Major Depression - neuropsychologische und immunologische Aspekte eines heterogenen Störungsbildes

Major Depression (MD) is a heterogeneous disorder associated with neuropsychological and immunological features. The present cumulative dissertation including three peer-reviewed articles addresses different symptom-dimensions of major depression, potential causes and therapeutic approaches. In article I “Childhood adversity and cognitive functioning in patients with major depression“ we examined the potential association between early adversities and cognitive and executive functioning in patients with MD. Although Major depression is often accompanied by deficits in cognitive functioning and lowered executive functions, not all depressed patients show impairments in these domains. The present study suggests that the overall number of traumas of depressive patients was significantly associated with poorer general knowledge, lower processing speed and impaired executive functions. Particularly an association between physical neglect and poorer verbal learning, and physical abuse and diminished executive functions was assumed. Article II „Cognitive behavioral therapy improves recognition memory in major depression: Results of a randomized controlled trial” examined whether cognitive behavioral therapy (CBT) improves verbal learning and memory in patients with MD. A second aim was to learn whether emphasizing physical exercise during behavioral activation has additional effects on verbal performance. When compared to a waiting list control group, CBT emphasizing exercise during behavioral activation and CBT with pleasurable low-energy activities as an active control condition were associated not only with reduced depressive symptom severity but also with improved recognition memory after treatment. These results contradict in part previous assumptions that cognitive impairments persists despite depressive symptom reduction. Article III titled “The predictive value of somatic and cognitive depressive symptoms for cytokine changes in patients with major depression” suggests that ‘‘cognitive-affective’’ and ‘‘somatic’’ symptom-dimensions are differently related to im-mune function in patients with Major Depression. Our results indicate that higher somato-form symptoms during the last 2 years might predict an increase in TNF-alpha in women with major depression. A subtype of MD, associated with especially somatic symptoms might be hypothesized.