Functional and cognitive impairment in the first episode of depression: A systematic review

Abstract

Objectives: To describe the cognitive and functional impairment in individuals with the first episode of major depressive disorder (MDD) as compared to controls and individuals with recurrent MDD. Also to describe the functional and cognitive trajectory after the first episode of MDD.Methods: A total of 52 studies were included in our systematic review. 32 studies compared the cognitive performance between first episode of depression (FED) and controls, 11 studies compared the cognitive performance between recurrent depression (RD) and FED, 10 compared global functioning between RD and FED, four studies assessed cognition in FED over time, and two studies assessed global functioning in FED over time. Results:The majority of studies (n = 22/32, 68.8%) found that FED subjects performed significantly worse than controls on cognitive tests, with processing speed (n = 12) and executive/working memory (n = 11) being the most commonly impaired domains. Seven out of 11 studies (63.6%) found that RD performed significantly worse than FED, with verbal learning and memory being the most commonly impaired domain (n = 4). Most studies (n = 7/10, 70%) did not find a significant difference in global functioning between RD and FED. In three of four longitudinal studies assessing cognition, subgroup analyses were used instead of directly assessing cognition in FED over time while the remaining study found significant cognitive declines over time in FED when compared to controls. The two longitudinal studies assessing functional trajectory found that functioning significantly improved over time, possibly due to the improvement of depressive symptoms. Conclusion:There is strong evidence that cognitive impairment is present during the first episode of depression, and individuals with multiple episodes display greater cognitive impairment than individuals with a single episode. Future studies aimed at identifying predictors of cognitive and functional impairment after the first episode of depression are needed to describe the functional and cognitive trajectory of individuals with the first episode of MDD over time.

Affective disorders: eliminate WArning signs and REstore functioning—AWARE—a randomised controlled multimodule intervention study, presentation of design and intervention

“…Furthermore, concerning cognition, impaired processing speed was significant associated with more difficulties in performing ADL 16. Finally, a similar pattern has been observed among patients with UD 17–19…”

High-density EEG sleep correlates of cognitive and affective impairment at 12-month follow-up after COVID-19

“…A possible explanation may be the high prevalence of PTSD: PTSD is characterized, among other symptoms, by poor cognitive flexibility, processing speed, controlled and sustained attention, higher response inhibition, and recall memory ( Schultebraucks et al, 2022 ), all traits observed in our cohort. On the other hand, processing speed and executive/working memory are the most commonly impaired domains in depression ( Varghese et al, 2022 ).…”

Altered Brain Function in First-Episode and Recurrent Depression: A Resting-State Functional Magnetic Resonance Imaging Study

“…According to the classification criteria of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems, MDD is classified into the first depressive episode (FDE) and recurrent depressive episodes (RDE) ( Yuksel et al, 2018 ). Previous studies have demonstrated differences in depressive and somatic symptoms ( Roca et al, 2011 ), cognitive functioning ( Roca et al, 2015 ; Zu et al, 2021 ; Varghese et al, 2022 ), and quality of life ( Zu et al, 2021 ) between patients with RDE and those with FDE. Epidemiological surveys have shown that depression has a high recurrence rate and that, once the first episode has occurred, it relapses within 5 years.…”