Disfunción Ejecutiva en la Depresión: Una Revisión Sistemática
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Entre las alteraciones observadas en la depresión, la reducción volumétrica del córtex prefrontal es frecuente y afecta las funciones ejecutivas (FE), aunque esto aún no se ha evaluado sistemáticamente. Para abordar esta brecha, realizamos una revisión sistemática siguiendo el protocolo PRISMA, con el objetivo de evaluar la presencia de disfunción ejecutiva (DE) en individuos con depresión. Se realizaron búsquedas en las bases de datos PubMed, Embase y Scielo, utilizando una estrategia que combinó los términos “Depresión” y “Disfunción Ejecutiva”, sin restricciones de fecha o idioma. Los estudios elegibles fueron analíticos longitudinales o transversales que evaluaron las FE con escalas y pruebas estandarizadas o validadas, incluyendo pacientes sin comorbilidades comparados con controles. Se excluyeron revisiones de literatura, estudios con pacientes con comorbilidades psiquiátricas y modelos no humanos. La búsqueda identificó 672 artículos en PubMed, 51 en Embase y 4 en Scielo (n=727), de los cuales 22 fueron seleccionados para lectura completa. Seis de estos estudios incluían pacientes con comorbilidades, resultando en la inclusión de dieciséis estudios. La mayoría encontró deterioro de las FE en la depresión, y el rendimiento de las FE parece ser inversamente proporcional al nivel de estrés inducido por los síntomas. Las evidencias sugieren que la DE puede dificultar la remisión, aunque la psicoterapia puede mitigar los daños ejecutivos. Además, la DE parece persistir incluso tras la remisión de los síntomas, con efectos más marcados en adultos mayores. Estos hallazgos subrayan la necesidad de investigar más sobre la DE en la depresión, que podría servir como marcador biológico del trastorno.
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