Successful Application of Adaptive Emotion Regulation Skills Predicts the Subsequent Reduction of Depressive Symptom Severity but neither the Reduction of Anxiety nor the Reduction of General Distress during the Treatment of Major Depressive Disorder

Objectives: Major depressive disorder (MDD) is associated with impairments in both cognition and functioning. However, whether cognitive deficits significantly contribute to impaired psychosocial and occupational functioning, independent of other depressive symptoms, is not well established. We examined the relationship between cognitive performance and functioning in depressed patients before and after antidepressant treatment using secondary data from the first Canadian Biomarker Integration Network in Depression-1 study. Methods: Cognition was assessed at baseline in unmedicated, depressed participants with MDD ( n = 207) using the Central Nervous System Vital Signs computerized battery, psychosocial functioning with the Sheehan Disability Scale (SDS), and occupational functioning with the Lam Employment Absence and Productivity Scale (LEAPS). Cognition ( n = 181), SDS ( n = 175), and LEAPS ( n = 118) were reassessed after participants received 8 weeks of open-label escitalopram monotherapy. A series of linear regressions were conducted to determine (1) whether cognitive functioning was associated with psychosocial and occupational functioning prior to treatment, after adjusting for overall depressive symptom severity and (2) whether changes in cognitive functioning after an 8-week treatment phase were associated with changes in psychosocial and occupational functioning, after adjusting for changes in overall symptom severity. Results: Baseline global cognitive functioning, after adjusting for depression symptom severity and demographic variables, was associated with the SDS work/study subscale (β = −0.17; P = 0.03) and LEAPS productivity subscale (β = −0.17; P = 0.05), but not SDS total (β = 0.19; P = 0.12) or LEAPS total (β = 0.41; P = 0.17) scores. Although LEAPS and SDS scores showed significant improvements after 8 weeks of treatment ( P < 0.001), there were no significant associations between changes in cognitive domain scores and functional improvements. Conclusion: Cognition was associated with occupational functioning at baseline, but changes in cognition were not associated with psychosocial or occupational functional improvements following escitalopram treatment. We recommend the use of more comprehensive functional assessments to determine the impact of cognitive change on functional outcomes in future research.

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Abnormalities in the structural covariance of emotion regulation networks in major depressive disorder

Journal of Psychiatric Research ◽

10.1016/j.jpsychires.2016.10.001 ◽

2017 ◽

Vol 84 ◽

pp. 237-242 ◽

Cited By ~ 21

Author(s):

Huawang Wu ◽

Hui Sun ◽

Chao Wang ◽

Lin Yu ◽

Yilan Li ◽

...

Keyword(s):

Major Depressive Disorder ◽

Emotion Regulation ◽

Depressive Disorder ◽

Major Depressive ◽

Structural Covariance

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High-frequency cognitive and mood assessment in major depressive disorder with wearable technology (Preprint)

10.2196/preprints.12814 ◽

2018 ◽

Author(s):

Francesca Cormack ◽

Maggie McCue ◽

Nick Taptiklis ◽

Caroline Skirrow ◽

Emilie Glazer ◽

...

Keyword(s):

