Cognitive mechanisms underlying depressive disorders in ADHD: A systematic review

Jutta S Mayer, Anka Bernhard, Nikola Fann, Sara Boxhoorn, Catharina A Hartman, Andreas Reif, Christine M Freitag

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Abstract

The risk for major depressive disorder (MDD) is considerably increased in young adults with attention-deficit/hyperactivity disorder (ADHD) but underlying mechanisms are poorly understood. This review explores ADHD-specific neurocognitive impairments as possible underlying mechanisms for ADHD-depression comorbidity. Two systematic literature searches were conducted in EBSCOhost, PubMED, and Cochrane Reviews databases according to PRISMA guidelines. The first search identified 18 meta-analyses of cross-sectional and longitudinal studies on cognitive dysfunctions in MDD across the lifespan. The second search identified six original studies on reaction time variability in MDD. During acute depression, children and adults showed cognitive deficits that overlapped with some of the ADHD-related impairments. Findings from remitted patients, high-risk individuals, and few prospective studies suggest that a subset of these shared impairments, specifically executive dysfunctions (selective attention, verbal fluency, working memory) and long-term memory problems, are candidate pre-existing risk markers of depression. We discuss if and how these specific neurocognitive mechanisms may mediate developmental pathways from ADHD to depression. If replicated by longitudinal studies, these findings may guide future prevention strategies.

Original languageEnglish
Pages (from-to)307-345
Number of pages39
JournalNeuroscience and Biobehavioral Reviews
Volume121
Early online date23-Dec-2020
DOIs
Publication statusPublished - Feb-2021

Keywords

  • Attention-deficit/hyperactivity disorder
  • ADHD
  • Major depressive disorder
  • Comorbidity
  • Cognitive
  • Executive functions
  • Non-executive functions
  • Lifespan
  • Meta-analysis
  • ATTENTION-DEFICIT/HYPERACTIVITY DISORDER
  • DEFICIT HYPERACTIVITY DISORDER
  • REACTION-TIME VARIABILITY
  • EXECUTIVE FUNCTIONS
  • EMOTION REGULATION
  • ADULT ADHD
  • PSYCHIATRIC-DISORDERS
  • MENTAL-DISORDERS
  • FUNCTIONAL IMPAIRMENT
  • WORLDWIDE PREVALENCE

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