Cognitive Dysfunction as a Symptom Dimension Across Major Psychiatric Disorders

2019 ◽  
pp. 35-44
Author(s):  
Zihang Pan ◽  
Roger S. McIntyre
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Psychiatric Disorders ◽  
Cognitive Dysfunction ◽  
Cognitive Deficits ◽  
Functional Disability ◽  
Cognitive Symptoms ◽  
Compelling Evidence ◽  
Psychiatric Illnesses ◽  
Neurobiological Substrates

Cognitive dysfunction is a symptom domain across multiple psychiatric disorders. Cognitive deficits in individuals with major depressive disorder (MDD) and bipolar disorder (BD) are significant contributors to global occupational and functional disability. The subdomains of learning and memory, executive function, processing speed, and attention and concentration are significantly impaired in individuals with MDD and BD. Treatment outcomes of cognitive symptoms with first-line agents have been suboptimal. Neuroinflammatory pathways are hypothesized to play key roles in the pathoaetiology of cognitive symptoms in MDD and BD. There is compelling evidence to suggest that elevation of systemic proinflammatory cytokines is involved in neurotoxicity, apoptosis, and aberrant neurocircuit function. These substrates offer opportunities to identify relevant biomarkers, refine treatment targets, and manage cognitive deficits across major psychiatric illnesses. This chapter provides an overview of cognitive symptoms across MDD and BD and discusses potential neurobiological substrates contributing to cognitive dysfunction.

scholarly journals Cognitive impairment in major depressive disorder

CNS Spectrums ◽  
2018 ◽  
Vol 24 (1) ◽  
pp. 22-29 ◽  
Author(s):  
Zihang Pan ◽  
Caroline Park ◽  
Elisa Brietzke ◽  
Hannah Zuckerman ◽  
Carola Rong ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Cognitive Dysfunction ◽  
Cognitive Deficits ◽  
Functional Disability ◽  
Testable Hypothesis ◽  
Major Depressive ◽  
Cognitive Domains ◽  
Patient Reported ◽  
Neurobiological Substrates

Cognitive dysfunction is a symptomatic domain identified across many mental disorders. Cognitive deficits in individuals with major depressive disorder (MDD) contribute significantly to occupational and functional disability. Notably, cognitive subdomains such as learning and memory, executive functioning, processing speed, and attention and concentration are significantly impaired during, and between, episodes in individuals with MDD. Most antidepressants have not been developed and/or evaluated for their ability to directly and independently ameliorate cognitive deficits. Multiple interacting neurobiological mechanisms (eg, neuroinflammation) are implicated as subserving cognitive deficits in MDD. A testable hypothesis, with preliminary support, posits that improving performance across cognitive domains in individuals with MDD may improve psychosocial function, workplace function, quality of life, and other patient-reported outcomes, independent of effects on core mood symptoms. Herein we aim to (1) provide a rationale for prioritizing cognitive deficits as a therapeutic target, (2) briefly discuss the neurobiological substrates subserving cognitive dysfunction, and (3) provide an update on current and future treatment avenues.

Fatty acid composition of the postmortem corpus callosum of patients with schizophrenia, bipolar disorder, or major depressive disorder

2017 ◽  
Vol 39 ◽  
pp. 51-56 ◽  
Author(s):  
K. Hamazaki ◽  
M. Maekawa ◽  
T. Toyota ◽  
B. Dean ◽  
T. Hamazaki ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Fatty Acid ◽  
White Matter ◽  
Corpus Callosum ◽  
Depressive Disorder ◽  
Psychiatric Disorders ◽  
Postmortem Brain ◽  
Major Depressive

AbstractBackgroundStudies investigating the relationship between n-3 polyunsaturated fatty acid (PUFA) levels and psychiatric disorders have thus far focused mainly on analyzing gray matter, rather than white matter, in the postmortem brain. In this study, we investigated whether PUFA levels showed abnormalities in the corpus callosum, the largest area of white matter, in the postmortem brain tissue of patients with schizophrenia, bipolar disorder, or major depressive disorder.MethodsFatty acids in the phospholipids of the postmortem corpus callosum were evaluated by thin-layer chromatography and gas chromatography. Specimens were evaluated for patients with schizophrenia (n = 15), bipolar disorder (n = 15), or major depressive disorder (n = 15) and compared with unaffected controls (n = 15).ResultsIn contrast to some previous studies, no significant differences were found in the levels of PUFAs or other fatty acids in the corpus callosum between patients and controls. A subanalysis by sex gave the same results. No significant differences were found in any PUFAs between suicide completers and non-suicide cases regardless of psychiatric disorder diagnosis.ConclusionsPatients with psychiatric disorders did not exhibit n-3 PUFAs deficits in the postmortem corpus callosum relative to the unaffected controls, and the corpus callosum might not be involved in abnormalities of PUFA metabolism. This area of research is still at an early stage and requires further investigation.

