Are cognitive deficits in major depressive disorder progressive?

Cléry-Melin, Marie Laure; Gorwood, Philip

doi:10.1017/cbo9781139860567.010

Cited by 2 publications

(1 citation statement)

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“…Other more specific cognitive symptoms are equally integral to the diagnosis of MDD, such as a diminished ability to think or concentrate, indecisiveness, or psychomotor retardation 1 . Depression-related impairments in attention, memory, psychomotor speed, and executive functioning that were assessed by laboratory tasks are well described at the acute phase of a major depressive episode (MDE), might persist beyond clinical recovery, are related to neuroimaging abnormalities, and could have trait-like characteristics 4 . Such impaired cognitive processes are likely to contribute to reward-related impairments assessed in depression.…”

Section: Introductionmentioning

confidence: 99%

Reward systems and cognitions in Major Depressive Disorder

2018

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A lack of motivation and anhedonia represent frequent and pervasive symptoms in depression, although with poor specificity. Historically described as a response bias, reward-related impairments in depression may account for the important aspects of the cognitive impairments associated with diagnosis of major depressive disorder. Reward processing is a broad psychological construct that can be parsed into 3 distinct components known as “reinforcement learning” (learning), “reward responsiveness” (liking), and “motivation to obtain a reward” (wanting). Depressed patients respond hyposensitively to reward and maladaptively to punishment: this pattern is related to a dysfunction in the frontostriatal systems modulated by the monoamine systems; seems to be observed in medicated and unmedicated patients with depression and in healthy individuals with high levels of anhedonia; and could be observed in patients with a history of depression, even when in full remission. Considered to be cognitive impairments, reward-related-impairments may also constitute part of an underlying neurobiological vulnerability to major depressive disorder (MDD). For example, the reward-related impairment is state dependent and, more or less, correlated with symptom severity in some studies but has also been proposed as being trait like, with endophenotype characteristics, possibly contributing to the persistence of the disease or treatment resistance. The 3 core aspects of reward processing have specific neurobiological correlates that involve the ventral and dorsal striatum, lateral habenula, ventral tegmental area, orbitofrontal cortex, anterior cingulate cortex, and ventromedial and dorsolateral prefrontal cortex. These structures underline the important role of the dopaminergic mesolimbic pathway, but glutamate and serotonin could also have an important role, at least in some aspects of reward-related impairments.

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Section: Introductionmentioning

confidence: 99%