Irritability, Depressed Mood, Inattention and Spatial Working Memory in Children and Adolescents with Major Depressive D
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ORIGINAL ARTICLE
Irritability, Depressed Mood, Inattention and Spatial Working Memory in Children and Adolescents with Major Depressive Disorder With/ Without Persistent Depressive Disorder Alasdair Vance1,3 · Jo Winther2 Accepted: 12 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract The specific relationships between sad/low mood, irritability, inattention and spatial working memory (SWM) have not been systematically examined in young people with major depressive disorder with and without persistent depressive disorder. 313 medication naïve young people (aged 6–16 years) with active major depressive disorder (MDD) alone, persistent depressive disorder (DD) alone and comorbid active MDD and DD were identified. Standard multiple regression was used to investigate how well SWM components—Spatial Span, Strategy and Between Search Errors (BSE)-predict ‘sad/unhappy’, ‘irritable’ mood and ‘Inattention’. Spatial Span (4% of the variance—decreased), Strategy and BSE (both 1% of the variance increased) all made independent significant contributions to ‘Inattention’ while having no independent association with ‘sad/ unhappy’ or ‘Irritable’ mood. These findings support the independence of depressive cognitive impairment from the two main components of depressive mood. Improving SWM and attention via targeted management approaches may aid young people with these depressive disorders. Keywords Major depressive disorder · Persistent depressive disorder · Inattention · Spatial working memory · Irritability
Introduction Spatial working memory (SWM) involves the temporary storage and manipulation of visuospatial (non-verbal) information that is necessary for a range of more complex cognitive functions (see Fig. 1) [1, 2]. However, although differentiable, verbal and SWM functions are deeply interrelated [3]. SWM and attentional abilities are known to be subserved by overlapping neural substrates, including predominantly inferior and superior parietal regions together with lateral prefrontal regions [4, 5]. Importantly, cognitive neuroscience studies suggest that there are two functionally distinct subdivisions of the lateral frontal cortex that subserve different * Alasdair Vance [email protected] 1
Academic Child Psychiatry, Department of Paediatrics, University of Melbourne, Parkville, Australia
2
Developmental Neuropsychiatry Program, Royal Children’s Hospital Melbourne, Parkville, Australia
3
Academic Child Psychiatry Unit, Royal Children’s Hospital, Flemington Rd, Parkville, VIC 3052, Australia
components of SWM [6]: During the ‘online’ maintenance of spatial information in working memory (span), there is significant activation in the ventrolateral prefrontal cortex, while the active monitoring and manipulation of spatial information within working memory (strategy) is associated with significant activation in mid-dorsolateral prefrontal cortical regions. SWM is a crucial cognitive process that when impaired is associated with academic underachievement and int
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