Cognitive Impairment in Adolescent Major Depressive Disorder With Nonsuicidal Self-Injury: Evidence Based on Multi-indicator ERPs.

Yujiao Wen,Dan Qiao,Shanshan Guo,Ning Sun,Xuemin Zhang,Chunxia Yang,Zhifen Liu,Yifan Xu,Min Han

doi:10.3389/fnhum.2021.637407

Abstract

The lifetime prevalence of major depressive disorder (MDD) in adolescents is reported to be as high as 20%; thus, MDD constitutes a significant social and public health burden. MDD is often associated with nonsuicidal self-injury (NSSI) behavior, but the contributing factors including cognitive function have not been investigated in detail. To this end, the present study evaluated cognitive impairment and psychosocial factors in associated with MDD with NSSI behavior. Eighteen and 21 drug-naïve patients with first-episode MDD with or without NSSI (NSSI+/– group) and 24 healthy control subjects (HC) were enrolled in the study. The Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Adolescent Self-injury Questionnaire, Beck Scale for Suicide Ideation–Chinese Version (BSI-CV), Shame Scale for Middle School Students, Sensation Seeking Scale (SSS) and Childhood Trauma Questionnaire (CTQ) were used to assess depression-related behaviors, and event-related potentials (ERPs) were recorded as a measure of cognitive function. The latency of the N1, N2, P3a, P3b, and P50 components of ERPs at the Cz electrode point; P50 amplitude and P50 inhibition (S1/S2) showed significant differences between the 3 groups. CTQ scores also differed across three groups, and the NSSI– and NSSI+ groups showed significant differences in scores on the Shame Scale for Middle School Students. Thus, cognitive function was impaired in adolescents with MDD with NSSI behavior, which was mainly manifested as memory decline, attention and executive function deficits, and low anti-interference ability. We also found that childhood abuse, lack of social support, and a sense of shame contributed to NSSI behavior. These findings provide insight into the risk factors for MDD with NSSI behavior, which can help mental health workers more effectively diagnose and treat these patients.

Highlights

Major depressive disorder (MDD) is a common chronic mental disease characterized by persistent sadness, apathy, and anhedonia
Covariance analysis showed that the main effect between grouping and Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Childhood Trauma Questionnaire (CTQ), Sensation Seeking Scale (SSS), and Beck Scale for Suicide Ideation–Chinese Version (BSI-CV) was not significant (P > 0.05)
To the best of our knowledge, this study investigated for the first time the differences in cognitive function and psychosocial factors between patients diagnosed with major depression and healthy controls

Summary

Introduction

Major depressive disorder (MDD) is a common chronic mental disease characterized by persistent sadness, apathy, and anhedonia. Among adolescents in China, the rate of MDD is 15–20% and the lifetime prevalence may be as high as 20%, with a male-to-female ratio of 1:2 (Zheng et al, 2018). Nonsuicidal self-injury (NSSI) behavior involves direct, intentional injury to one’s body without suicidal intent, and is socially and culturally unacceptable (Ross and Heath, 2002). The incidence of NSSI behavior among adolescents is 10–20% (Zetterqvist et al, 2013; Célia et al, 2017). The co-occurrence of NSSI behavior with MDD in adolescents is mainly related to difficulties in interpersonal relationships, low self-esteem, childhood abuse, and lack of social support (Jiang et al, 2011; VanDerhei et al, 2014; Barreto Carvalho et al, 2017; Wang et al, 2017). One study found that shame and guilt were significant positive and negative predictors, respectively, of NSSI behavior (Xie et al, 2007)

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Conclusion