The Relationship Between Neurocognitive and Psychosocial Functioning in Major Depressive Disorder

Evans, Vanessa; Iverson, Grant L.; Yatham, Lakshmi N.; Lam, Raymond W.

doi:10.4088/jcp.13r08939

Cited by 167 publications

(132 citation statements)

References 58 publications

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“…Furthermore, a preliminary study suggests that deficits in executive functioning exert a mediating effect on the relationship between depression and impaired activities of daily living (33). A recently published systematic review confirms the relevance of cognitive function in day-to-day functional activities in MDD (34). …”

Section: Introductionmentioning

confidence: 73%

Clinical, Functional, and Biological Correlates of Cognitive Dimensions in Major Depressive Disorder – Rationale, Design, and Characteristics of the Cognitive Function and Mood Study (CoFaM-Study)

Baune

Air

2016

Front. Psychiatry

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Cross-sectional and longitudinal studies exploring clinical, functional, and biological correlates of major depressive disorder are frequent. In this type of research, depression is most commonly defined as a categorical diagnosis based on studies using diagnostic instruments. Given the phenotypic and biological heterogeneity of depression, we chose to focus the phenotypic assessments on three cognitive dimensions of depression including (a) cognitive performance, (b) emotion processing, and (c) social cognitive functioning. Hence, the overall aim of the study is to investigate the long-term clinical course of these cognitive dimensions in depression and its functional (psychosocial) correlates. We also aim to identify biological “genomic” correlates of these three cognitive dimensions of depression. To address the above overall aim, we created the Cognition and Mood Study (CoFaMS) with the key objective to investigate the clinical, functional, and biological correlates of cognitive dimensions of depression by employing a prospective study design and including a healthy control group. The study commenced in April 2015, including patients with a primary diagnosis of a major depressive episode of major depressive disorder or bipolar disorder according to DSM-IV-TR criteria. The assessments cover the three cognitive dimensions of depression (cognitive performance, emotion processing, and social cognition), cognitive function screening instrument, plus functional scales to assess general, work place, and psychosocial function, depression symptom scales, and clinical course of illness. Blood is collected for comprehensive genomic discovery analyses of biological correlates of cognitive dimensions of depression. The CoFaM-Study represents an innovative approach focusing on cognitive dimensions of depression and its functional and biological “genomic” correlates. The CoFaMS team welcomes collaborations with both national and international researchers.

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Section: Introductionmentioning

confidence: 73%

Clinical, Functional, and Biological Correlates of Cognitive Dimensions in Major Depressive Disorder – Rationale, Design, and Characteristics of the Cognitive Function and Mood Study (CoFaM-Study)

Baune

Air

2016

Front. Psychiatry

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“…[14][15][16][17] Cognitive deficits can be demonstrated with neuropsychological tests during acute MDEs and are associated with significant impact on daily functioning and quality of life. 16,18,19 Moreover, cognitive dysfunction is a common residual symptom during treatment and may continue even after mood symptoms have remitted. 20,21 These observations reflect the need and importance for clinical assessment and monitoring of cognitive symptoms during management of MDD.…”

Section: What Are Important Clinical Specifiers and Dimensions Of Depmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder

et al. 2016

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Background: The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals. Methods: Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. This section is the first of six guidelines articles.Results: In Canada, the annual and lifetime prevalence of MDD was 4.7% and 11.3%, respectively. MDD represents the second leading cause of global disability, with high occupational and economic impact mainly attributable to indirect costs. DSM-5 criteria for depressive disorders remain relatively unchanged, but other clinical dimensions (sleep, cognition, physical symptoms) may have implications for depression management. e-Mental health is increasingly used to support clinical and selfmanagement of MDD. In the 2-phase (acute and maintenance) treatment model, specific goals address symptom remission, functional recovery, improved quality of life, and prevention of recurrence. Conclusions:The burden attributed to MDD remains high, whether from individual distress, functional and relationship impairment, reduced quality of life, or societal economic cost. Applying core principles of care, including comprehensive assessment, therapeutic alliance, support of self-management, evidence-informed treatment, and measurement-based care, will optimize clinical, quality of life, and functional outcomes in MDD.

