Somatization Symptoms Regulate Emotional Memory Bias in Adolescents With Major Depressive Disorder

Abstract

Objective: Somatization symptoms are commonly comorbid with depression. Furthermore, people with depression and somatization have a negative memory bias. We investigated the differences in emotional memory among adolescent patients with depressive disorders, with and without functional somatization symptoms (FSS). Methods: We recruited 30 adolescents with depression and FSS, 38 adolescents with depression but without FSS, and 38 healthy participants. Emotional memory tasks were conducted to evaluate the emotional memory of the participants in the three groups. The clinical symptoms were evaluated using the Hamilton Depression Rating Scale (HDRS) and the Children's Somatization Inventory (CSI). Results: The valence ratings and recognition accuracy rates for positive and neutral images of adolescent patients were significantly lower than those of the control group (F = 12.208, P < 0.001; F = 6.801, P < 0.05; F = 14.536, P < 0.001; F = 6.306, P < 0.05, respectively); however, the recognition accuracy rate for negative images of adolescent patients of depression without FSS was significantly lower than that of patients with FSS and control group participants (F = 10.316, P < 0.001). These differences persisted after controlling for HDRS scores. The within-group analysis revealed that patients of depression with FSS showed significantly higher recognition accuracy rates for negative images than the other types (F = 5.446, P < 0.05). The recognition accuracy rate for negative images was positively correlated with CSI scores (r = 0.352, P < 0.05). Conclusion: Therefore, emotional memory impairment exists in adolescent patients of depression and FSS are associated with negative emotional memory retention.

Keywords: adolescents; depression; emotional; memory; somatization.

Figure 1

Both the positive image score and recognition accuracy, neutral image score and recognition accuracy, negative image recognition accuracy, and total recognition accuracy in depressed patients were significantly lower than healthy control. (A) Summarized data for the image score of different emotional image. (B) Averaged data for the recognition accuracy of different emotional image. *p < 0.05, **p < 0.001.

Figure 2

Comparison for image score or recognition accuracy between three groups and different image recognition accuracy within FSS group. (A,B) Summarized data for positive (A) and neutral (B) image score recognition accuracy, showing that both positive and neutral image score in depression with or without FSS were significantly lower than healthy control. (C–E) Comparative analysis for the averaged data of positive, neutral and negative image recognition accuracy, suggesting that the recognition accuracy of positive and neutral images in depression with FSS or without FSS was significantly lower than that of healthy control (C,D), but in negative image recognition accuracy, depression without FSS was significantly lower than with FSS, synchronously lower than healthy control (E). (F) Summarized data for the total recognition accuracy in three groups. (G) Within depression with FSS group, negative image recognition accuracy was significantly higher than positive or neutral image, respectively. *p < 0.05, **p < 0.001.

Figure 3

Negative image recognition accuracy had a positive correlation with CSI scores, while positive or neutral image recognition accuracy had no relation with CSI scores, respectively. (A–C) Scatter diagram for the recognition accuracy of positive image (A), neutral image (B), and negative image (C), showing that positive or neutral image recognition accuracy had no relation with CSI score (A,B), but there was a positive correlation between negative image recognition accuracy and CSI score (C).

Figure 4

Examples of one positive and negative target picture in two phases of emotional memory test (unintentional learning and recognition).