Pain and major depressive disorder: Associations with cognitive impairment as measured by the THINC-integrated tool (THINC-it)

2017 ◽  
Vol 15 (1) ◽  
pp. 62-67 ◽  
Author(s):  
Danielle S. Cha ◽  
Nicole E. Carmona ◽  
Rodrigo B. Mansur ◽  
Yena Lee ◽  
Hyun Jung Park ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Cognitive Function ◽  
Depressive Disorder ◽  
Cognitive Performance ◽  
Cognitive Deficits ◽  
Preliminary Evidence ◽  
Digit Symbol Substitution Test ◽  
Major Depressive ◽  
Subjective Cognitive Function

AbstractObjectivesTo examine the role of pain on cognitive function in adults with major depressive disorder (MDD).MethodsAdults (18–65) with a Diagnostic and Statistical Manual – Fifth Edition (DSM-5)-defined diagnosis of MDD experiencing a current major depressive episode (MDE) were enrolled (nMDD = 100). All subjects with MDD were matched in age, sex, and years of education to healthy controls (HC) (nHC = 100) for comparison. Cognitive function was assessed using the recently validated THINC-integrated tool (THINC-it), which comprises variants of the choice reaction time (i.e., THINC-it: Spotter), One-Back (i.e., THINC-it: Symbol Check), Digit Symbol Substitution Test (i.e., THINC-it: Codebreaker), Trail Making Test – Part B (i.e., THINC-it: Trails), as well as the Perceived Deficits Questionnaire for Depression – 5-item (i.e., THINC-it: PDQ-5-D). A global index of objective cognitive function was computed using objective measures from the THINC-it, while self-rated cognitive deficits were measured using the PDQ-5-D. Pain was measured using a Visual Analogue Scale (VAS). Regression analyses evaluated the role of pain in predicting objective and subjective cognitive function.ResultsA significant between-group differences on the VAS was observed (p < 0.001), with individuals with MDD reporting higher pain severity as evidenced by higher scores on the VAS than HC. Significant interaction effects were observed between self -rated cognitive deficits and pain ratings (p < 0.001) on objective cognitive performance (after adjusting for MADRS total score), suggesting that pain moderates the association between self-rated and objective cognitive function.ConclusionsResults indicated that pain is associated with increased self-rated and objective cognitive deficits in adults with MDD.ImplicationsThe study herein provides preliminary evidence demonstrating that adults with MDD reporting pain symptomatology and poorer subjective cognitive function is predictive of poorer objective cognitive performance. THINC-it is capable of detecting cognitive dysfunction amongst adults with MDD and pain.

Cognitive Dimensions of Major Depressive Disorder

2021 ◽  
Author(s):  
Bernhard T. Baune
Keyword(s):  
Major Depressive Disorder ◽  
Cognitive Function ◽  
Depressive Disorder ◽  
Cognitive Processing ◽  
Social Cognitive ◽  
Treatment Options ◽  
Major Depressive ◽  
Social Cognitive Processing ◽  
Cognitive Dimensions

Cognitive Dimensions of Major Depressive Disorder (MDD) examines the key clinical and pathophysiological characteristics and treatment options of MDD. The volume emphasizes that while the traditional model of depression implicates mood as the primary symptom cluster, a more recently published conceptual understanding of depression has been extended to consider cognitive function as more than just a symptom. It furthers our understanding of the central role of the cognitive dimension for the pathophysiology, diagnosis, and treatment of MDD. It reviews the key cognitive dimensions of depression comprising impaired cognitive and emotional processes of cognitive function, emotion processing, and social cognitive processing. It focuses on the cognitive and emotional dimensions of depression and offers extended and novel diagnostic and treatment approaches ranging from pharmacological to psychological interventions targeting those dimensions of depression.

scholarly journals A Randomized, Placebo-Controlled, Active-Reference, Double-Blind, Flexible-Dose Study of the Efficacy of Vortioxetine on Cognitive Function in Major Depressive Disorder

2015 ◽  
Vol 40 (8) ◽  
pp. 2025-2037 ◽  
Author(s):  
Atul R Mahableshwarkar ◽  
John Zajecka ◽  
William Jacobson ◽  
Yinzhong Chen ◽  
Richard SE Keefe
Keyword(s):  
Major Depressive Disorder ◽  
Cognitive Function ◽  
Depressive Disorder ◽  
Path Analysis ◽  
Cognitive Dysfunction ◽  
Digit Symbol Substitution Test ◽  
Major Depressive ◽  
Double Blind ◽  
End Points ◽  
Patient Reported

