Verbal Memory Performance in Depressed Children and Adolescents: Associations with EPA but Not DHA and Depression Severity
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Instruments
2.2.1. Sociodemographic Variables
2.2.2. Independent Variables
Severity of Depression (CDRS-R)
EPA and DHA Statuses
2.2.3. Outcome Variables
Cognitive Tests—Memory
- Verbal Memory: VLMTWe used a validated German version (Verbaler Lern- und Merkfähigkeitstest (VLMT) [88]) of the Auditory Verbal Learning Test (AVLT) [89], in which a list of 15 semantically independent words is presented auditorily to an individual and he or she is asked to remember and reproduce as many words as possible. This process is repeated five times. Then, a second list of 15 words (= interference list (I)) is presented and the individual is asked to remember and reproduce as many words as possible from the second list. In the next step, the individual is asked to reproduce the words from the first list. After 20–30 min, he or she is once again asked to reproduce the first list of words. In the last step, the individual is asked to recognize the words from a list of 50 semantically or phonetically related and unrelated words. The test measures declarative verbal memory capacity. Short-term verbal memory is characterized by the number of words correctly reproduced by the individual in each of the five rounds (T1, T2, T3, T4, and T5). The long-term memory parameters are T7, which is the number of words from the first list recalled after 20–30 min, and T5–T7, which is the difference between the number of words recalled at T5 and T7. The interference score is I, which represents the number of correctly reproduced words from the interference list, T6, which is the number of words from the first list recalled after interference, and T5–6, which is the difference between the number of words reproduced from the first list before and after interference. Lastly, recognition (W) is the number of words correctly identified as belonging to the first list, and W–F is the correctly identified words minus the words wrongly attributed to the first list.
- Numeric Memory: WISC-IV Digit SpanThe digit span subtest from the Wechsler Intelligence Scale for Children—Fourth Edition (WISC-IV) [90] consists of two parts, namely, forward and backward. In the first part, the individual has to reproduce sequences of digits of increasing length. In the second part, the individual is instructed to repeat a sequence of digits in reverse order. The test measures numeric short-term memory and working memory.
2.2.4. Control Variables
IQ: Reynolds Intellectual Assessment Scales and Screening (RIAS)
C-Reactive Protein (CRP)
Body Mass Index (BMI)
2.3. Statistical Analysis
3. Results
3.1. Descriptive Statistics
3.2. Main Analysis—EPA Status and Depression Severity in Relation to Memory
3.3. Main Analysis—DHA Status and Depression Severity in Relation to Memory
