Background. Although depressed patients demonstrate impaired
performance on a range of
neuropsychological tests, there is little research that examines either
frontal cognitive deficits or
possible differences in test performance between melancholic and non-melancholic
Methods. Depressed subjects were administered a broad neuropsychological
battery. In an overall
analysis, 77 depressed subjects were compared with 28 controls. In a second
set of analyses,
the depressed sample was divided into melancholic and non-melancholic subsets
DSM-III-R, the CORE system and the Newcastle scale. These depressed subsets
to controls and with each other using ANCOVA controlling for age, IQ, simple
reaction time and
Hamilton Depression scores where appropriate.
Results. The total depressed sample was impaired on most mnemonic
tasks, simple reaction time and
Trails B. Similar findings applied to DSM-III-R melancholic and non-melancholic
defined by the CORE and Newcastle (narrower definitions of melancholia),
were additionally impaired on WCST (perseverative response) and (for Newcastle)
substitution. In contrast, the cognitive performance of the CORE and Newcastle-defined
non-melancholic patients was largely unimpaired.
Conclusions. Using narrower definitions of melancholia, i.e.
CORE and (in particular) Newcastle,
melancholic patients were impaired on mnemonic tasks and tasks of selective
attention, and set-shifting while non-melancholic subjects were largely unimpaired in their
These differences may be due to impairment of specific neuroanatomical
regions in narrowly defined
melancholic patients, in particular the anterior cingulate.