Abstract

Objectives

Decision making (DM) is a component of executive functioning, essential for choosing appropriate decisions. Executive dysfunctioning is particularly common in late-life depression, however the literature is scarce on DM. This case-control study aimed to evaluate the DM profile and performance in participants with and without unipolar major depression.

Method

The DM profile and performance were assessed by the Melbourne Decision Making Questionnaire and the Iowa Gambling Task (IGT), respectively, in three groups of older adults from a university-based geriatric psychiatry clinic, i.e. current depression (n = 30), remitted depression (n = 43) and healthy controls (n = 59). The Hamilton Depression scale (HAM-D) 21 items, the Hamilton Anxiety scale, and the Mini-Mental State Examination were used to access depressive symptoms, anxiety symptoms, and cognitive impairment, respectively. Multinomial, nominal and binary logistic regression was used to evaluate the associations between depression, depressive symptomatology and DM.

Results

In comparison to the control group, patients with current depression presented higher scores in buck-passing and proscratination DM profiles. In the hypervigilance profile, there was a significant difference between current and remitted depression groups. A higher value ​in the HAM-D scale increased the probability of disadvantageous DM profiles. Depressive patients showed a tendency of a higher mean score in both disadvantageous decks (A and B) of IGT. Patients with current depression showed a worse performance compared to the remitted depression group in the IGT netscore.

Conclusion

Older adults with current depression showed DM profiles considered maladaptive or disadvantageous compared to both remitted depression and healthy controls groups.

中文翻译：

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患有重度抑郁症的老年人的决策执行功能概况和表现：一项病例对照研究

摘要

目标

决策 (DM) 是执行功能的一个组成部分，对于选择适当的决策至关重要。执行功能障碍在晚年抑郁症中尤为常见，但关于 DM 的文献很少。这项病例对照研究旨在评估患有和不患有单相重性抑郁症的参与者的 DM 特征和表现。

方法

DM 概况和表现分别通过墨尔本决策问卷和爱荷华赌博任务 (IGT) 在来自大学老年精神病学诊所的三组老年人中进行评估，即当前抑郁症 ( n  = 30)、缓解抑郁症( n  = 43) 和健康对照组 ( n  = 59)。汉密尔顿抑郁量表 (HAM-D) 21 项、汉密尔顿焦虑量表和简易精神状态检查分别用于评估抑郁症状、焦虑症状和认知障碍。多项式、名义式和二元逻辑回归用于评估抑郁症、抑郁症状学和 DM 之间的关联。

结果

与对照组相比，目前患有抑郁症的患者在降压和拖延 DM 特征方面的得分更高。在高度警惕的情况下，当前和缓解的抑郁症组之间存在显着差异。HAM-D 量表中的较高值增加了不利的 DM 配置文件的概率。抑郁症患者在 IGT 的两个不利牌组（A 和 B）中均表现出更高的平均得分趋势。在 IGT 网络评分中，与抑郁症缓解组相比，当前抑郁症患者的表现更差。

结论

与缓解抑郁症和健康对照组相比，患有当前抑郁症的老年人表现出被认为适应不良或不利的 DM 特征。