Decision-making cognition in mania and depression

Murphy, Fionnuala C.; Rubinsztein, Judy S.; Michael, A.; Rogers, Robert D.; Robbins, Trevor W.; Paykel, Eugene S.; Sahakian, Barbara J.

doi:10.1017/s0033291701003804

Cited by 295 publications

(221 citation statements)

References 70 publications

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“…While deficits in more standard tests of cognitive functioning (motor function, memory, planning) do not appear to be specific for manic episodes and do not provide a significant means of differentiating between, eg mania and depression (Martinez-Aran et al, 2004;Quraishi and Frangou, 2002), tasks of decision making or response inhibition seem to be suitable to identify impairments specific to manic episodes (Murphy et al, 2001;Murphy et al, 1999).…”

Section: Outcomementioning

confidence: 95%

“…In healthy subjects, such expectation signals are believed to help prepare for upcoming events and support decision making and planning processes. Dysfunctions of expectation signals could therefore help to explain the observation (Murphy et al, 2001) that manic patients tend to make suboptimal, often disadvantageous, decisions.…”

Section: Expectation Phasementioning

confidence: 99%

“…This deficit in prediction error monitoring is in line with previous findings in bipolar disorder. For example, manic patients make suboptimal decisions in the Cambridge Decision Making Task and this deficit correlates positively with the clinical severity of mania (Murphy et al, 2001). When manic patients performed this task during PET scanning, they showed abnormal brain activation in dorsal anterior cingulate, frontal polar, and right inferior frontal cortical regions, with anterior cingulate activation being predicted by the severity of manic symptoms ).…”

Section: Outcomementioning

confidence: 99%

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Abnormal Reward System Activation in Mania

Abler

Greenhouse

Öngür

et al. 2007

Neuropsychopharmacol

198

137

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Transmission of reward signals is a function of dopamine, a neurotransmitter known to be involved in the mechanism of psychosis. Using functional magnetic resonance imaging (fMRI), we investigated how expectation and receipt of monetary rewards modulate brain activation in patients with bipolar mania and schizophrenia. We studied 12 acutely manic patients with a history of bipolar disorder, 12 patients with a current episode of schizoaffective disorder or schizophrenia and 12 healthy subjects. All patients were treated with dopamine antagonists at the time of the study. Subjects performed a delayed incentive paradigm with monetary reward in the scanner that allowed for investigating effects of expectation, receipt, and omission of rewards. Patients with schizophrenia and healthy control subjects showed the expected activation of dopaminergic brain areas, that is, ventral tegmentum activation upon expectation of monetary rewards and nucleus accumbens activation during receipt vs omission of rewards. In manic patients, however, we did not find a similar pattern of brain activation and the differential signal in the nucleus accumbens upon receipt vs omission of rewards was significantly lower compared to the healthy control subjects. Our findings provide evidence for abnormal function of the dopamine system during receipt or omission of expected rewards in bipolar disorder. These deficits in prediction error processing in acute mania may help to explain symptoms of disinhibition and abnormal goal pursuit regulation.

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Section: Outcomementioning

confidence: 95%

Section: Expectation Phasementioning

confidence: 99%

Section: Outcomementioning

confidence: 99%

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Abnormal Reward System Activation in Mania

Abler

Greenhouse

Öngür

et al. 2007

Neuropsychopharmacol

198

137

View full text Add to dashboard Cite

show abstract

“…Indeed, pronounced deficits in verbal learning, recall and recognition were found only in major depression patients with melancholia compared both with controls and major depression patients without melancholia (Austin et al 1999). Patients with major depression also have widespread executive dysfunctions, including working memory, set-shifting and inhibition processes, even during the euthymic state (Elliott et al 1998;Murphy et al 2001;Harvey et al 2004). Several studies have reported that depressed patients are impaired on verbal fluency tasks (Landro et al 2001;Moritz et al 2002;Ravnkilde et al 2002), Trail Making Tests (Austin et al 1999;Grant et al 2001;Moritz et al 2002), Wisconsin Card Sorting Test (Ilonen et al 2000;Grant et al 2001;Moritz et al 2002), and on the Tower of London task (Beats et al 1996;Elliott et al 1996).…”

Section: Cognitive Deficits In Major Depressionmentioning

confidence: 99%

Consensus paper of the WFSBP Task Force on Biological Markers: Biological Markers in Depression

Mößner

Mikova

Koutsilieri

et al. 2007

The World Journal of Biological Psychiatry

227

126

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Biological markers for depression are of great interest to aid in elucidating the causes of major depression. We assess currently available biological markers to query their validity for aiding in the diagnosis of major depression. We specifically focus on neurotrophic factors, serotonergic markers, biochemical markers, immunological markers, neuroimaging, neurophysiological findings, and neuropsychological markers. We delineate the most robust biological markers of major depression. These include decreased platelet imipramine binding, decreased 5-HT1A receptor expression, increase of soluble interleukin-2 receptor and interleukin-6 in serum, decreased brain-derived neurotrophic factor in serum, hypocholesterolemia, low blood folate levels, and impaired suppression of the dexamethasone suppression test. To date, however, none of these markers are sufficiently specific to contribute to the diagnosis of major depression. Thus, with regard to new diagnostic manuals such as DSM-V and ICD-11 which are currently assessing whether biological markers may be included in diagnostic criteria, no biological markers for major depression are currently available for inclusion in the diagnostic criteria.

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“…During the task subjects are required to decide which of two outcomes is most likely and to then bet a proportion of their current points total on this decision. Both manic and MDD medicated subjects had slower deliberation times and made more conservative bets at the most favourable odds ratios than healthy controls (Murphy et al 2001). Manic patients, unlike patients with MDD, also made suboptimal decisions, being more likely than controls to select the less likely of the two outcomes.…”

Section: Executive Functionmentioning

confidence: 99%

Cognition in mania and depression

Tavares¹,

Drevets²,

Sahakian³

2003

Psychol. Med.

Self Cite

100

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The inclusion of cognitive symptoms in the DSM-IV criteria for major depressive and manic episodes highlight the importance of cognition in both of these psychiatric disorders (American Psychiatric Association, 1994). For example, criteria for diagnosis of these conditions include a diminished ability to concentrate and indecisiveness. In addition, numerous studies have demonstrated wide-ranging cognitive deficits in depression (for example Elliott et al. 1996; Purcell et al. 1997; Murphy et al. 2003) and mania (Goldberg et al. 1993; Murphy et al. 1999, 2001; Sweeney et al. 2000). These include deficits in early information processing (Tsourtos et al. 2002), recollection memory (MacQueen et al. 2002) and planning (Elliott et al. 1996) as well as affective biases (Murphy et al. 1999) and abnormal responses to negative feedback (Elliott et al. 1996, 1997; Murphy et al. 2003). Some residual deficits are also evident in a proportion of remitted subjects, even when controlling for mood (for example, Clark et al. 2002).

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Decision-making cognition in mania and depression

Cited by 295 publications

References 70 publications

Abnormal Reward System Activation in Mania

Abnormal Reward System Activation in Mania

Consensus paper of the WFSBP Task Force on Biological Markers: Biological Markers in Depression

Cognition in mania and depression

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