Abstract This multicenter, randomized, double-blind, placebo-controlled, active-referenced (duloxetine 60 mg), parallel-group study evaluated the short-term efficacy and safety of vortioxetine (10–20 mg) on cognitive function in adults (aged 18–65 years) diagnosed with major depressive disorder (MDD) who self-reported cognitive dysfunction. Efficacy was evaluated using ANCOVA for the change from baseline to week 8 in the digit symbol substitution test (DSST)–number of correct symbols as the prespecified primary end point. The patient-reported perceived deficits questionnaire (PDQ) and physician-assessed clinical global impression (CGI) were analyzed in a prespecified hierarchical testing sequence as key secondary end points. Additional predefined end points included the objective performance-based University of San Diego performance-based skills assessment (UPSA) (ANCOVA) to measure functionality, MADRS (MMRM) to assess efficacy in depression, and a prespecified multiple regression analysis (path analysis) to calculate direct vs indirect effects of vortioxetine on cognitive function. Safety and tolerability were assessed at all visits. Vortioxetine was statistically superior to placebo on the DSST (P<0.05), PDQ (P<0.01), CGI-I (P<0.001), MADRS (P<0.05), and UPSA (P<0.001). Path analysis indicated that vortioxetine’s cognitive benefit was primarily a direct treatment effect rather than due to alleviation of depressive symptoms. Duloxetine was not significantly different from placebo on the DSST or UPSA, but was superior to placebo on the PDQ, CGI-I, and MADRS. Common adverse events (incidence ⩾5%) for vortioxetine were nausea, headache, and diarrhea. In this study of MDD adults who self-reported cognitive dysfunction, vortioxetine significantly improved cognitive function, depression, and functionality and was generally well tolerated.

Cognitive dimensions of major depressive disorder

2021 ◽  
pp. 1-8
Author(s):  
Bernhard T. Baune
Keyword(s):  
Major Depressive Disorder ◽  
Cognitive Function ◽  
Depressive Disorder ◽  
Cognitive Dysfunction ◽  
Cognitive Deficits ◽  
Social Cognitive ◽  
Suicide Ideation ◽  
Major Depressive ◽  
Psychosocial Impairment ◽  
Symptomatic Remission

Major depressive disorder is characterized by impaired affect, cognitive dysfunction, and significant psychosocial impairment that persists from weeks to years. Cognitive symptoms are pervasive, affecting functioning in several domains, including reduced executive functioning, attention, memory, learning, psychomotor speed, and verbal processing. Recent evidence suggests that cognitive dysfunction persists following symptomatic remission, highlighting the need to treat cognition separately from mood symptoms. Residual cognitive deficits may contribute to ongoing occupational and social dysfunction and promote suicide ideation. In addition, retention of cognitive impairment may interact with existing emotional and social vulnerability, increasing the risk of recurrent depressive episodes. The chapter characterizes the domains of emotional, nonemotional, and social cognitive function in major depressive disorder. It examines the domains and descriptors of nonemotional cognitive function. It evaluates the important relationship between cognitive deficits and psychosocial function, as well as the clinical interactions between ‘cold’ and ‘hot’ cognitive function. It extends our understanding of the social cognitive function and its implications for social performance and impact on emotional and empathic performance.

Differences in memory function between 5-HT1A receptor genotypes in patients with major depressive disorder

CNS Spectrums ◽  
2016 ◽  
Vol 21 (5) ◽  
pp. 379-384 ◽  
Author(s):  
Keith A. Wesnes ◽  
Seth C. Hopkins ◽  
Helen J. Brooker ◽  
Kenneth S. Koblan
Keyword(s):  
Major Depressive Disorder ◽  
Cognitive Function ◽  
Depressive Disorder ◽  
Episodic Memory ◽  
Serotonin Receptor ◽  
Memory Function ◽  
Extensive Literature ◽  
Major Depressive ◽  
Memory Tests

BackgroundWhile extensive literature on the role of the serotonin receptor 1A (5-HT1A-R) in cognition exists, the findings are largely from animal studies. There has been little research conducted into 5-HT1A-R genotypes and cognitive function in humans. This article evaluates the role of 5-HT1A-R genotypes on the profile of cognitive function in patients with major depressive disorder (MDD).MethodsThe study sample was 455 MDD patients aged between 18 and 55 years. They had enrolled into a clinical trial and were tested prior to dosing on the baseline study day using the CDR System, an integrated set of 3 attention tests, 2 working memory tests, and 4 episodic memory tests. 5-HT1A-R genotyping for (SNP ID rs6295) had been conducted during the study screening period.ResultsValidated factor scores were derived from the 9 tests. It was found that patients with the C/C genotype for the C(1019)G polymorphism of the 5-HT1A-R were significantly superior in retaining and retrieving information, in both working and episodic memory, than those with either the C/G or the G/G genotypes. No differences were found in measures of attention or in the speed of retrieval of information from memory.ConclusionsThis is, to our knowledge, the first relationship found between objective tests of cognitive function and 5-HT1A-R genotypes in MDD.

