Cognitive Impairment and Neurocognitive Profiles in Major Depression—A Clinical Perspective

Abstract

Increasingly, studies have investigated cognitive functioning from the perspective of acute state- to remitted phases of Major Depressive Disorder (MDD). Some cognitive deficits observed in the symptomatic phase persist in remission as traits or scars. The etiological origin and clinical consequences of the neurocognitive profiles reported in the literature are still unclear and may vary across populations. Deficits are suspected to influence the association between MDD and neurodegenerative disorders and could thus be of particular clinical consequence. The aim of this review is to describe the clinical neuropsychological profile in MDD and how it is related to research during the past decade on cognitive deficits in MDD from a state, trait, and scar perspective. This review, with a clinical perspective, investigates research from the past decade regarding cognitive functioning in MDD in a long-term perspective. We focus on the clinical manifestation of deficits, and the potential neurodegenerative consequences of the neurocognitive profile in MDD. Searches in Medline, PsycINFO and Embase were conducted targeting articles published between 2010 and 2020. Examination of the evidence for long-lasting neurocognitive deficits in major depression within the cognitive domains of Memory, Executive Functions, Attention, and Processing Speed was conducted and was interpreted in the context of the State, Scar and Trait hypotheses. Defining the neurocognitive profiles in MDD will have consequences for personalized evaluation and treatment of residual cognitive symptoms, and etiological understanding of mood disorders, and treatments could potentially reduce or delay the development of neurodegenerative disorders.

No Sex Differences in Self-Reported Childhood Maltreatment in Major Depressive and Bipolar Disorders: A Retrospective Study

“…Our samples had an elderly mean age, and patients admitted to Villa San Benedetto Menni Hospital for a psychiatric rehabilitation program typically have chronic psychiatric conditions of long durations. Therefore, it is conceivable that the well-documented cognitive impairment associated with MDD and BD may have compromised retrospective recall of CM, particularly in older patients [ 47 , 48 , 49 ]. Unfortunately, the sample size did not allow us to analyze the CM distribution across age cohorts in order to achieve a more comprehensive understanding of this topic.…”

Computerized Working Memory Training in Remission From Major Depressive Disorder: Effects on Emotional Working Memory, Processing Speed, Executive Functions, and Associations With Symptoms

“…Also, deficits could be a result of depression history or significant stress, through neurotoxic effects and thus exacerbate, as suggested by the scar hypothesis (for reviews refer to Hasselbalch et al, 2011;Allott et al, 2016;Ahern et al, 2019). A recent review by Hammar et al (2022) found support for all these perspectives, relative to the cognitive functions measured. PS could be more state-or scar-related, whereas some EFs could be traits.…”

“…However, the literature is inconclusive. Cognitive deficits are a major health challenge (Nafilyan et al, 2021 ), partly on account of the high (Mueller et al, 2013 ), cumulative relapse rate in MDD (Kessing and Andersen, 2017 ), and the link between MDD and dementia (Woolf et al, 2021 ; Hammar et al, 2022 ). Thus, it is paramount to investigate interventions to improve cognitive deficits for future healthcare needs.…”

Fear of COVID-19, prolonged smartphone use, sleep disturbances, and depression in the time of COVID-19: A nation-wide survey

“…They estimated there were 53.2 million cases of major depressive disorder globally (an increase of 27.6%) due to the COVID-19 pandemic, which caused 49.4 million DALYs globally in 2020. Depression, characterized by depressive mood (in adolescents, it may be described as an irritable or empty feeling), has various other symptoms, such as diminished interest, loss of pleasure, feelings of hopelessness and worthlessness, changes in appetite or sleep, and reduced energy or fatigue, or even suicidal ideation and attempts (24)(25)(26). Despite the high rates and vast influence of depression, the risk factors and pathological mechanisms remain largely unknown.…”