Effects of Symptom Reduction and Psychotropic Medication on Cognitive Impairment in Depression

Abstract

Background: Depression is related to cognitive performance. This follow-up study examines the influence of depression symptoms and psychopharmacological treatment on change in the cognitive performance of patients with depressive episodes over a 2-year period. Sampling and Methods: Sixty-two in- and outpatients with depression of varying severity (ICD-10: F31–F33) were examined in an open prospective naturalistic observational study with 3 points of measurement and tested by use of 3 computerized cognitive performance tests [Visual Attentiveness Test (VAT), Continuous Attention Test (CAT), Word Recognition Test (WRT)], while the psychotropic medication was classified by subclass and dosage. Statistical analysis was performed by random-effects regression models. Results: The raw values of VAT speed, CAT speed and WRT quality improved over time. However, the positive time trend disappeared after the patients’ clinical and personal characteristics were controlled for. The processing speed of the VAT was found to be negatively influenced by depressive symptoms. That of the CAT developed favorably with increasing level of education. The performance qualities of the VAT, WRT and CAT were positively related to the participants’ educational level. The patients who received antipsychotic treatment performed worse on WRT quality than those who were not treated with antipsychotics. Conclusions: The cognitive performance was relatively stable during the treatment process and not affected by clinical characteristics or type of medication. Cognitive deficits in patients with depression could be a trait rather than a state marker.

Enduring cognitive dysfunction in unipolar major depression: A test–retest study using the Stroop paradigm

“…The present results may indicate that even patients treated with SSRIs show a persistent impairment in cognitive functioning in spite of receiving effective antidepressant medication. On the other hand, a recent study found that cognitive functioning was not affected by type of medication (Frach, Bullacher, Jâger et al ., 2009).…”

Cognitive Functioning in Patients with Bipolar Disorder: Association with Depressive Symptoms and Alcohol Use

“…Nevertheless, depressive symptoms explained a large proportion of the variance in some of the cognitive domains, indicating that the effect is substantive. To our knowledge, only one previous two-year follow up study by Frasch et al [49] reported the effect of mood symptoms on cognitive functioning reporting effect sizes; within a depressed cohort of patients with both unipolar and bipolar depression (total n = 62), they used three experimental tasks and indirectly reported that depressive symptoms were associated with processing speed instead of verbal memory. These findings are in line with our results.…”

Contrasting patterns of deficits in visuospatial memory and executive function in patients with major depression with and without ECT referral

“…However, in schizophrenia, data strongly suggest that atypical ones in particular either have no effect or improve executive functioning (Meyer-Lindberg et al 1997 ;Burke et al 1998 ;Cuesta et al 2001 ;Velligan et al 2002 ;McGurk et al 2004 ;Mishara & Goldberg, 2004 ;Tyson et al 2004 ;Woodwart et al 2005 ;O'Grada & Dinan, 2007). In depression, data on the cognitive effects of antipsychotics are sparse but in the same direction (Olver et al 2008 ;Frasch et al 2009). …”