Exploring the complex relationship between depression and risky decision-making: A meta-analysis

Numerous studies have examined the association between depression and risky decision-making, but the results are mixed. To address this issue, we conducted a meta-analysis of risky decision-making in individuals with current Major depressive disorder (MDD). Patients with MDD exhibit divergent performances in risky decision-making across various tasks. Specifically, MDD patients tend to select the disadvantageous decks in the Iowa Gambling Task (SMD = 0.40; 95%CI = 0.09 to 0.70; p = 0.011), make fewer pumps on the balloon in the Balloon Analog Risk Task (SMD = -0.29; 95%CI = -0.47 to -0.12; p < 0.01), and demonstrate similar performance in the Cambridge Gambling Task and the Game of Dice Task when compared to healthy controls. The meta-regression analysis revealed that age exhibits a significant correlation with the effect size in the Balloon Analog Risk Task (z = 2.375, p = 0.018, 95%CI = [0.004,0.043]). The subgroup analysis showed a significant difference in effect sizes among age groups within both the Iowa Gambling Task (Q = 9.34, df = 3, p = 0.025) and the Balloon Analog Risk Task (Q = 6.48, df = 1, p = 0.011). These findings indicate that MDD might impair the distinct process of risky decision-making, and age may paly vital role in the performance of MDD patients in risky decision-making. Understanding this could potentially facilitate more effective clinical interventions, thus reducing the burden on society.