Risky decision-making in major depressive disorder: A three-level meta-analysis

• Published in: International journal of clinical and health psychology Vol. 24; no. 1; p. 100417
• Main Authors: Lu, Jiaqi, Zhao, Xu, Wei, Xuxuan, He, Guibing
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.01.2024
• Subjects: Decision task type; Major depressive disorder; Meta-analysis; Risky decision-making; Decision task type; Major depressive disorder; Risky decision-making; Meta-analysis
• ISSN: 1697-2600
• DOI: 10.1016/j.ijchp.2023.100417

Individuals with major depressive disorder (MDD) are usually observed making inappropriate risky decisions. However, whether and to what extent MDD is associated with impairments in risky decision-making remains unclear. We performed a three-level meta-analysis to explore the relationship between risky decision-making and MDD. We searched the Web of Science, PubMed, Scopus, and PsycINFO databases up to February 7, 2023, and calculated Hedges' g to demonstrate the difference in risky decision-making between MDD patients and healthy controls (HCs). The moderating effect of sample and task characteristics were also revealed. Across 73 effect sizes in 39 cross-sectional studies, MDD patients exhibited greater risk-seeking than HCs (Hedges' g = 0.187, p = .030). Furthermore, age (p = .068), region (p = .005), and task type (p < .001) were found to have moderating effects. Specifically, patients preferred risk-seeking over HCs as age increased. European patients showed significantly increased risk-seeking compared to American and Asian patients. Patients in the Iowa Gambling Task (IGT) exhibited a notable rise in risk-seeking compared to other tasks, along with an increased risk aversion in the Balloon Analogue Risk Task (BART). The multiple-moderator analysis showed that only task type had significant effects, which may be explained by a tentative framework of "operationalization-mechanism-measure" specificity. MDD patients generally exhibit higher risk-seeking than HCs. It implies that impaired risky decision-making might be a noteworthy symptom of depression, which should be placed more emphasis for clinical management and psycho-education.