Cognitive Deficits and Functional Outcomes in Major Depressive Disorder: Determinants, Substrates, and Treatment Interventions

McIntyre, Roger S.; Danielle, S.; Soczynska, Joanna K.; Woldeyohannes, Hanna O.; Gallaugher, Laura Ashley; Kudlow, Paul; Alsuwaidan, Mohammad; Baskaran, Anusha

doi:10.1002/da.22063

Cited by 618 publications

(469 citation statements)

References 97 publications

Supporting

Mentioning

439

Contrasting

Unclassified

Order By: Relevance

“…20 Continued impairment is a risk factor for future depression 14 and associated with poorer response to treatment. Differential diagnosis of residual cognitive impairment includes comorbid physical or psychiatric diagnoses, discontinuation syndrome associated with non-compliance, incorrect diagnosis, psychosocial factors, medication side-effects and, in older patients, dementia.…”

Section: The Needsmentioning

confidence: 99%

“…A challenge for most PCPs is that they may not understand the various domains of cognitive impairment, such as executive function, working memory, episodic memory, attention and psychomotor processing speed. 20,21 So what tools are suitable and available to assist PCPs in identifying residual symptoms? The Conradi study used the Composite International Diagnostic Interview (CIDI).…”

Section: The Needsmentioning

confidence: 99%

See 1 more Smart Citation

Challenges of residual symptoms and functioning in management of MDD

Rasmussen

Young²

2018

Prog Neurol Psychiatry

View full text Add to dashboard Cite

Major depression is the leading cause of ill health and disability worldwide. 2017 marked the year when the World Health Organization led a one‐year global campaign with the goal that more people with depression both seek and get help.1,2 In England, Hospital Episode Statistics and Mental Health and Learning Disabilities data sets show that one in three patients with depression are unrecognised. Those who are recognised are often then under‐treated, fail to achieve remission and have difficulty returning to full functioning.

show abstract

Section: The Needsmentioning

confidence: 99%

Section: The Needsmentioning

confidence: 99%

Challenges of residual symptoms and functioning in management of MDD

Rasmussen

Young²

2018

Prog Neurol Psychiatry

View full text Add to dashboard Cite

show abstract

“…These deficits are of significant concern as they contribute to impairments in multiple psychosocial domains (McIntyre et al., 2013) and are related to disruptions in instrumental activities of daily living (McCall & Dunn, 2003). Notably, patients with trauma‐related disorders, including post‐traumatic stress disorder (PTSD), show deficits in a similar range of cognitive domains (Cohen et al., 2013), with structural and functional brain changes observed across MDD and trauma‐related disorders in regions linked to recollective memory (e.g., hippocampus) (McKinnon, Yucel, Nazarov, & MacQueen, 2009), attention (e.g., anterior cingulate cortex [ACC]) (Yucel et al., 2008), and executive functioning (e.g., dorsolateral prefrontal cortex [dlPFC]) (Koenigs & Grafman, 2009).…”

Section: Introductionmentioning

confidence: 99%

Relation between patterns of intrinsic network connectivity, cognitive functioning, and symptom presentation in trauma‐exposed patients with major depressive disorder

et al. 2017

View full text Add to dashboard Cite

ObjectiveThe present study investigated resting fMRI connectivity within the default mode (DMN), salience (SN), and central executive (CEN) networks in relation to neurocognitive performance and symptom severity in trauma‐exposed patients with major depressive disorder (MDD).MethodGroup independent component analysis was conducted among patients with MDD (n = 21), examining DMN, SN, and CEN connectivity in relation to neurocognitive performance and symptom severity. Activation in these networks was also compared between the patient group and healthy controls (n = 20).ResultsAmong the patient group, higher levels of performance on measures of verbal memory and executive functioning were related to increased connectivity within the DMN (i.e., inferior parietal lobe; precuneus). Greater depression severity was related to reduced connectivity between the SN and a node of the DMN (i.e., posterior cingulate cortex) and higher depersonalization symptoms were related to enhanced connectivity between the SN and a node of the DMN (i.e., middle temporal gyrus). Higher symptoms of depersonalization were also associated with reduced integration of the DMN with the medial frontal gyrus. Relative to controls, patients with MDD showed greater connectivity of the ventromedial prefrontal cortex within the DMN.ConclusionIntrinsic connectivity network patterns are related to cognitive performance and symptom presentation among trauma‐exposed patients with MDD.

