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.

scholarly journals Social cognition and major depressive disorder: impact on psychosocial function and therapeutic opportunities

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S300-S300
Author(s):  
Michael Weightman ◽  
Bernhard Baune
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Cognitive Deficits ◽  
Psychosocial Functioning ◽  
Social Cognitive ◽  
Major Depressive ◽  
Depressed Patients ◽  
The Social ◽  
Social Cognitive Deficits ◽  
The Impact

AimsThis poster aims to examine the impact of social cognitive deficits on psychosocial functioning in depressed patients, as well as summarise the utility of various evidence-based therapeutic interventions employed to target these deficits. The stated hypotheses were twofold: (1) that social cognitive impairment in major depressive disorder will correlate with poorer psychosocial functioning; and (2) that these deficits will respond to existing anti-depressant therapies.BackgroundSocial cognition is an important adaptive trait that incorporates the identification, perception and interpretation of socially relevant information from the external world. It is frequently affected in major depressive disorder such that depressed patienMethodA review of the existing literature was performed in order to test the stated hypotheses. Pertinent sources were identified via the MEDLINE, EMBASE, PsycINFO, PubMed, Scopus and Google Scholar databases. A total of 107 studies met inclusion criteria for review.ResultImpaired social cognitive performance in depressed patients correlated with poorer psychosocial functioning across the key domains of general cognitive functioning and quality of life. Many current anti-depressant therapies were found to have a normalising effect on the social cognitive abilities of depressed subjects, both at a neural and functional level. Anti-depressant medications, in particular citalopram and reboxetine, appeared to correct facial affect recognition deficits, while a psychotherapeutic approach demonstrated improvements in theory of mind and negative interpretive bias. Data relating to other common treatments, such as electroconvulsive therapy, are limited.ConclusionThe impact and treatment of social cognitive deficits in major depressive disorder is an important emerging field. The social cognitive deficits evident in depressed patients are sometimes subtle, but afford a significant functional impact. Additionally, it appears these impairments are at least partially reversible using anti-depressants or psychotherapy.

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 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.

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.

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.

scholarly journals The Relationship Between Cognitive Dysfunction Through THINC-Integrated Tool (THINC-it) and Psychosocial Function in Chinese Patients With Major Depressive Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Han Han ◽  
Yanyan Hou ◽  
Shuqiao Yao ◽  
Shaohua Hu ◽  
Qi Zhou ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Cognitive Dysfunction ◽  
Cognitive Deficits ◽  
Depression Scale ◽  
Chinese Patients ◽  
Hamilton Depression Scale ◽  
Major Depressive ◽  
Psychosocial Function ◽  
Workplace Productivity

Background: Herein, we validate the psychometric properties of the Chinese version of the THINC-integrated tool (THINC-it) as a screening tool for cognitive deficits in patients with major depressive disorder. The primary aim of this study is to determine whether cognitive deficits as detected by the THINC-it tool in adults with major depressive disorder (MDD) are associated with workplace productivity and/or psychosocial function.Methods: Subjects aged 18–65 (n = 91) with MDD were evaluated and compared to age-, sex- and education- matched healthy controls (n = 95). Symptoms of cognitive dysfunction, workplace productivity, and psychosocial function were measured using the THINC-it tool, Hamilton Depression Scale (HAMD), Sheehan Disability Scale (SDS), The Work Productivity and Activity Impairment questionnaire- Specific Health Problem (WPAI-SHP).Results: There were significant differences in THINC-it scores (p &lt; 0.01), the average of HAMD total score (p &lt; 0.01) and all aspects of SDS (p &lt; 0.01) between two groups. There were significant differences in the four aspects of WPAI between the two groups in the employed status (p &lt;0.01). THINC-it subjective cognition and SDS total score, SDS work/school, SDS social, SDS family showed significantly correlation (r ranging from 0.255 to 0.386, p &lt;0.01). SDS and THINC-it Objective cognition, THINC-it comprehensive cognition were no correlation between two groups. HAMD total score and SDS total score, SDS social, SDS family showed significantly correlation (r ranging

Impacts on Quality of Life with Escitalopram Monotherapy and Aripiprazole Augmentation in Patients with Major Depressive Disorder: A CAN-BIND Report

2021 ◽  
Author(s):  
Emma Morton ◽  
Venkat Bhat ◽  
Peter Giacobbe ◽  
Wendy Lou ◽  
Erin E. Michalak ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Repeated Measures ◽  
Short Form ◽  
Treatment Phase ◽  
Major Depressive ◽  
Symptomatic Remission ◽  
Substantial Degree

Abstract Introduction Many individuals with major depressive disorder (MDD) do not respond to initial antidepressant monotherapy. Adjunctive aripiprazole is recommended for treatment non-response; however, the impacts on quality of life (QoL) for individuals who receive this second-line treatment strategy have not been described. Methods We evaluated secondary QoL outcomes in patients with MDD (n=179). After 8 weeks of escitalopram, non-responders (<50% decrease in clinician-rated depression) were treated with adjunctive aripiprazole for 8 weeks (n=97); responders continued escitalopram (n=82). A repeated-measures ANOVA evaluated change in Quality of Life Enjoyment and Satisfaction Short Form scores. QoL was described relative to normative benchmarks. Results Escitalopram responders experienced the most QoL improvements in the first treatment phase. For non-responders, QoL improved with a large effect during adjunctive aripiprazole treatment. At the endpoint, 47% of patients achieving symptomatic remission still had impaired QoL. Discussion Individuals who were treated with adjunctive aripiprazole after non-response to escitalopram experienced improved QoL, but a substantial degree of QoL impairment persisted. Since QoL deficits may predict MDD recurrence, attention to ways to support this outcome is required.

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