title: Is impaired set-shifting a feature of "pure" anorexia nervosa? Investigating the role of depression in set-shifting ability in anorexia nervosa and unipolar depression.
abstract: Impaired set-shifting has been reported in patients with anorexia nervosa (AN) and in patients with affective disorders, including major depression. Due to the prevalent comorbidity of major depression in AN, this study aimed to examine the role of depression in set-shifting ability. Fifteen patients with AN without a current comorbid depression, 20 patients with unipolar depression (UD) and 35 healthy control participants were assessed using the Trail Making Test (TMT), the Wisconsin Card Sorting Test (WCST) and a Parametric Go/No-Go Test (PGNG). Set-shifting ability was intact in patients with AN without a comorbid depression. However, patients with UD performed significantly poorer in all three tasks compared to AN patients and in the TMT compared to healthy control participants. In both patient groups, set-shifting ability was moderately negatively correlated with severity of depressive symptoms, but was unrelated to BMI and severity of eating disorder symptoms in AN patients. Our results suggest a pivotal role of comorbidity for neuropsychological functioning in AN. Impairments of set-shifting ability in AN patients may have been overrated and may partly be due to comorbid depressive disorders in investigated patients.
authors: Medical University Hospital Tübingen, Department of Psychosomatic Medicine and Psychotherapy, Osianderstr. 5, 72076 Tübingen, Germany. katrin.giel@med.uni-tuebingen.de
authors: Katrin E
authors: KE
authors: Giel
authors: Andreas
authors: A
authors: Wittorf
authors: Larissa
authors: L
authors: Wolkenstein
authors: Stefan
authors: S
authors: Klingberg
authors: Eyal
authors: E
authors: Drimmer
authors: Michael
authors: M
authors: Schönenberg
authors: Alexander M
authors: AM
authors: Rapp
authors: Andreas J
authors: AJ
authors: Fallgatter
authors: Martin
authors: M
authors: Hautzinger
authors: Stephan
authors: S
authors: Zipfel
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology*; D003071:Cognition; D003863:Depression / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology*; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012718:Set, Psychology