4. Discussion
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Sample Characteristics | Variable Specifics | n | M (SD) | Min | Max | Moderate Depression M (SD) | Severe Depression M (SD) | t/χ2/U | p |
---|---|---|---|---|---|---|---|---|---|
Sociodemographic information | Age | 107 | 15.50 (1.89) | 8.67 | 18.00 | 15.25 (2.09) | 15.85 (1.51) | −1.630 | 0.106 |
Sex: %female | 107 | 67% | 57% | 82% | 7.166 | 0.007 ** | |||
Physiological parameters | BMI | 99 | 22.35 (4.87) | 14.00 | 39.80 | 21.86 (4.35) | 23.06 (5.52) | 1285.0 | 0.454 |
CRP | 105 | 0.79 (1.26) | 0 | 6.6 | 0.65 (0.81) | 0.99 (1.69) | 1220.0 | 0.410 | |
IQ | |||||||||
RIAS | VIX | 100 | 101.73 (9.93) | 79 | 129 | 102.58 (10.18) | 100.51(9.61) | 1.019 | 0.102 |
NIX | 100 | 106.33 (8.93) | 70 | 123 | 107.71 (8.61) | 104.34 (9.12) | 1.879 | 0.310 | |
GIX | 100 | 104.52 (9.35) | 76 | 128 | 105.78 (9.32) | 102.68 (9.21) | 1.651 | 0.102 | |
Depression severity | |||||||||
CDRS-R | Total score | 107 | 57.73 (7.76) | 42 | 79 | 52.37 (4.18) | 65.41 (4.54) | −15.331 | <0.001 *** |
Severe % a | 44 | 41.1% | - | - | - | - | |||
Course of illness | |||||||||
Mean duration of depression (months) | Months | 104 | 14.71 (11.69) | 1 | 84 | 13.45 (9.76) | 16.43 (13.84) | 1503.0 | 0.228 |
Total number of episodes | 105 | 1.46 (0.95) | 1 | 8 | 1.44 (1.10) | 1.48 (0.70) | 1490.0 | 0.230 | |
Recurrent depression | Yes | 104 | 31% | 26% | 38% | 1.775 | 0.183 | ||
Use of antidepressant medication | Yes | 102 | 37% | 35% | 40% | 0.317 | 0.573 |
Total | Moderate MDD (n = 63) | Severe MDD (n = 44) | t | p | |
---|---|---|---|---|---|
Fatty acid | M (SD) | M (SD) | M (SD) | ||
EPA | 0.49 (0.15) | 0.47 (0.14) | 0.51 (0.16) | −1.515 | 0.133 |
DHA | 3.63 (0.79) | 3.50 (0.71) | 3.82 (0.87) | −2.077 | 0.040 * |
All n-6 | 34.37 (1.32) | 34.45 (1.26) | 34.32 (1.40) | 0.512 | 0.609 |
All n-3 | 6.45 (1.0) | 6.26 (0.93) | 6.71 (1.06) | −2.318 | 0.022 * |
AA/EPA | 35.10 (11.27) | 36.08 (11.21) | 33.74 (11.60) | 1.045 | 0.298 |
MANCOVA EPA status (EPA) Depression Severity (S) Interaction Severity * EPA Status (I) Covariate: Gender (G) | ||||||||
---|---|---|---|---|---|---|---|---|
VLMT short-term memory parameters | EPA: F(10,194) = 2.094, p = 0.027 *, ηp2 = 0.097 S: F(5,96) = 0.622, p = 0.684, ηp2 = 0.031 I: F(10,194) = 0.910, p = 0.525, ηp2 = 0.045 G: F(5,96) = 1.287, p = 0.276, ηp2 = 0.063 | |||||||
Moderate depression N = 63 M (SD) | Severe depression N = 44 M (SD) | F p ηp2 | Pairwise | p | ||||
EPA | S | I | G | |||||
T1 score | ||||||||
Low EPA | 6.52 (0.33) | 6.55 (0.53) | 1.044 | 0.816 | 0.415 | 0.6 | NS | NS |
Moderate EPA | 7.00 (0.35) | 6.29 (0.46) | 0.356 | 9.369 | 0.661 | 0.44 | ||
High EPA | 7.11 (0.40) | 7.06 (0.42) | 0.02 | 0.008 | 0.008 | 0.006 | ||
T2 score | ||||||||
Low EPA | 9.74 (0.52) | 8.91 (0.69) | 6.096 | 1.577 | 2.03 | 0 | EPA: h > m EPA: h > l | p = 0.009 ** p = 0.010 * |
Moderate EPA | 10.14 (0.56) | 8.71 (0.46) | 0.003 * | 0.212 | 0.137 | 0.997 | ||
