Elsevier

Journal of Affective Disorders

Volume 220, 1 October 2017, Pages 79-85
Journal of Affective Disorders

Research paper
Prospective memory deficits in patients with depression: A meta-analysis

https://doi.org/10.1016/j.jad.2017.05.042Get rights and content

Highlights

  • Prospective memory (PM) is vulnerable to change in patients with psychiatric disorders including depression.

  • To date, 10 case-control studies on PM in depression have been published with inconsistent findings.

  • This meta-analysis showed that both TBPM and EBPM appeared to be impaired in patients with depression.

Abstract

Background

Prospective memory (PM) can be impaired in patients with psychiatric disorders including depression. This meta-analysis systematically examined PM in patients with depression.

Methods

The meta-analysis was conducted according to the guidelines from Strengthening the Reporting of Observational studies in Epidemiology (STROBE). Case-control studies on PM in patients with depression were included. Standardized mean differences (SMDs) and 95% confidence interval (CI) were calculated using random effect models.

Results

Ten case-control studies (n = 596) comparing patients with depression (n = 299) with healthy controls (n = 297) were included in the analyses. Compared with healthy controls, patients with depression had significant impairment in event-based PM (EBPM) [8 trials, n = 436; SMD: −0.87 (95%CI: −1.43, −0.31), P = 0.002; I2 = 87%]. Significance was observed after removing two outlier trials [SMD: −0.44 (95%CI: −0.69, −0.20), P = 0.0004; I2 = 23%] and also in 8 out of the 13 subgroup analyses. Similarly, time-based PM (TBPM) was significantly impaired in patients with depression [4 trials, n = 239; SMD: −0.89 (95%CI: −1.46, −0.31), P = 0.003; I2 = 78%] when compared with healthy controls.

Conclusions

This meta-analysis showed that both TBPM and EBPM appeared to be impaired in patients with depression.

Introduction

Cognitive impairment occurs in up to two-thirds of patients with depression (Afridi et al., 2011, Butters et al., 2004) including first-episode patients (Lee et al., 2012) and those in remission (Bora et al., 2013). Among the cognitive domains affected in depression, prospective memory (PM), defined as the ability of formation, maintenance and execution of future intentions (Kvavilashvili and Ellis, 1996), has gained increasing attention (Albinski et al., 2012). In contrast, retrospective memory (RM) is a form of memory that involves remembering past information (Burgess and Shallice, 1997).

PM involves encoding an intention, retaining the information, executing the intention and evaluating the outcome (Elvevag et al., 2003). PM includes the several subtypes according to the cues that trigger the execution of intention: time-based PM (TBPM) and event-based PM (EBPM). With a TBPM task, the individual remembers to perform an intention at a specific time in the future. In contrast, EBPM is triggered by an external event that serves as a reminder of a previously formed intention to be performed. In addition, a special PM subtype, activity-based PM (ABPM), has been described (Kvavilashvili and Ellis, 1996) which involves an external cue similar to EBPM, but the cue coincides with the end of an ongoing activity, thus does not interrupt of the activity, making it easy to perform. PM appears to be impaired in a number of neuropsychiatric disorders, such as schizophrenia (Liu et al., 2016; Zhou et al., 2012) and mood disorders (Lee et al., 2010).