Major Depressive Disorder ◽

Cognitive Function ◽

Depressive Disorder ◽

Symptom Severity ◽

High Frequency ◽

Depression Symptom ◽

Cognitive Assessments ◽

Major Depressive ◽

Good Correspondence ◽

Adequate Treatment

BACKGROUND Cognitive symptoms are common in major depressive disorder, and may help to identify patients that need treatment or who are not experiencing adequate treatment response. Digital tools to provide real time data assessing cognitive function could help to support patients treatment and remediation of cognitive and mood symptoms. OBJECTIVE This study examined adherence, feasibility, and validity of a wearable high-frequency cognitive and mood assessment app over 6 weeks, corresponding to when antidepressant pharmacotherapy begins to show efficacy. METHODS Thirty patients (aged 19−63; 19 women) with mild-moderate depression participated. The new Cognition Kit application was delivered via the Apple Watch, providing a high-resolution touch screen display for task presentation and logging responses. Cognition was assessed by the n-back task up to 3 times daily and depressed mood by 3 short questions once daily. Selected tests sensitive to depression from the Cambridge Neuropsychological Test Automated Battery and validated questionnaires of depression symptom severity were administered on 4 occasions (baseline, weeks 1, 3, and 6). Adherence was defined as participants completing at least one assessment daily. RESULTS Adherence was excellent for mood and cognitive assessments (95% and 96%, respectively), did not deteriorate over time, and was not influenced by depression symptom severity or cognitive function at study onset. Daily mood assessments showed good correspondence with validated depression questionnaires (correlations range from .45 to .69 for total daily mood score) and daily cognitive assessments showed good correspondence with cognitive tests sensitive to depression (correlations ranged from .37 to .50 for mean n-back). CONCLUSIONS The study supports the feasibility and validity of high-frequency assessment of cognitive function and mood function using wearable devices over an extended period in patients with major depressive disorder. CLINICALTRIAL clinicaltrials.gov NCT03067506

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Patient-reported outcomes before and after treatment of major depressive disorder

Dialogues in Clinical Neuroscience ◽

10.31887/dcns.2014.16.2/rcohen ◽

2014 ◽

Vol 16 (2) ◽

pp. 171-183 ◽

Cited By ~ 5

Keyword(s):

Depressive Symptom ◽

Symptom Severity ◽

Patient Reported Outcomes ◽

Burden Of Illness ◽

Major Depressive ◽

Patient Reported ◽

Before And After ◽

Depressive Symptom Severity ◽

The Impact ◽

Level 2

Patient reported outcomes (PROs) of quality of life (QoL), functioning, and depressive symptom severity are important in assessing the burden of illness of major depressive disorder (MDD) and to evaluate the impact of treatment. We sought to provide a detailed analysis of PROs before and after treatment of MDD from the large Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. This analysis examines PROs before and after treatment in the second level of STAR*D. The complete data on QoL, functioning, and depressive symptom severity, were analyzed for each STAR*D level 2 treatment. PROs of QoL, functioning, and depressive symptom severity showed substantial impairments after failing a selective serotonin reuptake inhibitor trial using citalopram (level 1). The seven therapeutic options in level 2 had positive statistically (P values) and clinically (Cohen's standardized differences [Cohen's d]) significant impact on QoL, functioning, depressive symptom severity, and reduction in calculated burden of illness. There were no statistically significant differences between the interventions. However, a substantial proportion of patients still suffered from patient-reported QoL and functioning impairment after treatment, an effect that was more pronounced in nonremitters. PROs are crucial in understanding the impact of MDD and in examining the effects of treatment interventions, both in research and clinical settings.

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THE PATTERN OF IRRATIONAL BELIEFS ASSOCIATED WITH MAJOR DEPRESSIVE DISORDER

Social Behavior and Personality An International Journal ◽

10.2224/sbp.1992.20.3.199 ◽

1992 ◽

Vol 20 (3) ◽

pp. 199-212 ◽

Cited By ~ 6

Author(s):

Lyne Prud'homme ◽

Pierre Barron

Keyword(s):

Major Depressive Disorder ◽

Discriminant Analysis ◽

Depressive Disorder ◽

Symptom Severity ◽

Irrational Beliefs ◽

Irrational Belief ◽

Normal Control Group ◽

Control Group ◽

Major Depressive ◽

Normal Controls

In light of Rational-Emotive Theory, this study was undertaken to determine the pattern of irrational beliefs underlying Major Depressive Disorder (MDD). A total of 126 subjects (50 males, 76 females) volunteered to participate. Patients clinically diagnosed with MDD (unipolar type) and a control group of non-depressed patients were solicited from the inpatient and outpatient facilities of several Ottawa and Montreal hospitals; the normal control group comprised students and civil servants. The subjects completed questionnaires to measure irrational belief endorsement (IBT, RBI) and symptom severity (STAI, BDI) and to verify the depression diganosis (IDD). Multivariate statistics were used to determine the pattern of beliefs which best discriminates between the MDD group, the psychiatric control group, and the normal controls. Discriminant analysis of the IBT revealed a pattern of four irrational beliefs generally known as demand for approval, frustration reactivity, anxious overconcern, and helplessness over past. The implications of such findings for RET theory are discussed.

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