The Mental Status Examination in Neurology

Abstract

Despite awareness that depression may affect performance on commonly used neuropsychological tests, little research has been conducted on the relative impact of severity and type of depression o n higher problem-solving ability. Major depressives (n = 13), dysthymics (n = 17), and non-psychiatric comparison subjects (n = 18) were administered the Wisconsin Card Sorting Test (WCST). Although diagnostic category was related only marginally to some WCST measures after controlling for intellectual function, depressive symptom severity emerged as an independent predictor of Total Errors, Perseverative Responses, and Failure to Maintain Set. These findings lend support to the suggestion that neuropsychological test batteries should include assessment for depression and suggest that even relatively mild depression may affect WCST scores. A major concern in the practice of clinical neuropsychology is the effect of depression on cognition. Clinicians frequently must judge the degree to which observed cognitive deficits on neuropsychological tests reflect only neurological conditions, neurological conditions complicated by coexistent depression, or only depression. The effects of depression on tests of memory, attention, mental processing speed, language, and motor dexterity and praxis have received some attention (cf. Caine, 1986), but relatively little research has been published on the impact of depression on higher problem-solving tasks, also referred to as "executive" or "frontal lobe" tests. Diminished performance in