Depression – Let’s Talk - Role of Aashwasan Chikitsa

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Priya Vishal Naik ◽  
Prachi Datta Dalvi U.
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Positive Attitude ◽  
Medical Intervention ◽  
Medical Illness ◽  
Suicidal Tendency ◽  
Major Depressive ◽  
Curative Therapy ◽  
Personal Interaction

The WHO theme for the year 2017 is Depression. Depression (major depressive disorder) is a common and serious medical illness that negatively affects how a person feels, thinks and behaves. Psychotherapy if incorporated along with medications can be of substantial help in depression. It is also called ‘talking therapy’ and is based on personal interaction with the patient. Patients suffering from this disorder do not easily accept it and hence do not feel the need to seek medical intervention or counselling. In this process the symptoms might get aggravated and suicidal tendency (which is the worst effect of this disease) may develop. So it is extremely essential for the patient, family and society to accept, talk, discuss and seek treatment for this disease. This ‘talking therapy’ is of utmost importance in today’s life where concept of privacy is taking its toll. This therapy is mentioned in Ayurveda as Aashwasan Chikitsa. Aashwasan Chikitsa consists of good, pleasing and benevolent thoughts, spiritual ideas, positive attitude, ethics and communication with near ones. So in the treatment of psychological disorders, along with medications counselling therapy plays a very important role. Finally counselling can act as a part of preventive, curative therapy and also aids to avoid recurrence in the patients of depression.

scholarly journals The Role of Dynorphin and the Kappa Opioid Receptor in Schizophrenia and Major Depressive Disorder: A Translational Approach

2020 ◽  
Author(s):  
Samuel David Clark
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Healthy Volunteers ◽  
Opioid Receptor ◽  
Clinical Data ◽  
Potential Role ◽  
Kappa Opioid Receptor ◽  
Kappa Opioid ◽  
Major Depressive

AbstractThe kappa opioid receptor (KOR) and its endogenous ligands dynorphins (DYN) have been implicated in the development or symptomatology of a variety of neuropsychiatric disorders. This review covers a brief history of the development of KOR agonists and antagonists, their effects in healthy volunteers, and the potential role of DYN/KOR dysfunction in schizophrenia and major depressive disorder from a translational perspective. The potential role of DYN/KOR dysfunction in schizophrenia is based on several lines of evidence. Selective KOR agonists induce affective states in healthy volunteers with similarities to the symptoms of schizophrenia. Studies have shown increased DYN in patients with schizophrenia, although the data have been mixed. Finally, meta-analytic data have shown that opioid antagonists are associated with reductions in the symptoms of schizophrenia. The potential role of DYN/KOR dysfunction in major depressive disorder is also based on a combination of preclinical and clinical data. Selective KOR agonists have shown pro-depressive effects in human volunteers, while selective KOR antagonists have shown robust efficacy in several preclinical models of antidepressant activity. Small studies have shown that nonselective KOR antagonists may have efficacy in treatment-resistant depression. Additionally, recent clinical data have shown that the KOR may be an effective target for treating anhedonia, a finding relevant to both schizophrenia and depression. Finally, recommendations are provided for translating preclinical models for schizophrenia and major depressive disorder into the clinic.

A qualitative and quantitative account of patient’s experiences of ketamine and its antidepressant properties

2021 ◽  
pp. 026988112199832
Author(s):  
Rachael L Sumner ◽  
Emme Chacko ◽  
Rebecca McMillan ◽  
Meg J Spriggs ◽  
Christie Anderson ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Rating Scale ◽  
Qualitative Interviews ◽  
Qualitative Interview ◽  
Preliminary Evidence ◽  
Altered States Of Consciousness ◽  
Altered States ◽  
Major Depressive ◽  
States Of Consciousness

Background: Ketamine is central to one of the most rapidly growing areas of neuroscientific research into novel treatments for depression. Limited research has indicated that the psychedelic properties of ketamine may play a role in its antidepressant effects. Aim: The aim of the current study was to explore the psychedelic experiences and sustained impact of ketamine in major depressive disorder. Methods: In the current study, ketamine (0.44 mg/kg) was administered to 32 volunteers with major depressive disorder in a crossover design with the active-placebo remifentanil, in a magnetic resonance imaging (MRI) environment. The 11-dimension altered states of consciousness questionnaire and individual qualitative interviews were used to capture the acute psychedelic experience. The Montgomery-Asberg Depression Rating Scale and further interviewing explored lasting effects. The second qualitative interview took place ⩾3 weeks post-ketamine. Results: Greater antidepressant response (reduction in Montgomery-Asberg Depression Rating Scale at 24 h) correlated with the 11-dimension altered states of consciousness dimensions: spirituality, experience of unity, and insight. The first qualitative interview revealed that all participants experienced perceptual changes. Additional themes emerged including loss of control and emotional and mood changes. The final interview showed evidence of a psychedelic afterglow, and changes to perspective on life, people, and problems, as well as changes to how participants felt about their depression and treatments. Conclusions: The current study provides preliminary evidence for a role of the psychedelic experience and afterglow in ketamine’s antidepressant properties. Reflexive thematic analysis provided a wealth of information on participants’ experience of the study and demonstrated the psychedelic properties of ketamine are not fully captured by commonly used questionnaires.

Sign in / Sign up

Export Citation Format

Share Document