High EPA | 10.67 (0.26) | 11.25 (0.44) | 0.109 | 0.016 | 0.039 | 0 | ||
T3 score | ||||||||
Low EPA | 11.43 (0.40) | 10.36 (0.64) | 4.825 | 1.674 | 1.366 | 2.47 | EPA: h > m EPA: h > l | p = 0.027 * p = 0.023 * |
Moderate EPA | 11.27 (0.52) | 10.71 (0.45) | 0.010 ° | 0.199 | 0.26 | 0.119 | ||
High EPA | 11.94 (0.38) | 12.50 (0.52) | 0.088 | 0.016 | 0.027 | 0.024 | ||
T4 score | ||||||||
Low EPA | 12.17 (0.38) | 10.91 (0.64) | 2.652 | 0.944 | 0.082 | 3.069 | NS | NS |
Moderate EPA | 12.32 (0.50) | 11.88 (0.70) | 0.075 | 0.334 | 0.921 | 0.083 | ||
High EPA | 13.00 (0.33) | 13.06 (0.42) | 0.05 | 0.009 | 0.002 | 0.03 | ||
T5 score | ||||||||
Low EPA | 12.57 (0.38) | 12.55 (0.51) | 0.41 | 0.103 | 0.059 | 2.101 | NS | NS |
Moderate EPA | 12.32 (0.50) | 12.18 (0.58) | 0.665 | 0.749 | 0.942 | 0.15 | ||
High EPA | 12.50 (0.41) | 12.75 (0.37) | 0.008 | 0.001 | 0.001 | 0.021 | ||
VLMT interference parameters | EPA: F(6,198) = 1.426, p = 0.206, ηp2 = 0.041 S: F(3,98) = 1.056, p = 0.372, ηp2 = 0.031 I: F(6,198) = 0.102, p = 0.996, ηp2 = 0.003 G: F(3,98) = 0.869, p = 0.460, ηp2 = 0.026 | |||||||
I | ||||||||
Low EPA | 6.43 (0.40) | 6.18 (0.62) | 1.671 | 2.28 | 0.079 | 1.414 | NS | NS |
Moderate EPA | 6.41 (0.44) | 5.71 (0.58) | 0.193 | 0.134 | 0.924 | 0.237 | ||
High EPA | 7.33 (0.71) | 6.63 (0.52) | 0.032 | 0.022 | 0.002 | 0.014 | ||
T6 | ||||||||
Low EPA | 11.96 (0.59) | 11.55 (0.56) | 2.364 | 0.68 | 0.134 | 1.917 | NS | NS |
Moderate EPA | 11.36 (0.56) | 10.94 (0.70) | 0.101 | 0.411 | 0.875 | 0.169 | ||
High EPA | 12.28 (0.43) | 12.44 (0.48) | 0.045 | 0.007 | 0.003 | 0.019 | ||
T5–6 | ||||||||
Low EPA | 0.61 (0.43) | 1.00 (0.54) | 2.556 | 0.756 | 0.075 | 0.107 | NS | NS |
Moderate EPA | 0.95 (0.24) | 1.24 (0.36) | 0.083 | 0.387 | 0.928 | 0.744 | ||
High EPA | 0.22 (0.31) | 0.31 (0.37) | 0.049 | 0.008 | 0.001 | 0.001 | ||
VLMT long-term memory parameters | EPA: F(4,200) = 0.604, p = 0.660, ηp2 = 0.012 S: F(2,99) = 0.055, p = 0.946, ηp2 = 0.001 I: F(4,200) = 0.093, p = 0.984, ηp2 = 0.002 G: F(2,99) = 1.123, p = 0.330, ηp2 = 0.022 | |||||||
T7 | ||||||||
Low EPA | 11.78 (0.54) | 11.82 (0.48) | 1.1 | 0.091 | 0.157 | 1.832 | NS | NS |
Moderate EPA | 11.55 (0.67) | 11.18 (0.69) | 0.337 | 0.763 | 0.855 | 0.179 | ||
High EPA | 12.00 (0.46) | 12.44 (0.58) | 0.022 | 0.001 | 0.003 | 0.001 | ||
T5–7 | ||||||||
Low EPA | 0.78 (0.36) | 0.73 (0.41) | 0.774 | 0.007 | 0.123 | 0.128 | NS | NS |
Moderate EPA | 0.77 (0.44) | 1.00 (0.39) | 0.464 | 0.934 | 0.884 | 0.721 | ||
High EPA | 0.50 (0.31) | 0.31 (0.44) | 0.015 | 0 | 0.002 | 0.001 | ||
Moderate depression N = 62 M (SD) | Severe depression N = 44 M (SD) | |||||||
Digits forward | ||||||||
Low EPA | 8.68 (0.44) | 8.64 (0.41) | 0.654 | 0.018 | 0.019 | 0.043 | NS | NS |
Moderate EPA | 8.45 (0.37) | 8.29 (0.49) | 0.522 | 0.894 | 0.981 | 0.837 | ||
High EPA | 8.89 (0.40) | 8.88 (0.52) | 0.013 | 0 | 0 | 0 | ||
Digits backward | ||||||||
