A meta-analysis of cognitive performance in melancholic versus non-melancholic unipolar depression

J Affect Disord. 2016 Sep 1:201:15-24. doi: 10.1016/j.jad.2016.04.039. Epub 2016 Apr 21.


Background: Recently there is increasing recognition of cognitive dysfunction as a core feature of Major Depressive Disorder (MDD). The goal of the current meta-analysis was to review and examine in detail the specific features of cognitive dysfunction in Melancholic (MEL) versus Non-Melancholic (NMEL) MDD.

Methods: An electronic literature search was performed to find studies comparing cognitive performance in MEL versus NMEL. A meta-analysis of broad cognitive domains (processing speed, reasoning/problem solving, verbal learning, visual learning, attention/working memory) was conducted on all included studies (n=9). Sensitivity and meta-regression analyses were also conducted to detect possible effects of moderator variables (age, gender, education, symptom severity and presence of treatments).

Results: MEL patients were older and more severly depressed than NMEL subjects. The MEL group was characterized by a worse cognitive performance in attention/working memory (ES=-0.31), visual learning (ES=-0.35) and reasoning/problem solving (ES=-0.46). No difference was detected in drug-free patients by sensitivity analyses. No effect was found for any of our moderators on the cognitive performance in MEL vs NMEL.

Conclusion: Our findings seem to support a moderate but specific effect of melancholic features in affecting the cognitive performance of MDD, in particular as regards visual learning and executive functions.

Keywords: Cognitive; Depressive disorder; Major depression; Melancholic; Neuropsychology.

Publication types

  • Meta-Analysis

MeSH terms

  • Adult
  • Cognition Disorders / complications*
  • Cognition Disorders / physiopathology
  • Cognition Disorders / psychology*
  • Depressive Disorder, Major / complications*
  • Depressive Disorder, Major / physiopathology
  • Depressive Disorder, Major / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests