Neuropsychological deficits in psychotic versus nonpsychotic major depression and no mental illness

Objective: At least three studies have indicated that patients with psychot ic major depression studied under nondrug-free conditions differ from patie nts with nonpsychotic major depression and healthy comparison subjects on s everal measures of neuropsychological performance. The current study explor ed specific impairments in cognitive function in subjects with psychotic ma jor depression, subjects with nonpsychotic major depression, and healthy co mparison subjects studied under drug-free conditions. Method: A battery of neuropsychological tests was administered to 11 patien ts with psychotic major depression, 32 patients with nonpsychotic major dep ression, and 23 normal comparison subjects under drug-free conditions. The three groups did not differ statistically in age, sex, or level of educatio n. To ensure that participants had minimal levels of severity and endogenic ity, all patients were required to have a score of at least 20 on the 21-it em Hamilton Depression Rating Scale and a score of at least 7 on the Core E ndogenomorphic Scale, which uses eight items from the Hamilton depression s cale. Results: Patients with psychotic major depression demonstrated significantl y greater impairment than patients with nonpsychotic major depression and/o r comparison subjects in attention and response inhibition (as measured by the Stroop color-word subscale score) as well as in verbal declarative memo r (as measured by the Paragraph Recall Test). Conclusions: These data indicate that patients with psychotic major depress ion demonstrate impairment in functions thought to be mediated by the front al cortex and mediotemporal lobes.