Several brain areas are involved in PM process, particularly the prefrontal cortex (PFC) and the temporal cortex (Burgess et al., 2003, Okuda et al., 2007). Although both TBPM and EBPM require the activation of the prefrontal cortex (Okuda et al., 2007), the right polar prefrontal region is closely associated with TBPM tasks (Volle et al., 2011). Neurobiological dysfunction in these areas have also been implicated in depression. There is evidence that projections from the amygdala to anterior cingulate cortex (ACC) and also to PFC are impaired in depression (Davidson et al., 2002, Elliott et al., 1997). Altered PFC activation (Harvey et al., 2005, Wagner et al., 2006) as well as volumetric reduction in the gray matter of PFC (Botteron et al., 2002) have been associated with depression. Neural circuits involving these brain areas are likely to be involved in PM (Volle et al., 2011) and may act as an integrated circuit during PM tasks (Churchwell and Kesner, 2011, Goto and Grace, 2008). Therefore, PM deficit may arise from the functional dysconnectivity in these neural circuits (Greicius et al., 2007, Zeng et al., 2012). Although several previous reviews have described the neuropsychological changes in depression (Bosaipo et al., 2016, Vives et al., 2015), none have covered cognitive functions that reflect functional connectivity.

To date, 10 case-control studies on PM in depression have been published with inconsistent findings; six studies examined TBPM (Albinski et al., 2012, Li et al., 2013, Liu et al., 2013, Rude et al., 1999, Wang et al., 2009, Wang et al., 2012), eight studies examined EBPM (Altgassen et al., 2011, Altgassen et al., 2009, Chen et al., 2013, Li et al., 2013, Liu et al., 2013, Wang et al., 2012, Zhang and He, 2009) and four studies examined both PM types (Li et al., 2013, Liu et al., 2013, Wang et al., 2009, Wang et al., 2012).

A thorough search of the literature could not locate any systematic review or meta-analysis specifically examining PM in depression, which gave the impetus to conduct a comprehensive meta-analysis of PM in depression. Both English- and Chinese-language databases were included since the latter could not be readily accessed by the international readership.

Section snippets

Search strategy and selection criteria

This meta-analysis was conducted according to the guidelines of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) (Elm et al., 2007). A systematic review was performed covering English (PubMed, PsycINFO, Embase, Cochrane Library databases) and Chinese databases (WanFang, Chinese Biomedical and China Journal Net databases) from their inception until Nov 4, 2016 with search items listed as follows: ("prospective memory"[All Fields] OR "prospective memories"[All

Results of the search

The original search from the above databases yielded 139 electronic records (Fig. 1). Finally, 10 eligible case-control studies, including 5 published in English (Albinski et al., 2012, Altgassen et al., 2011, Altgassen et al., 2009, Li et al., 2013, Rude et al., 1999) and 5 in Chinese (Chen et al., 2013, Liu et al., 2013, Wang et al., 2009, Wang et al., 2012, Zhang and He, 2009) were included in the analysis.

Study characteristics

Ten case-control studies (n = 596) compared patients with depression (n=299) and

Discussion

To the best of our knowledge, this was the first meta-analysis (10 trials, n = 596) that examined PM in patients with depression. The main finding is that compared to controls both TBPM and EBPM were significantly impaired in depression. The result is consistent with the emotion-cognition interaction theory of depression; i.e., depressive mood having a substantial influence on memory performance by reducing the initiative to control attentional resources when performing a task (Hertel, 1994,

Role of funding

The study was supported by the University of Macau (SRG2014-00019-FHS; MYRG2015-00230-FHS; MYRG2016-00005-FHS).

Contributors

Study design: Fu-Chun Zhou, Yu-Tao Xiang. Data collection, analysis and interpretation: Fu-Chun Zhou, Yuan-Yuan Wang, Wei Zheng, Yu-Tao Xiang. Drafting of the manuscript: Fu-Chun Zhou, Yuan-Yuan Wang, Wei Zheng, Qinge Zhang, Yu-Tao Xiang. Critical revision of the manuscript: Gabor S. Ungvari, Chee H. Ng, Juan Zhang. Approval of the final version for publication: all co-authors.

Conflict of interest

There is no conflict of interest concerning the authors in conducting this study and preparing the manuscript.

Acknowledgments

The study was supported by the University of Macau (SRG2014-00019-FHS; MYRG2015-00230-FHS; MYRG2016-00005-FHS). The University of Macau had no role in the study design, generating or interpreting the results and publication of the study.

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