Low EPA | 8.09 (0.41) | 7.64 (0.49) | 0.556 | 1.016 | 0.188 | 0.151 | NS | NS |
Moderate EPA | 8.41 (0.47) | 7.88 (0.36) | 0.575 | 0.316 | 0.829 | 0.699 | ||
High EPA | 8.33 (0.43) | 8.31 (0.27) | 0.011 | 0.01 | 0.004 | 0.002 |
MANCOVA DHA Status (DHA) Depression Severity (S) Interaction Severity * DHA Status (I) Covariates: Gender (G), GIX (IQ) | |||||||||
---|---|---|---|---|---|---|---|---|---|
VLMT short-term memory parameters | DHA: F(10,178) = 1.323, p = 0.221, ηp2 = 0.069 S: F(5,88) = 0.524, p = 0.758, ηp2 = 0.029 I: F(10,178) = 0.686, p = 0.736, ηp2 = 0.037 G: F(5,88) = 1.218, p = 0.308, ηp2 = 0.065 IQ: F(5,88) = 6.113, p < 0.001 ***, ηp2 = 0.258 | ||||||||
Moderate depression N = 59 M (SD) | Severe depression N = 41 M (SD) | F p ηp2 | Pairwise | p | |||||
DHA | S | I | G | IQ | |||||
T1 score | |||||||||
Low DHA | 6.65 (1.61) | 6.40 (2.07) | 1.57 | 0.057 | 0.115 | 0.073 | 7.401 | NS | NS |
Moderate DHA | 7.25 (1.68) | 7.00 (1.41) | 0.214 | 0.812 | 0.892 | 0.788 | 0.008 * | ||
High DHA | 6.94 (1.61) | 6.78 (1.90) | 0.033 | 0.001 | 0.002 | 0.001 | 0.074 | ||
T2 score | |||||||||
Low DHA | 9.87 (2.97) | 8.91 (0.69) | 1.733 | 0.923 | 0.323 | 0 | 14.652 | NS | NS |
Moderate DHA | 10.85 (2.87) | 9.10 (2.13) | 0.182 | 0.339 | 0.725 | 0.982 | <0.001 * | ||
High DHA | 10.25 (1.18) | 10.28 (2.63) | 0.036 | 0.01 | 0.007 | 0 | 0.137 | ||
T3 score | |||||||||
Low DHA | 11.09 (2.17) | 11.50 (2.72) | 1.096 | 0.184 | 0.641 | 3.039 | 15.105 | NS | NS |
Moderate DHA | 11.70 (2.06) | 10.38 (2.06) | 0.338 | 0.669 | 0.529 | 0.085 | <0.001 * | ||
High DHA | 11.75 (2.05) | 11.94 (1.86) | 0.023 | 0.002 | 0.014 | 0.032 | 0.141 | ||
T4 score | |||||||||
Low DHA | 11.96 (2.35) | 12.20 (2.20) | 1.769 | 0.1 | 0.913 | 2.062 | 31.252 | NS | NS |
Moderate DHA | 13.15 (1.73) | 11.54 (3.05) | 0.176 | 0.752 | 0.405 | 0.154 | <0.001 * | ||
High DHA | 12.63 (1.09) | 13.06 (1.51) | 0.037 | 0.001 | 0.019 | 0.022 | 0.254 | ||
T5 score | |||||||||
Low DHA | 12.09 (2.28) | 13.10 (1.60) | 0.038 | 0.366 | 1.816 | 0.881 | 19.51 | NS | NS |
Moderate DHA | 13.05 (1.79) | 11.77 (1.88) | 0.963 | 0.547 | 0.169 | 0.35 | <0.001 * | ||
High DHA | 12.44 (1.63) | 12.89 (1.64) | 0.001 | 0.004 | 0.038 | 0.009 | 0.175 | ||
VLMT interference parameters | DHA: F(6,182) = 0.933, p = 0.472, ηp2 = 0.039 S: F(3,90) = 0.716, p = 0.545, ηp2 = 0.023 I: F(6,182) = 2.219, p = 0.052 °, ηp2 = 0.066 G: F(3,90) = 0.480, p = 0.697, ηp2 = 0.016 IQ: F(3,90) = 8.593, p = < 0.001 ***, ηp2 = 0.223 | ||||||||
I | |||||||||
Low DHA | 7.13 (2.70) | 5.90 (2.38) | 0.066 | 0.804 | 0.753 | 1.131 | 16.398 | NS | NS |
Moderate DHA | 6.60 (1.76) | 5.92 (2.63) | 0.936 | 0.372 | 0.474 | 0.29 | <0.001 * | ||
High DHA | 6.25 (2.46) | 6.39 (1.91) | 0.001 | 0.009 | 0.016 | 0.012 | 0.151 | ||
T6 | |||||||||
Low DHA | 11.43 (2.76) | 12.70 (2.36) | 1.405 | 0.006 | 4.337 | 0.445 | 12.435 | I: s/h > s/m I: m/m > s/m | p = 0.036 * p = 0.021 * |
