Cognitive impairment in the euthymic phase of chronic unipolar depression.

Cognitive functioning in the nonsymptomatic phase and the long-term cognitive outcome of patients with mood disorders are both heuristic and important clinical issues in the study of mood disorders. Literature findings are inconsistent because of design confounds. We tried to address these issues while controlling for several confounds including age, education, gender differences in neurobehavioral functioning, and diagnosis. Nonsymptomatic patients with a history of chronic unipolar depression and bipolar affective disorder and healthy male individuals were administered neuropsychological tests to assess attention, visual-motor tracking, executive abilities, and immediate verbal memory. Subjects had comparable depression scores at the time of testing. Disease duration was 7.5 years (SD 5.1) for unipolar and 11 years (SD 7.3) for bipolar patients. Unipolar patients were more impaired than healthy normal comparison subjects on measures of visual-motor sequencing (Trail Making Test A, p < .05), executive function (Trail Making Test B, Stroop Test Color/Word Trial, p < .05), and immediate memory and attention (CERAD 1st trial, WAIS Digit Symbol subtest, p < .05). Differences between bipolar patients and normal comparison subjects did not reach significance in any of the selected measures. Male patients with a history of chronic unipolar disorder are at risk for cognitive impairment in the nonsymptomatic phase of their disease. Cognitive disturbance is the type seen with prefrontal dysfunction and may be assessed with standard neuropsychological assessments.

Clinical utility of the CERAD word list memory test.

The word list memory test from the Consortium to establish a registry for Alzheimer's disease (CERAD) neuropsychological battery (Morris et al. 1989) was administered to 230 psychiatric outpatients. Performance of a selected, age-matched psychiatric group and normal controls was compared using an ANCOVA design with education as a covariate. Results indicated that controls performed better than psychiatric patients on most learning and recall indices. The exception to this was the savings index that has been found to be sensitive to the effects of progressive dementias. The current data are compared and integrated with published CERAD data for Alzheimer's disease patients. The CERAD list memory test is recommended as a brief, efficient, and sensitive memory measure that can be used with a range of difficult patients.

Evidence for a verbal deficit in alexithymia.

This study examined the relationship between alexithymia and specific domains of cognitive function. Fifty-nine neurologically intact combat veterans completed the Toronto Alexithymia Scale (TAS), a number of other symptom measures, and several neuropsychological tests. Modest but consistent correlations were noted between TAS scores and measures of developmental verbal ability. These relationships were not observed between the neuropsychological variables and the other symptom measures. Results suggest that poorly developed verbal ability may relate to the presence of primary alexithymia, irrespective of secondary etiologic factors.

Distinguishing between depression and dementia in the elderly: a review of neuropsychological findings.

Distinguishing between cognitive deficits seen in depression and progressive dementing, diseases is complex and often difficult clinically. We review recent neuropsychological studies comparing normal elderly individuals, depressed patients, and patients with progressive dementias. Findings from these studies suggest that the distinction between depression and dementia is fairly straightforward and facilitated by neuropsychological evaluation. Data from neuroimaging studies of depressed elderly are reviewed and integrated with the neuropsychological findings. A descriptive scheme for categorizing elderly patients is proposed. It is suggested that the label "pseudodementia" be discarded in favor of more thorough description of cognitive deficits associated with various clinical presentations.

Posttrial treatment with ethanol enhances recall of prose narratives.

A small number of studies have examined the effects of postlearning alcohol intoxication on memory for various materials. In contrast to most research examining the effects of alcohol on human memory, these studies demonstrated a facilitation of memory for information learned prior to intoxication. The present study was designed to examine the effects of alcohol on memory for two different kinds of materials. Standard word lists and narrative prose passages were employed to obtain a more detailed picture of the effects of posttrial intoxication with alcohol on memory. Intoxication with alcohol did not affect subject's ability to recall simple word lists. However, recall of prose passages was facilitated to a statistically significant degree. Results are discussed within the context of a current theory of retrograde facilitation of memory via various drugs/substances.