The role of cognitive impairment in general functioning in major depression

Baune, Bernhard T.; Miller, Roger; McAfoose, Jordan; Johnson, Melissa; Quirk, Frances; Mitchell, David A.

doi:10.1016/j.psychres.2008.12.001

Cited by 328 publications

(216 citation statements)

References 42 publications

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“…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.…”

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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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confidence: 99%

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

et al. 2014

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“…For example, in a 3-year prospective study of 267 primary care patients, cognitive impairment was present ~94% of the time during depressive episodes and 44% of the time during periods of remission (Conradi et al, 2011). Furthermore, recurrent depression has increased detrimental effects on cognitive ability (Baune et al, 2010). Indeed, psychiatrists were more inclined to recognise that recovery of cognitive function is less likely following repeated episodes of depression than GPs, perhaps as a result of differences in how GPs and psychiatrists follow up patients.…”

Section: Discussionmentioning

confidence: 99%

Analysing UK clinicians’ understanding of cognitive symptoms in major depression: A survey of primary care physicians and psychiatrists

McAllister-Williams

Bones

Goodwin

et al. 2017

Journal of Affective Disorders

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Background: Cognitive dysfunction occurs in depression and can persist into remission. It impacts on patient functioning but remains largely unrecognised, unmonitored and untreated. We explored understanding of cognitive dysfunction in depression among UK clinicians.Methods: A multi-step consultation process.Step 1: a multi-stakeholder steering committee identified key themes of burden, detection and management of cognitive dysfunction in depression, and developed statements on each to explore understanding and degree of agreement among clinicians.Step 2: 100 general practitioners (GPs) and 100 psychiatrists indicated their level of agreement with these statements.Step 3: the steering committee reviewed responses and highlighted priority areas for future education and research.Results: There was agreement that clinicians are not fully aware of cognitive dysfunction in depression. Views of the relationship between cognitive dysfunction and other depressive symptom severities was not consistent with the literature. In particular, there was a lack of recognition that some cognitive dysfunction can persist into remission. There was understandable uncertainty around treatment options, given the current limited evidence base. However, it was recognised that cognitive dysfunction is an area of unmet need and that there is a lack of objective tests of cognition appropriate for depressed patients that can be easily implemented in the clinic.Limitations: Respondents are likely to be 'led' by the direction of the statements they reviewed. The study did not involve patients and carers. Conclusions: UK clinicians should undergo training regarding cognitive dysfunction in depression, and further research is needed into its assessment, treatment and monitoring.

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“…The RBANS aided in determining the neuropsychological status of adults, who had neurological injury or disease [23]. Several recent studies also have shown that the RBANS was used to to detect cognitive functions of MDD [10,24,25]. The RBANS of MDD have been reported in the following domains: executive function, episodic memory, visuospatial memory, attention, and processing speed [5][6][7].…”

Section: Clinical Measuresmentioning

confidence: 99%

Education and Cognition of Major Depressive Disorder in a Chinese Population

Li¹,

Chen²,

Zhu³

et al. 2018

Neuropsychiatry

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Objective: Cognitive impairments have been identified as a core feature of major depressive disorder (MDD). To date, no studies on the association between education level and cognitive impairments of MDD from a Chinese population adopting the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) for cognitive measurement emerged. This study is the first to adopt the RBANS to examine whether cognitive impairments of MDD were influenced by education level in a Chinese population.Methods: 90 patients with MDD and 90 healthy controls with matched gender and age were recruited in a case-control study. Cognitive functions were assessed using the RBANS. Moreover, the demographic and clinical data were collected from patients with MDD and healthy controls.Results: There were significant differences in the RBANS total score (F=19.56, p<0.001), subscales of language (F=58.21, p<0.001) and delayed memory (F=7.72, p=0.006) between two groups after controlling for the variables. These differences still passed Bonferroni corrections (all, p<0.05). Education level of MDD was significantly correlated with the RBANS total score (r=0.277, p=0.010), language score (r=0.255, p=0.018) and delayed memory score (r=0.220, p=0.042). Stepwise multivariate regression analysis indicated that education level was an independent contributor to the RBANS total score (t=2.666, p=0.009), language score (t=3.644, p<0.001), and delayed memory score (t=3.312, p=0.001) of MDD. Conclusions:Our findings supported that patients with MDD had poorer cognitive functions than healthy controls, especially in language and delayed memory. Moreover, education level could influence cognitive performance of MDD in a Chinese population.

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The role of cognitive impairment in general functioning in major depression

Cited by 328 publications

References 42 publications

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

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

Analysing UK clinicians’ understanding of cognitive symptoms in major depression: A survey of primary care physicians and psychiatrists

Education and Cognition of Major Depressive Disorder in a Chinese Population

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