the quality of life in remission period.ConclusionThese results support the use of art therapy in treatment in patients with melancholy in major depressive disorder during period of active treatment, and after achieving clinical remission contributes to achieving and maintaining high-quality and stable remission with full restoration of quality of life and social functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.


CNS Spectrums ◽  
2009 ◽  
Vol 14 (S5) ◽  
pp. 11-13
Author(s):  
R. Bruce Lydiard

Data from a variety of studies, including the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, have shown that fewer patients achieve remission from symptoms of major depressive disorder (MDD) and other depressive disorders after taking the first-prescribed antidepressant treatment than was expected. The goal of treatment is true remission: the complete absence of symptoms. Achieveing less than true remission is associated with MDD recurrence and continued impairment.


2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Tracy L. Greer ◽  
Prabha Sunderajan ◽  
Bruce D. Grannemann ◽  
Benji T. Kurian ◽  
Madhukar H. Trivedi

Introduction. Cognitive deficits are commonly reported by patients with major depressive disorder (MDD). Duloxetine, a dual serotonin/noradrenaline reuptake inhibitor, may improve cognitive deficits in MDD. It is unclear if cognitive improvements occur independently of antidepressant effects with standard antidepressant medications.Methods. Thirty participants with MDD who endorsed cognitive deficits at screening received 12-week duloxetine treatment. Twenty-one participants completed treatment and baseline and posttreatment cognitive testing. The Cambridge Neuropsychological Test Automated Battery was used to assess the following cognitive domains: attention, visual memory, executive function/set shifting and working memory, executive function/spatial planning, decision making and response control, and verbal learning and memory.Results. Completers showed significant cognitive improvements across several domains on tasks assessing psychomotor function and mental processing speed, with additional improvements in visual and verbal learning and memory, and affective decision making and response control. Overall significance tests for executive function tasks were also significant, although individual tasks were not, perhaps due to the small sample size. Most notably, cognitive improvements were observed independently of symptom reduction on all domains except verbal learning and memory.Conclusions. Patients reporting baseline cognitive deficits achieved cognitive improvements with duloxetine treatment, most of which were independent of symptomatic improvement. This trial is registered withNCT00933439.


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