Managing Cognitive Dysfunction in Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S15-S16
Author(s):  
K. Miskowiak
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Functional Recovery ◽  
Cognitive Deficits ◽  
Clinical Treatment ◽  
Screening Tools ◽  
Treatment Target ◽  
Concentration Difficulty

Cognitive dysfunction, including memory and concentration difficulty, is an emerging treatment target in bipolar disorder. However, a key challenge in the management of these cognitive deficits is the lack of treatments with robust effects on cognition. Further, it is unclear how cognitive dysfunction should be assessed and addressed in the clinical treatment of the disorder. This talk will review the evidence for cognitive impairment in bipolar disorder, including its severity, persistence and impact on patients’ functional recovery. It will then discuss when and how to assess cognition and present some new feasible screening tools for cognitive dysfunction. Finally, it will highlight some novel candidate cognition treatments.Disclosure of interestI have acted as a consultant and received honoraria from Lundbeck and Allergan.

Clinical features and diagnosis

2012 ◽  
Author(s):  
Raymond W. Lam
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Differential Diagnosis ◽  
Depressive Disorder ◽  
Clinical Features ◽  
Cognitive Symptoms ◽  
Major Depressive ◽  
Low Mood ◽  
Different Types ◽  
Variable Presentation

• Depression is associated with a number of physical, emotional, and cognitive symptoms.• Sub-typing of major depressive disorder has implications for treatment choice and selection.• The differential diagnosis of depression includes bereavement, bipolar disorder, and other medical or substance-induced conditions.Depression is associated with many different types of symptoms which can result to a variable presentation in any given person. The features of depression can be physical (sleep, energy, appetite, libido), emotional (low mood, anxiety, crying) or cognitive (guilt, pessimism, suicidal thoughts). ...

Lifestyle and neuroprogression: Diet, sleep, and exercise

2019 ◽  
pp. 207-222
Author(s):  
Adrian L. Lopresti ◽  
Peter D. Drummond
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Psychiatric Disorders ◽  
Lifestyle Factors ◽  
Therapeutic Effects ◽  
Physiological Mechanisms ◽  
Prevention And Treatment ◽  
Psychiatric Conditions

Diet, sleep, and exercise are lifestyle factors important for the prevention and treatment of psychiatric disorders, including major depressive disorder, anxiety disorders, bipolar disorder, and schizophrenia. These lifestyle factors can contribute to dysregulation in important physiological mechanisms associated with psychiatric disorders and influence neuroprogression. We review research highlighting the important role of these lifestyle factors for different psychiatric conditions, and examine the potential mechanisms behind their therapeutic effects, with a particular emphasis on how they may each influence neuroprogression.

scholarly journals Cognition in mania and depression

2003 ◽  
Vol 33 (6) ◽  
pp. 959-967 ◽  
Author(s):  
J. V. TAYLOR TAVARES ◽  
W. C. DREVETS ◽  
B. J. SAHAKIAN
Keyword(s):  
Information Processing ◽  
Psychiatric Disorders ◽  
Negative Feedback ◽  
Cognitive Deficits ◽  
American Psychiatric Association ◽  
Cognitive Symptoms ◽  
Major Depressive ◽  
Dsm Iv ◽  
Early Information ◽  
Criteria For Diagnosis

The inclusion of cognitive symptoms in the DSM-IV criteria for major depressive and manic episodes highlight the importance of cognition in both of these psychiatric disorders (American Psychiatric Association, 1994). For example, criteria for diagnosis of these conditions include a diminished ability to concentrate and indecisiveness. In addition, numerous studies have demonstrated wide-ranging cognitive deficits in depression (for example Elliott et al. 1996; Purcell et al. 1997; Murphy et al. 2003) and mania (Goldberg et al. 1993; Murphy et al. 1999, 2001; Sweeney et al. 2000). These include deficits in early information processing (Tsourtos et al. 2002), recollection memory (MacQueen et al. 2002) and planning (Elliott et al. 1996) as well as affective biases (Murphy et al. 1999) and abnormal responses to negative feedback (Elliott et al. 1996, 1997; Murphy et al. 2003). Some residual deficits are also evident in a proportion of remitted subjects, even when controlling for mood (for example, Clark et al. 2002).