show abstract

“…Presenteeism is related to decreased performance at work when people still attend to work despite ongoing illness or they cannot return to previous performance levels after recovery. Cognitive symptoms were suggested to be major factor contributing to functional impairments (McIntyre et al 2013).Clinically, cognitive symptoms are commonly endorsed by the patients both during episodes and as residual symptoms (Conradi et al 2011). Numerous studies reported poorer neuropsychological performance in tests of memory, attention and executive function in patients with depression (Bora et al The impact of cognitive dysfunction on functioning may be related to persistence of cognitive deficits even after mood symptoms recover.…”

mentioning

confidence: 99%

Cognition as a treatment target in depression

2016

View full text Add to dashboard Cite

Cognitive dysfunction in depression is associated with poorer clinical outcomes and impaired psychosocial functioning. However, most treatments for depression do not specifically target cognition. Neurocognitive deficits such as memory and concentration problems tend to persist after mood symptoms recover. Improving cognition in depression requires a better understanding of brain systems implicated in depression. A comprehensive approach is warranted for refined methods of assessing and treating cognitive dysfunction in depression. Depression is a major cause of disability worldwide. It is estimated to be second largest contributor to disease burden by 2020 according to World Health Organization (World Federation of Mental Health, 2012). Depression could interfere with various aspects of functioning including work, quality of life, or psychosocial functioning. At workplace, depression is one of the main causes of absenteeism and presenteeism (Druss et al. 2001). Absenteeism refers to direct impact of depression on occupational functioning where people cannot attend work due to depressive illness. Presenteeism is related to decreased performance at work when people still attend to work despite ongoing illness or they cannot return to previous performance levels after recovery. Cognitive symptoms were suggested to be major factor contributing to functional impairments (McIntyre et al. 2013).Clinically, cognitive symptoms are commonly endorsed by the patients both during episodes and as residual symptoms (Conradi et al. 2011). Numerous studies reported poorer neuropsychological performance in tests of memory, attention and executive function in patients with depression (Bora et al. The impact of cognitive dysfunction on functioning may be related to persistence of cognitive deficits even after mood symptoms recover. A meta-analysis of studies using a standardized test battery (CANTAB) showed that the magnitude of cognitive deficits during episode and in remission were comparable (Rock et al. 2014). On the other hand, recurrent nature of depressive disorders and accompanying cognitive dysfunction could contribute to further disability associated with depression. The 'toxicity' of repeated episodes (Gorwood et al. 2008) on cognition, also known as 'scarring' (Kessing, 1998) was proposed to explain persistence of cognitive dysfunction. According to this, each episode leads to accumulation of vulnerability, hence leading to further decline in cognitive functioning over the years. In later life, memory deficits seen in depression could be vulnerability factors for dementia (Kessing & Andersen, 2004). In a longitudinal epidemiological study (Baltimore Longitudinal Study of Aging), elevated depressive symptoms over the life course were associated with increased risk of dementia (Dotson et al. 2010).Despite the clear impact on the course of depression, cognition is yet to be accepted as a treatment target for depression. In a recent survey, more than 90% of the patients with a history of depression reported significant...

show abstract

Cognitive Deficits and Functional Outcomes in Major Depressive Disorder: Determinants, Substrates, and Treatment Interventions

Cited by 618 publications

References 97 publications

Challenges of residual symptoms and functioning in management of MDD

Challenges of residual symptoms and functioning in management of MDD

Relation between patterns of intrinsic network connectivity, cognitive functioning, and symptom presentation in trauma‐exposed patients with major depressive disorder

Cognition as a treatment target in depression

Contact Info

Product

Resources

About