Subjective experiences of neurocognitive functioning in young people with major depression

Abstract

Background: Research suggests that young people with major depressive disorder (MDD) experience neurocognitive deficits and that these are associated with poorer functional and clinical outcomes. However, we are yet to understand how young people experience such difficulties. The aim of the current study was to explore the subjective experiences of neurocognitive functioning among young people with MDD. Methods: Semi-structured qualitative interviews were conducted with 11 young people (aged 17-24 years) attending a specialist clinic for youth experiencing moderate-severe depression. Interview transcripts were analysed via Thematic Analysis to identify patterns and themes representing how young people with MDD subjectively experience neurocognitive deficits. Results: Five main themes were identified: (1) experience of neurocognitive complaints; (2) relationship between neurocognitive complaints and depression; (3) impact on functioning; (4) strategies and supports; and (5) neurocognitive complaints and treatment. Overall, young people with MDD commonly experienced a range of subjective neurocognitive complaints. These appeared to have a bidirectional relationship with depressive symptomatology and significantly disrupted vocational, social and independent functioning, and aspects of psychological well-being including self-esteem. Neurocognitive difficulties represented an experiential barrier to psychological therapeutic engagement and were perceived as variably responsive to psychotropic medications, highlighting the need for targeted intervention. Discussion: Neurocognitive difficulties are a common and pervasive experience for young people with MDD, with perceived impacts on depressive symptoms, attitudinal beliefs, everyday functioning and therapeutic engagement. Subjective neurocognitive complaints may therefore contribute to or exacerbate personal challenges faced by young people with MDD and thus, require early identification, consideration in psychological formulation, and treatment. Further research into the mechanisms of neurocognitive impairment in MDD is also needed.

Subjective cognitive functioning in relation to changes in levels of depression and anxiety in youth over 3 months of treatment

“…11,35,36 Alternatively, cognitive failures in daily life may increase one's negative affect. 23 Research has shown that subjective cognitive impairment in mood disorders is associated with poorer socio-occupational functioning, 37,38 which may in turn have an impact on mood. A vicious cycle may ensue where cognitive difficulties and affective symptoms feed into one another.…”

“…A vicious cycle may ensue where cognitive difficulties and affective symptoms feed into one another. 23,36 When subjective cognitive impairment is perceived to have a negative impact on important aspects of daily life, the influence on the development or exacerbation of depression or anxiety symptoms may be greater. It is also possible that depleted cognitive resources are a consequence of poor sleep and mental fatigue, which are common in anxiety and depression.…”

“…22 Ongoing subjective cognitive complaints may increase one's risk for maintenance of affective symptoms, relapse or poor functional outcomes. 20,23,24 Similarly, improvements in subjective cognitive functioning may signal clinical and functional improvement. Subjective cognitive functioning can be easily assessed within clinical settings and thus, research understanding its course and clinical significance remains an important endeavour.…”

New Evidences about Subjective Well-Being in Adolescence and Its Links with Neurocognitive Performance

“…For instance, Tickell et al [21] found that impairments in different neurocognitive domains were related to anxiety and stress, among others. In addition, a recent study revealed the association between neurocognitive functioning and depressive symptoms [22].…”

“…Neurocognitive domains such as sustained attention or memory were related to anxiety and stress, among others. In another relevant study with young people between 17 and 24 years old, Morey-Nase et al [22] found that major depression was related to subjective experiences of neurocognitive functioning.…”