Moderate DHA | 12.45 (2.21) | 10.00 (2.35) | 0.251 | 0.936 | 0.016 * | 0.506 | 0.001 * | ||
High DHA | 12.06 (1.95) | 12.61 (1.29) | 0.03 | 0 | 0.086 | 0.005 | 0.119 | ||
T5–6 | |||||||||
Low DHA | 0.65 (1.56) | 0.40 (1.58) | 2.621 | 0.613 | 1.959 | 0.017 | 0.006 | NS | NS |
Moderate DHA | 0.60 (1.60) | 1.77 (1.64) | 0.078 | 0.436 | 0.147 | 0.897 | 0.936 | ||
High DHA | 0.38 (1.41) | 0.28 (1.32) | 0.054 | 0.007 | 0.041 | 0 | 0 | ||
VLMT Long-term memory parameters | DHA: F(4,184) = 0.599, p = 0.664, ηp2 = 0.013 S: F(2,91) = 0.181, p = 0.835, ηp2 = 0.004 I: F(4,184) = 1.805, p = 0.130, ηp2 = 0.038 G: F(2,91) = 0.488, p = 0.615, ηp2 = 0.011 IQ: F(2,91) = 11.721, p < 0.001 ***, ηp2 = 0.205 | ||||||||
T7 | |||||||||
Low DHA | 11.70 (2.79) | 11.90 (2.51) | 0.804 | 0.151 | 1.598 | 0.744 | 19.794 | NS | NS |
Moderate DHA | 12.25 (2.95) | 10.62 (2.18) | 0.45 | 0.698 | 0.208 | 0.391 | <0.001 * | ||
High DHA | 11.69 (2.02) | 13.00 (1.33) | 0.017 | 0.002 | 0.034 | 0.008 | 0.177 | ||
T5–7 | |||||||||
Low DHA | 0.39 (1.64) | 1.20 (1.75) | 1.11 | 0.011 | 1.86 | 0.031 | 1.802 | NS | NS |
Moderate DHA | 0.80 (2.12) | 1.15 (1.46) | 0.334 | 0.916 | 0.161 | 0.86 | 0.183 | ||
High DHA | 0.75 (1.44) | −0.11 (1.41) | 0.024 | 0 | 0.039 | 0 | 0.019 | ||
Moderate depression N = 58 M (SD) | Severe depression N = 41 M (SD) | ||||||||
Digits forward | |||||||||
Low DHA | 9.09 (2.18) | 9.90 (1.37) | 3.342 | 0.956 | 1.523 | 0.23 | 25.145 | NS | NS |
Moderate DHA | 8.45 (1.50) | 7.85 (1.41) | 0.040 * | 0.543 | 0.224 | 0.633 | <0.001 * | ||
High DHA | 8.69 (1.66) | 8.28 (2.08) | 0.068 | 0.004 | 0.032 | 0.003 | 0.216 | ||
Digits backward | |||||||||
Low DHA | 8.64 (2.36) | 8.60 (1.17) | 0.78 | 0.005 | 0.192 | 0.058 | 17.851 | NS | NS |
Moderate DHA | 8.15 (1.81) | 7.62 (1.26) | 0.461 | 0.942 | 0.826 | 0.81 | <0.001 * | ||
High DHA | 8.19 (1.64) | 7.89 (1.61) | 0.017 | 0 | 0.004 | 0.001 | 0.164 |
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Emery, S.; Häberling, I.; Berger, G.; Baumgartner, N.; Strumberger, M.; Albermann, M.; Nalani, K.; Schmeck, K.; Erb, S.; Bachmann, S.; et al. Verbal Memory Performance in Depressed Children and Adolescents: Associations with EPA but Not DHA and Depression Severity. Nutrients 2020, 12, 3630. https://doi.org/10.3390/nu12123630
Emery S, Häberling I, Berger G, Baumgartner N, Strumberger M, Albermann M, Nalani K, Schmeck K, Erb S, Bachmann S, et al. Verbal Memory Performance in Depressed Children and Adolescents: Associations with EPA but Not DHA and Depression Severity. Nutrients. 2020; 12(12):3630. https://doi.org/10.3390/nu12123630
Chicago/Turabian StyleEmery, Sophie, Isabelle Häberling, Gregor Berger, Noemi Baumgartner, Michael Strumberger, Mona Albermann, Kristin Nalani, Klaus Schmeck, Suzanne Erb, Silke Bachmann, and et al. 2020. "Verbal Memory Performance in Depressed Children and Adolescents: Associations with EPA but Not DHA and Depression Severity" Nutrients 12, no. 12: 3630. https://doi.org/10.3390/nu12123630