Cognitive outcomes are differentially associated with depression severity trajectories during psychotherapy treatment for late life major depressive disorder

Abstract

Objectives Late Life Depression (LLD) is associated with persistent cognitive dysfunction even after depression symptoms improve. The present study was designed to examine cognitive outcomes associated with the pattern of depression severity change during psychotherapy intervention for LLD. Methods 96 community‐dwelling adults ages 65–91 with major depressive disorder completed 12 sessions of Problem‐Solving Therapy at the University of California, San Francisco. Nonlinear trajectories of depression severity ratings using the Hamilton Depression Rating Scale were computed from multiple time points collected throughout the weekly psychotherapy intervention. Performance on measures of cognition (information processing speed, executive functioning, verbal learning, memory) was assessed at baseline and post‐treatment. Linear mixed‐effects models examined associations between nonlinear depression severity trajectories and post‐treatment change in cognitive performance. Results Broadly, different patterns of depression change during treatment were associated with improved cognition post‐treatment. Greater and more consistent interval improvements in depression ratings were differentially associated with improvements in aspects of verbal learning, memory, and executive function post‐treatment, while no associations were found with information processing speed. Conclusions The heterogeneity of depression trajectories associated with improved cognitive outcomes suggests that the temporal pattern of depression response may impact specific cognitive processes distinctly. Results suggest that use of nonlinear depression severity trajectories may help to elucidate complex associations between the time course of depression response and cognitive outcomes of psychotherapy in LLD. These findings have important implications for identifying treatment targets to enhance clinical and cognitive outcomes of psychotherapy in LLD.

Childhood Trauma and Depressive Level Among Chinese College Students in Guangzhou: The Roles of Rumination and Perceived Stress

“…Then, moderated mediation analyses were conducted to test the mediation effect of perceived stress on the relationship between childhood trauma and depressive level, and the moderation effect of rumination on the relationship between childhood trauma and perceived stress as well as between childhood trauma and depressive level. Considering that sex and age were common influential factors for depression 50,51 and were always regarded as covariates in analyses, 52,53 Sex (0=female, 1=male) and age were also controlled for their effects on depressive level in this study. In addition, childhood trauma and rumination were grand-mean centered before creating the interactive term.…”

Supraphysiologic doses of 17β-estradiol aggravate depression-like behaviors in ovariectomized mice possibly via regulating microglial responses and brain glycerophospholipid metabolism

“…This observation could be explained from two perspectives. First, the pathogenetic causes of both memory deficits and depression were different, i.e., depression was not necessarily sufficient to impair the memory function of the brain [49]. Second, the brain damage caused by sE2 was not sufficient to affect the neuronal circuits responsible for memory [50,51].…”

Supraphysiologic doses of 17β-Estradiol aggravate depression-like behaviors in ovariectomized mice possibly via regulating microglial responses and brain glycerophospholipid metabolism

“…This observation could be explained from two perspectives. First, the pathogenetic causes of both memory de cits and depression were different, i.e., depression was not necessarily su cient to impair the memory function of the brain [40]. Second, the brain damage caused by sE2 was not su cient to affect the neuronal circuits responsible for memory [41,42].…”