Abstract
<p>Introduction: Alterations in executive functioning are frequent in depressed subjects, being the Wisconsin Card Sorting Test (WCST) one of the most utilized instruments to assess it, even though, when individually compared, this test’s items did not show consistency.</p><p>Method: This study aimed to compare the performance of a group comprising 36 non-psychotic unipolar depressed patients (23 women and 13 men, with a mean age of 44.28 years old [<em>SD</em> = 14.78]) with 36 healthy controls (22 women and 14 men, with a mean age of 42.22 years old [<em>SD</em> = 15.19]) in a computerized version of WCST.</p><p>Results: We found significant differences between depressed patients and healthy controls regarding number of categories, perseverative responses, perseverative errors, non-perseverative errors, percentage of conceptual level responses and failure to maintain set, clearly influenced by the variable age, which showed a shared variance between 17% and 33% in depressive patients’ performance and between 16% and 26% in healthy controls’ performance.</p><p>Conclusions: Results allowed us to identify differences in performance between the two groups, therefore this version of the WCST revealed itself a reliable alternative to assess Executive Functions (EFs), accessible to all clinicians.<strong></strong></p>
Highlights
Alterations in executive functioning are frequent in depressed subjects, being the Wisconsin Card Sorting Test (WCST) one of the most utilized instruments to assess it, even though, when individually compared, this test’s items did not show consistency
Given that the WCST is an instrument that provides a large amount of statistical information, there are frequently questions about what measures are more important in order to assess the subject’s performance, being the most utilized the result of perseverative errors, attempts to achieve the first category, and failure to maintain set (Strauss et al, 2006), as well as non-perseverative errors and number of achieved categories (Greve, Ingram, & Bianchini, 1998; Greve, Bianchini, Hartley, & Adams, 1999; Greve, Stickle, Love, Bianchini, & Stanford, 2005)
Depressed patients showed a higher mean in trials to achieve the first category (M = 26.25, SD = 24.70) compared to healthy controls (M = 18.08, SD = 12.94), that difference was not statistically significant (p = .085) (Table 1)
Summary
Alterations in executive functioning are frequent in depressed subjects, being the Wisconsin Card Sorting Test (WCST) one of the most utilized instruments to assess it, even though, when individually compared, this test’s items did not show consistency. It is common its utilization to assess set-maintenance and set-shifting abilities, involved in the execution of prefrontal areas (Carrillo-de-la-Peña & García-Larrea, 2007), more precisely dorsal regions of Prefrontal Cortex (PFC) (Zald & Andreotti, 2010). Despite this fact, the main manuals of neuropsychology caution against using WCST results isolatedly as a marker of damage in the frontal lobe, recommending convergent measures of assessment (Lezak, Howieson, & Loring, 2004; Strauss, Sherman, & Spreen, 2006). Given that the WCST is an instrument that provides a large amount of statistical information, there are frequently questions about what measures are more important in order to assess the subject’s performance, being the most utilized the result of perseverative errors, attempts to achieve the first category, and failure to maintain set (Strauss et al, 2006), as well as non-perseverative errors and number of achieved categories (Greve, Ingram, & Bianchini, 1998; Greve, Bianchini, Hartley, & Adams, 1999; Greve, Stickle, Love, Bianchini, & Stanford, 2005)
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