The Assessment of Cognitive Dysfunction in Major Depressive Disorder
Accurately capturing an individual’s cognitive status is a key requirement for identifying levels of impairment in patients with central nervous system indications, including in those with diagnoses of major depressive disorders (MDD). This requirement extends to the determination of whether a therapeutic intervention has impacted cognition and, if so, the extent to which this has occurred. In this chapter we will consider these issues with respect to the assessment of cognition in patients with MDD. We begin with a review of performance on measures reported in recent meta-analyses and with a particular focus on their sensitivity to treatment effects. We proceed to a consideration of how best we might accurately capture levels of cognitive performance and the precautions required to reduce sources of measurement error. These methods will then be considered in the context of a recent case study of a treatment (vortioxetine) development programme. The issues explored in the context of assessing cognition in the vortioxetine programme are then considered in the context of screening for deficits in patients with MDD. We close the chapter with a summary and recommendations for the accurate assessment of cognition, as well as a brief consideration of how technological developments might aid this process.