Cognitive Dysfunction in Major Depressive Disorder: Assessment, Impact, and Management

Chakrabarty, Trisha; Hadjipavlou, George; Lam, Raymond W.

doi:10.1176/appi.focus.20150043

Cited by 45 publications

(41 citation statements)

References 162 publications

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“…In patients suffering from somatic diseases, such as cancer, cardiovascular disease, and infection, depression further increases the risk of death. Not only can depression lead to emotional changes and reduced activity, but as many as two-thirds of patients also suffered from cognitive impairment-which can last even after symptoms have been alleviated (Behnken et al, 2010;Rock et al, 2014;Chakrabarty et al, 2016). Cognitive defects are an important determinant of psychosocial function, and their persistence weakens the capacity for psychosocial rehabilitation (Reppermund et al, 2009).…”

Section: Depressionmentioning

confidence: 99%

Exercise Intervention in Treatment of Neuropsychological Diseases: A Review

et al. 2020

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Faced with a constant inundation of information and increasing pressures brought by the continuous development of modern civilization, people are increasingly faced with mental health challenges that are only now being actively researched. Mental illness is caused by brain dysfunction due to internal and external pathogenic factors that destroy the integrity of the human brain and alter its function. Regular participation in physical exercise can stimulate the cerebral cortex and simultaneously increase the supply of oxygen and nutrients, helping to preserve or restore normal functioning of the nervous system. In conjunction with other systems of the body, the nervous system constitutes the neuro-humoral regulation system responsible for maintaining the stable state of the human body. This paper is a systematic review of studies investigating the effects of exercise intervention on several common neuropsychological diseases, including depression, anxiety disorder, autism, and attention-deficit/hyperactivity disorder. Furthermore, we discuss possible physiological mechanisms underlying exercise-induced benefits and study limitations that must be addressed by future research. In many cases, drug therapy is ineffective and brings unwanted side effects. Based on the literature, we conclude that exercise intervention plays a positive role and that certain standards must be established in the field to make physical activity consistently effective.

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Section: Depressionmentioning

confidence: 99%

Exercise Intervention in Treatment of Neuropsychological Diseases: A Review

et al. 2020

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“…The fourth clinical variable of interest was use of psychotropic medication concurrent with cognitive assessment. Pharmacological treatment is expected to have a complex influence on cognitive functioning, although reliable evidence is limited [27]. Meta-analyses suggest that some antidepressants may improve cognition [28,29], but these results appear to be specific to particular treatments [30][31][32], while for other treatments, medication side-effects may potentially affect cognitive performance negatively [6,14,33].…”

Section: Introductionmentioning

confidence: 99%

Cognitive functioning and lifetime major depressive disorder in UK Biobank

et al. 2020

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Background. Cognitive impairment associated with lifetime major depressive disorder (MDD) is well-supported by meta-analytic studies, but population-based estimates remain scarce. Previous UK Biobank studies have only shown limited evidence of cognitive differences related to probable MDD. Using updated cognitive and clinical assessments in UK Biobank, this study investigated population-level differences in cognitive functioning associated with lifetime MDD. Methods. Associations between lifetime MDD and cognition (performance on six tasks and general cognitive functioning [g-factor]) were investigated in UK Biobank (N-range 7,457–14,836, age 45–81 years, 52% female), adjusting for demographics, education, and lifestyle. Lifetime MDD classifications were based on the Composite International Diagnostic Interview. Within the lifetime MDD group, we additionally investigated relationships between cognition and (a) recurrence, (b) current symptoms, (c) severity of psychosocial impairment (while symptomatic), and (d) concurrent psychotropic medication use. Results. Lifetime MDD was robustly associated with a lower g-factor (β = −0.10, PFDR = 4.7 × 10−5), with impairments in attention, processing speed, and executive functioning (β ≥ 0.06). Clinical characteristics revealed differential profiles of cognitive impairment among case individuals; those who reported severe psychosocial impairment and use of psychotropic medication performed worse on cognitive tests. Severe psychosocial impairment and reasoning showed the strongest association (β = −0.18, PFDR = 7.5 × 10−5). Conclusions. Findings describe small but robust associations between lifetime MDD and lower cognitive performance within a population-based sample. Overall effects were of modest effect size, suggesting limited clinical relevance. However, deficits within specific cognitive domains were more pronounced in relation to clinical characteristics, particularly severe psychosocial impairment.

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“…Maltreatment is also associated with alterations in the structure, functioning and connectivity of the hippocampus, insula, prefrontal cortex, and amygdala (Teicher et al ., 2016; Cross et al ., 2017; Clausen et al ., 2019). As these are key regions underlying cognition, cognitive dysfunction would be an expected behavioral manifestation of such neurobiological changes (Chakrabarty et al ., 2016). Indeed, adults with maltreatment cross-sectionally display significantly poorer working memory, attention, and processing speed than adults without maltreatment (Masson et al ., 2015); childhood maltreatment is also longitudinally associated with executive functioning deficits in middle-age (Nikulina and Widom, 2013).…”

Section: Introductionmentioning

confidence: 99%

Childhood maltreatment and cognitive functioning in patients with major depressive disorder: a CAN-BIND-1 report

et al. 2019

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BackgroundPatients with major depressive disorder (MDD) display cognitive deficits in acutely depressed and remitted states. Childhood maltreatment is associated with cognitive dysfunction in adults, but its impact on cognition and treatment related cognitive outcomes in adult MDD has received little consideration. We investigate whether, compared to patients without maltreatment and healthy participants, adult MDD patients with childhood maltreatment display greater cognitive deficits in acute depression, lower treatment-associated cognitive improvements, and lower cognitive performance in remission.MethodsHealthy and acutely depressed MDD participants were enrolled in a multi-center MDD predictive marker discovery trial. MDD participants received 16 weeks of standardized antidepressant treatment. Maltreatment and cognition were assessed with the Childhood Experience of Care and Abuse interview and the CNS Vital Signs battery, respectively. Cognitive scores and change from baseline to week 16 were compared amongst MDD participants with (DM+, n = 93) and without maltreatment (DM−, n = 90), and healthy participants with (HM+, n = 22) and without maltreatment (HM−, n = 80). Separate analyses in MDD participants who remitted were conducted.ResultsDM+ had lower baseline global cognition, processing speed, and memory v. HM−, with no significant baseline differences amongst DM−, HM+, and HM− groups. There were no significant between-group differences in cognitive change over 16 weeks. Post-treatment remitted DM+, but not remitted DM−, scored significantly lower than HM− in working memory and processing speed.ConclusionsChildhood maltreatment was associated with cognitive deficits in depressed and remitted adults with MDD. Maltreatment may be a risk factor for more severe and persistent cognitive deficits in adult MDD.

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Cognitive Dysfunction in Major Depressive Disorder: Assessment, Impact, and Management

Cited by 45 publications

References 162 publications

Exercise Intervention in Treatment of Neuropsychological Diseases: A Review

Exercise Intervention in Treatment of Neuropsychological Diseases: A Review

Cognitive functioning and lifetime major depressive disorder in UK Biobank

Childhood maltreatment and cognitive functioning in patients with major depressive disorder: a CAN-BIND-1 report

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