Wearable Technology for High-Frequency Cognitive and Mood Assessment in Major Depressive Disorder: Longitudinal Observational Study

Background Cognitive symptoms are common in major depressive disorder and may help to identify patients who need treatment or who are not experiencing adequate treatment response. Digital tools providing real-time data assessing cognitive function could help support patient treatment and remediation of cognitive and mood symptoms. Objective The aim of this study was to examine 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 A total of 30 patients (aged 19-63 years; 19 women) with mild-to-moderate depression participated in the study. The new Cognition Kit app 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. Adherence was defined as participants completing at least 1 assessment daily. Selected tests sensitive to depression from the Cambridge Neuropsychological Test Automated Battery and validated questionnaires of depression symptom severity were administered on 3 occasions (weeks 1, 3, and 6). Exploratory analyses examined the relationship between mood and cognitive measures acquired in low- and high-frequency assessment. 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. Analyses examining the relationship between high-frequency cognitive and mood assessment and validated measures showed good correspondence. Daily mood assessments correlated moderately with validated depression questionnaires (r=0.45-0.69 for total daily mood score), and daily cognitive assessments correlated moderately with validated cognitive tests sensitive to depression (r=0.37-0.50 for mean n-back). Conclusions This study supports the feasibility and validity of high-frequency assessment of cognition and mood using wearable devices over an extended period in patients with major depressive disorder.

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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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Cognition and Its Association with Psychosocial and Occupational Functioning during Treatment with Escitalopram in Patients with Major Depressive Disorder: A CAN-BIND-1 Report: La Cognition Et Son Association Avec Le Fonctionnement Psychosocial Et Professionnel Durant Le Traitement Par Escitalopram Chez Des Patients Souffrant De Trouble Dépressif Majeur: Une Étude Can-Bind-1

The Canadian Journal of Psychiatry ◽

10.1177/0706743720974823 ◽

2020 ◽

pp. 070674372097482

Author(s):

Shane J. McInerney ◽

Trisha Chakrabarty ◽

Malgorzata Maciukiewicz ◽

Benicio N. Frey ◽

Glenda M. MacQueen ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Cognitive Functioning ◽

Symptom Severity ◽

Cognitive Change ◽

Cognitive Domain ◽

Depression Symptom ◽

Major Depressive ◽

Occupational Functioning ◽

The Impact

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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Perfectionism and depression symptom severity in major depressive disorder

Behaviour Research and Therapy ◽

10.1016/s0005-7967(98)00188-0 ◽

1999 ◽

Vol 37 (8) ◽

pp. 783-794 ◽

Cited By ~ 100

Author(s):

Murray W. Enns ◽

Brian J. Cox

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Symptom Severity ◽

Depression Symptom ◽

Major Depressive

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Adverse childhood experiences, adult depression, and suicidal ideation in rural Uganda: A cross-sectional, population-based study

PLoS Medicine ◽

10.1371/journal.pmed.1003642 ◽

2021 ◽

Vol 18 (5) ◽

pp. e1003642

Author(s):

Emily N. Satinsky ◽

Bernard Kakuhikire ◽

Charles Baguma ◽

Justin D. Rasmussen ◽

Scholastic Ashaba ◽

...

Keyword(s):

Major Depressive Disorder ◽

Suicidal Ideation ◽

Depressive Disorder ◽

Symptom Severity ◽

Depression Symptom ◽

Cumulative Number ◽

Major Depressive ◽

Cross Sectional ◽

Childhood Experiences ◽

Adverse Childhood

Background Depression is recognized globally as a leading cause of disability. Early-life adverse childhood experiences (ACEs) have been shown to have robust associations with poor mental health during adulthood. These effects may be cumulative, whereby a greater number of ACEs are progressively associated with worse outcomes. This study aimed to estimate the associations between ACEs and adult depression and suicidal ideation in a cross-sectional, population-based study of adults in Uganda. Methods and findings Between 2016 and 2018, research assistants visited the homes of 1,626 adult residents of Nyakabare Parish, a rural area in southwestern Uganda. ACEs were assessed using a modified version of the Adverse Childhood Experiences-International Questionnaire, and depression symptom severity and suicidal ideation were assessed using the Hopkins Symptom Checklist for Depression (HSCL-D). We applied a validated algorithm to determine major depressive disorder diagnoses. Overall, 1,458 participants (90%) had experienced at least one ACE, 159 participants (10%) met criteria for major depressive disorder, and 28 participants (1.7%) reported suicidal ideation. We fitted regression models to estimate the associations between cumulative number of ACEs and depression symptom severity (linear regression model) and major depressive disorder and suicidal ideation (Poisson regression models). In multivariable regression models adjusted for age, sex, primary school completion, marital status, self-reported HIV status, and household asset wealth, the cumulative number of ACEs was associated with greater depression symptom severity (b = 0.050; 95% confidence interval [CI], 0.039–0.061, p < 0.001) and increased risk for major depressive disorder (adjusted relative risk [ARR] = 1.190; 95% CI, 1.109–1.276; p < 0.001) and suicidal ideation (ARR = 1.146; 95% CI, 1.001–1.311; p = 0.048). We assessed the robustness of our findings by probing for nonlinearities and conducting analyses stratified by age. The limitations of the study include the reliance on retrospective self-report as well as the focus on ACEs that occurred within the household. Conclusions In this whole-population, cross-sectional study of adults in rural Uganda, the cumulative number of ACEs had statistically significant associations with depression symptom severity, major depressive disorder, and suicidal ideation. These findings highlight the importance of developing and implementing policies and programs that safeguard children, promote mental health, and prevent trajectories toward psychosocial disability.

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White matter abnormalities and illness severity in major depressive disorder

The British Journal of Psychiatry ◽

10.1192/bjp.bp.111.100594 ◽

2012 ◽

Vol 201 (1) ◽

pp. 33-39 ◽

Cited By ~ 73

Author(s):

James Cole ◽

Christopher A. Chaddock ◽

Anne E. Farmer ◽

Katherine J. Aitchison ◽

Andrew Simmons ◽

...

Keyword(s):

Major Depressive Disorder ◽

White Matter ◽

Major Depression ◽

Corpus Callosum ◽

Depressive Disorder ◽

Symptom Severity ◽

White Matter Integrity ◽

Control Group ◽

Major Depressive ◽

The Relationship

BackgroundWhite matter abnormalities have been implicated in the aetiology of major depressive disorder; however, the relationship between the severity of symptoms and white matter integrity is currently unclear.AimsTo investigate white matter integrity in people with major depression and healthy controls, and to assess its relationship with depressive symptom severity.MethodDiffusion tensor imaging data were acquired from 66 patients with recurrent major depression and a control group of 66 healthy individuals matched for age, gender and IQ score, and analysed with tract-based spatial statistics. The relationship between white matter integrity and severity of depression as measured by the Beck Depression Inventory was examined.ResultsDepressive illness was associated with widespread regions of decreased white matter integrity, including regions in the corpus callosum, superior longitudinal fasciculus and anterior corona radiata, compared with the control group. Increasing symptom severity was negatively correlated with white matter integrity, predominantly in the corpus callosum.ConclusionsWidespread alterations in white matter integrity are evident in major depressive disorder. These abnormalities are heightened with increasing severity of depressive symptoms.

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