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Fortschr Neurol Psychiatr 2000; 68(1): 1-11
DOI: 10.1055/s-2000-11640
ORIGINALARBEIT
Georg Thieme Verlag Stuttgart ·New York

Neuropsychologische Defizite bei depressiven Störungen

Neuropsychological Deficits in Depressive Disorders:T. Beblo, M. Herrmann
  • Sektion Neuropsychologie, Otto-von-Guericke-Universität, Magdeburg (Leiter: PD Dr. med. Dr. phil. M. Herrmann)
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Publication History

Publication Date:
31 December 2000 (online)

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Zusammenfassung:

Neuropsychologische Beeinträchtigungen sind ein wesentliches Merkmal depressiver Störungen, welches sowohl differentialdiagnostisch als auch im Kontext der Pathophysiologie von depressiven Erkrankungen relevant sein kann. Wir berichten in dieser Übersichtsarbeit über Studien, die vorwiegend auf Gedächtnisdefizite aber auch auf „frontalhirn-assoziierte Funktionen”, wie Aufmerksamkeitsleistungen und exekutive Funktionen, fokussieren. Trotz z. T. heterogener Daten scheint sich zwischenzeitlich abzuzeichnen, daß exekutive Funktionen und Neugedächtnisleistungen herausragend stark beeinträchtigt sind. Nicht alle depressiven Patienten scheinen dabei von neuropsychologischen Defiziten betroffen zu sein, wobei hier Moderatorvariablen eine besondere Bedeutung zukommt. Wir diskutieren als mögliche intervenierende Variablen [[1]] die Schwere und Remission der depressiven Störung, [[2]] Alter der Patienten und Alter bei Erstmanifestation der depressiven Erkrankung, [[3]] psychologische Faktoren wie Motivation und Verarbeitung von Mißerfolg, [[4]] Art und Effekt der antidepressiven Medikation, [[5]] Dauer der Hospitalisierung, [[6]] Anzahl depressiver Episoden und [[7]] das Geschlecht der Patienten. Kontrovers diskutiert wird weiterhin die Auffassung einer fronto-striatalen Dysfunktion bei depressiven Störungen, wobei die Mehrheit der neuropsychologischen Befunde diese Theorie zur Pathophysiologie depressiver Störungen stützt.

Neuropsychological deficits are considered a significant feature of depression both for their differential value in the diagnostics and the underlying pathophysiology of depressive disorders. The studies reviewed in the present paper predominantly focus on memory disorders as well as frontal-lobe associated dysfunctions such as deficits of attentional performance and executive functions. Despite heterogenous results in the literature, there is emerging evidence that executive functions and anterograde memory performance are those domains predominantly affected in depressive disorders. The fact that not all depressive patients display neuropsychological deficits rather indicates a dominant role of moderating variables. We discuss the following variables possibly intervening with type and degree of neuropsychological dysfunction: [[1]] severity and remission of depressive disorders, [[2]] age of patients and age at the first manifestation of a depressive disorder, [[3]] psychological factors such as motivation and coping with failure, [[4]] type and efficacy of antidepressive drug treatment, [[5]] duration of the stay as inpatients, [[6]] number of depressive episodes, and [[7]] gender. Furthermore, we discuss the theory of a dysfunction of fronto-striatal circuits as an underlying mechanism of depressive disorders. The majority of neuropsychological findings seem to support this theory.

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phil. Dr. Dr. med. Priv.-Doz. Manfred Herrmann

Sektion Neuropsychologie mit neuropsychologischer undverhaltensneurologischer Poliklinik

Otto-von-Guericke-Universität Magdeburg

Leipziger Str. 44

D-39120 Magdeburg

Email: manfred.herrmann@medizin-uni-magdeburg.de

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