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Cited by 1,667Neural and Behavioral Psychology StudiesTreatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Major depressive disorder is associated with broad impairments on neuropsychological measures of executive function: A meta-analysis and review.

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Snyder, Hannah R.·2013·Psychological Bulletin
DOI 10.1037/a0028727PMC PMC3436964
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Abstract

Cognitive impairments are now widely acknowledged as an important aspect of major depressive disorder (MDD), and it has been proposed that executive function (EF) may be particularly impaired in patients with MDD. However, the existence and nature of EF impairments associated with depression remain strongly debated. Although many studies have found significant deficits associated with MDD on neuropsychological measures of EF, others have not, potentially due to low statistical power, task impurity, and diverse patient samples, and there have been no recent, comprehensive, meta-analyses investigating EF in patients with MDD. The current meta-analysis uses random-effects models to synthesize 113 previous research studies that compared participants with MDD to healthy control participants on at least one neuropsychological measure of EF. Results of the meta-analysis demonstrate that MDD is reliably associated with impaired performance on neuropsychological measures of EF, with effect sizes ranging from 0.32 to 0.97. Although patients with MDD also have slower processing speed, motor slowing alone cannot account for these results. In addition, some evidence suggests that deficits on neuropsychological measures of EF are greater in patients with more severe current depression symptoms, and those taking psychotropic medications, whereas evidence for effects of age was weaker. The results are consistent with the theory that MDD is associated with broad impairment in multiple aspects of EF. Implications for treatment of MDD and theories of EF are discussed. Future research is needed to establish the specificity and causal link between MDD and EF impairments.

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  • Most of the literature has generally found non-significant relationships between processing speed and internalizing disorders.

    “though most of the literature has generally found non-significant relationships9,34,58,59.”

    From Diagnostic Associations of Processing Speed in a Transdiagnostic, Pediatric Sample (2020) · cites this paper as [58]

    The Results section, “Processing Speed and Vocabulary,” reports significant processing-speed differences between patients with major depressive disorder and healthy controls, rather than generally non-significant findings. The Discussion likewise states that MDD is associated with slowed performance on processing-speed tasks. The paper addresses MDD, not internalizing disorders as a whole. (LLM, conf=0.82)

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  • Individuals with major depressive disorder exhibit non-specific cognitive deficits related to difficulty planning and slower processing speed.

    “Additionally, a recent meta-analysis noted that individuals with MDD exhibit non-specific cognitive deficits related to difficulty planning and slower processing speed (Snyder, 2013).”

    From Lisdexamfetamine Dimesylate Augmentation in Adults With Persistent Executive Dysfunction After Partial or Full Remission of Major Depressive Disorder (2014) · cites this paper as Snyder, 2013

    The Results sections on Planning and Processing Speed report poorer planning scores and slower processing-speed performance in patients with MDD than in healthy controls. However, the Discussion’s Conclusions and Future Directions section argues that motor slowing cannot account for the executive-function impairments and that the findings do not appear to reflect non-specific problems alone. The claim is supported for planning and speed, but not for characterizing the deficits as non-specific. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Both the present review and the Snyder meta-analysis suggest that MDD is associated with deficits across a wide range of cognitive domains.

    “Both publications suggest that MDD is associated with deficits across a wide range of cognitive domains”

    From Cognitive Effects of Pharmacotherapy for Major Depressive Disorder: A Systematic Review (2014) · cites this paper as [59]

    The Discussion section, “MDD is Associated with Broad Impairments on Neuropsychological Measures of EF” (page unavailable), reports impairments across all executive-function domains studied. The Results section, “Processing Speed and Vocabulary” (page unavailable), also reports slower processing speed, but only a very small vocabulary difference. The meta-analysis therefore supports deficits across executive-function domains and in processing speed, but does not establish deficits across a wide range of cognitive domains generally. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Both publications suggest that cognitive impairment may correlate with depressive symptom severity on some measures.

    “cognitive impairment may correlate with depressive symptom severity on some measures”

    From Cognitive Effects of Pharmacotherapy for Major Depressive Disorder: A Systematic Review (2014) · cites this paper as [59]

  • The categorization of neurocognitive tests offered in the Snyder meta-analysis sometimes differed from our own, indicating a need for greater understanding of and consensus on cognitive domains.

    “the categorization of neurocognitive tests offered in the meta-analysis sometimes differed from our own, again indicating the need for greater understanding of and consensus on the various domains of cognition”

    From Cognitive Effects of Pharmacotherapy for Major Depressive Disorder: A Systematic Review (2014) · cites this paper as [59]

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Authors
Snyder, H. R.
Affiliations
University of Colorado Boulder (US)
Corresponding author
Snyder, Hannah R.
ORCID
Snyder, Hannah R.
Venue
Psychological Bulletin
Publisher
American Psychological Association (APA)
Published
2013
Volume
139
Issue
1
Pages
81-132
ISSN
  • 0033-2909 (ISSN-L)
  • 1939-1455
DOI
10.1037/a0028727
PMC
PMC3436964
OpenAlex
W2093220018
Cited by
1,667
References
324
Citations by year
2026: 132 · 2025: 146 · 2024: 111 · 2023: 124 · 2022: 144 · 2021: 175 · 2020: 140 · 2019: 123 · 2018: 150 · 2017: 137 · 2016: 107 · 2015: 91 · 2014: 53 · 2013: 25 · 2012: 6
FWCI
28.63
Type
journal article
Language
en
Open access
Locations
  • Psychological Bulletin (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (F31-MH087073)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
major depressive disorder, executive function, cognitive impairment in depression, neuropsychological measures, processing speed, motor slowing, depression severity, age effects, depression treatment
MeSH terms
Cognition Disorders, Major Depressive Disorder, Humans, Neuropsychological Tests, Executive Function

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