title: Sensitivity of cognitive tests in four cognitive domains in discriminating MDD patients from healthy controls: a meta-analysis.
abstract: BACKGROUND
  We performed a meta-analysis in order to determine which neuropsychological domains and tasks would be most sensitive for discriminating between patients with major depressive disorder (MDD) and healthy controls.
  
  
  METHODS
  Relevant articles were identified through a literature search of the PubMed and Cochrane Library databases for the period between January 1997 and May 2011. A meta-analysis was conducted using the standardized means of individual cognitive tests in each domain. The heterogeneity was assessed, and subgroup analyses according to age and medication status were performed to explore the sources of heterogeneity.
  
  
  RESULTS
  A total of 22 trials involving 955 MDD patients and 7,664 healthy participants were selected for our meta-analysis. MDD patients showed significantly impaired results compared with healthy participants on the Digit Span and Continuous Performance Test in the attention domain; the Trail Making Test A (TMT-A) and the Digit Symbol Test in the processing speed domain; the Stroop Test, the Wisconsin Card Sorting Test, and Verbal Fluency in the executive function domain; and immediate verbal memory in the memory domain. The Finger Tapping Task, TMT-B, delayed verbal memory, and immediate and delayed visual memory failed to separate MDD patients from healthy controls. The results of subgroup analysis showed that performance of Verbal Fluency was significantly impaired in younger depressed patients (<60 years), and immediate visual memory was significantly reduced in depressed patients using antidepressants.
  
  
  CONCLUSIONS
  Our findings have inevitable limitations arising from methodological issues inherent in the meta-analysis and we could not explain high heterogeneity between studies. Despite such limitations, current study has the strength of being the first meta-analysis which tried to specify cognitive function of depressed patients compared with healthy participants. And our findings may provide clinicians with further evidences that some cognitive tests in specific cognitive domains have sensitivity to discriminate MDD patients from healthy controls.
authors.affiliation: Department of Psychiatry, Korea University Ansan Hospital, Ansan-shi, Gyeonggi-do, Republic of Korea.
authors.forename: JaeHyoung
authors.initials: J
authors.lastname: Lim
authors.forename: In Kyung
authors.initials: IK
authors.lastname: Oh
authors.forename: Changsu
authors.initials: C
authors.lastname: Han
authors.forename: Yu Jeong
authors.initials: YJ
authors.lastname: Huh
authors.forename: In-Kwa
authors.initials: IK
authors.lastname: Jung
authors.forename: Ashwin A
authors.initials: AA
authors.lastname: Patkar
authors.forename: David C
authors.initials: DC
authors.lastname: Steffens
authors.forename: Bo-Hyoung
authors.initials: BH
authors.lastname: Jang
mesh_terms: D001288:Attention; D016022:Case-Control Studies; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000523:psychology*; D003865:Major Depressive Disorder / Q000523:psychology*; D056344:Executive Function / Q000502:physiology*; D006801:Humans; D008568:Memory; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D012680:Sensitivity and Specificity