Euthymic bipolar disorder: Are there cognitive dysfunctions?

2011 ◽  
Vol 26 (S2) ◽  
pp. 198-198
Author(s):  
G. Da Ponte ◽  
T. Neves ◽  
M. Lobo
Keyword(s):  
Bipolar Disorder ◽  
Executive Functions ◽  
Cognitive Dysfunction ◽  
Cognitive Deficits ◽  
Verbal Memory ◽  
Clinical Case ◽  
Relevant Literature ◽  
Psychological Tests ◽  
Drug Treatments ◽  
Depressive Episodes

IntroductionThe presence of cognitive dysfunction in bipolar disorder is well established, but in the euthymic phase appear a few studies that point to the absence of cognitive deficits.ObjectivesAlert to cases of euthymic bipolar disorder with no cognitive dysfunction.MethodsReview of relevant literature and description of a clinical case with psychological tests that assess memory and executive functions.ResultsDescription of a clinical case: FP is a middle age woman, early retired, with a bipolar disorder type 2, which begins at age 30.Her disease has several depressive episodes, and in the last 10 years, she spent most of the days lying in bed and repeatedly resorted to the emergency department for excessive voluntary drug intoxication or simply because she “wanted” to be hospitalized; her husband could not stand this situation. In September of 2009, in addition to the medical and psychological consultations, she starts attending group therapy; over the next 6 months her medication was changed and finally her disease goes into remission.The psychological tests, made at euthymic phase, show’s no significant deficits in verbal memory and executive functions.ConclusionsThis patient has a disease with prolonged course and multiple hospitalizations and drug treatments, but don’t present relevant cognitive deficits, which may point to the fact that cognitive impairment is determined by biological factors.

scholarly journals White matter microstructural alterations across four major psychiatric disorders: mega-analysis study in 2937 individuals

2019 ◽  
Vol 25 (4) ◽  
pp. 883-895 ◽  
Author(s):  
Daisuke Koshiyama ◽  
◽  
Masaki Fukunaga ◽  
Naohiro Okada ◽  
Kentaro Morita ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
White Matter ◽  
Depressive Disorder ◽  
Psychiatric Disorders ◽  
Limbic System ◽  
Autism Spectrum ◽  
Major Depressive ◽  
Microstructural Alterations

AbstractIdentifying both the commonalities and differences in brain structures among psychiatric disorders is important for understanding the pathophysiology. Recently, the ENIGMA-Schizophrenia DTI Working Group performed a large-scale meta-analysis and reported widespread white matter microstructural alterations in schizophrenia; however, no similar cross-disorder study has been carried out to date. Here, we conducted mega-analyses comparing white matter microstructural differences between healthy comparison subjects (HCS; N = 1506) and patients with schizophrenia (N = 696), bipolar disorder (N = 211), autism spectrum disorder (N = 126), or major depressive disorder (N = 398; total N = 2937 from 12 sites). In comparison with HCS, we found that schizophrenia, bipolar disorder, and autism spectrum disorder share similar white matter microstructural differences in the body of the corpus callosum; schizophrenia and bipolar disorder featured comparable changes in the limbic system, such as the fornix and cingulum. By comparison, alterations in tracts connecting neocortical areas, such as the uncinate fasciculus, were observed only in schizophrenia. No significant difference was found in major depressive disorder. In a direct comparison between schizophrenia and bipolar disorder, there were no significant differences. Significant differences between schizophrenia/bipolar disorder and major depressive disorder were found in the limbic system, which were similar to the differences in schizophrenia and bipolar disorder relative to HCS. While schizophrenia and bipolar disorder may have similar pathological characteristics, the biological characteristics of major depressive disorder may be close to those of HCS. Our findings provide insights into nosology and encourage further investigations of shared and unique pathophysiology of psychiatric disorders.

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