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“…The evidence suggests that cognitive dysfunction is associated with and may mediate functional impairments in MDD. However, systematic reviews 21,22 have highlighted the limited evidence base of studies relating objective cognitive dysfunction with psychosocial functioning. Deficits in cognitive domains, including attention and processing speed, executive function, and verbal knowledge, have been correlated with some measures of psychosocial functioning.…”

Section: Cognitive Dysfunction and Psychosocial Functioningmentioning

confidence: 99%

Cognitive Dysfunction in Major Depressive Disorder: Effects on Psychosocial Functioning and Implications for Treatment

et al. 2014

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Major depressive disorder is a common condition with a high rate of recurrence, chronicity, and staggering economic burden, including disability in the workforce.1 In 2010, MDD was the second leading medical cause of burden globally, with highest estimates of disability in people of working age.2 In Canada, the annual prevalence of MDD is 3% to 4% overall, and 79% of people with MDD report some interference with work functioning, either decreased work productivity and (or) absenteeism.1 In addition to work impairment, the psychosocial impact of MDD often affects a person's level of functioning in family and social relationships. While there is clearly an association between improvement in depressive symptoms and functioning, symptom improvement can also be dissociated from functional improvement and work loss.3,4 Hence there has been increasing recognition that symptomatic remission is an insufficient goal of treatment for MDD and that return to premorbid psychosocial functioning should be targeted. 5Cognitive dysfunction refers to deficits in attention, verbal and nonverbal learning, short-term and working memory, visual and auditory processing, problem solving, processing speed, and motor functioning. Cognitive dysfunction may be a primary mediator of functional impairment in MDD. 6 Cognitive complaints are core symptoms of acute MDEs, and diminished ability to think or concentrate and (or) indecisiveness are criterion items for the diagnosis of MDD. Several other core symptoms of MDD may act as mediators of cognitive dysfunction, including psychomotor retardation, amotivation, fatigue, insomnia, and mood disturbances. Deficits on neuropsychological testing are well demonstrated in people with MDD, compared with healthy subjects, with many studies and meta-analyses showing moderate effect sizes in neurocognitive domains of processing speed, attention, executive function, learning, and memory 7,8 as well as in cognitive affective bias. Cognitive affective bias reflects distorted information processing and (or) focus moving away from positive stimuli and toward negative stimuli, 7 and abnormal responses to negative feedback and decision making. It is also apparent that, while cognitive dysfunction in MDD may improve with treatment and resolution of depressive symptoms, cognitive deficits can still be detected even in periods of symptom remission. In a 3-year, follow-up study of patients with MDD, the proportion of time with cognitive complaints was reported as 94% during acute depressive episodes; this remained at 44% despite full or partial symptom remission during treatment. 10 Cognitive performance on tests of immediate memory, attention, 11 and processing speed 12 was reported to be inferior in patients with MDD who met criteria for remission, compared with healthy subjects. Meta-analyses show that cognitive deficits in executive function are still present in remitted patients, 13,14 which may explain persistent psychosocial impairment in remission.While it is beyond the scope of our paper to review the unde...

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The Relationship Between Neurocognitive and Psychosocial Functioning in Major Depressive Disorder

Cited by 167 publications

References 58 publications

Clinical, Functional, and Biological Correlates of Cognitive Dimensions in Major Depressive Disorder – Rationale, Design, and Characteristics of the Cognitive Function and Mood Study (CoFaM-Study)

Clinical, Functional, and Biological Correlates of Cognitive Dimensions in Major Depressive Disorder – Rationale, Design, and Characteristics of the Cognitive Function and Mood Study (CoFaM-Study)

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder

Cognitive Dysfunction in Major Depressive Disorder: Effects on Psychosocial Functioning and Implications for Treatment

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