included late-onset depression patients and earlier-onset ones [9,16]. Some authors considered together patients remitted from MDD and from other affective disorders such as bipolar disorder, schizoaffective disorder and dysthymia [17]. Almost all did not investigate comorbid psychiatric conditions especially anxiety disorders wich can affect cognitive functions [18].Contradictory results could also be explained by the lack of consensus to define MDD and to state full-remission.Some authors did not consider manual's diagnostic criteria to establish the MDD diagnosis. To state remission, some investigators used self-assessment scales. Even when performing psychometric evaluation, there was no consensus concerning cut-off scores to define remission. Number of studies examined together patients partly and fully remitted. In several studies, temporal duration of euthymic mood has not been specified and some authors examined cognitive functions in patients at discharge without specifying duration of remission.The aim of the present study was to (1) examine the cognitive performance in a well-defined homogenous group of MDD patients in Abstract Background: Neurocognitive deficits in Major Depressive Disorder (MDD) might hamper social readjustment and impede full recovery. Their reversibilityafter remission remains controversial.Diverge results are mainly explained by methodological biases.The aim of the present study was to (1) examine the cognitive performance in a well-defined homogenous group of MDD patients in remitted state and to (2) determine clinical features associated with cognitive deficits.
Methods :We recruited thirty outpatients meeting the DSM-IV criteria of former MDD, 18 to 60 years-old, free from axis-I comorbid disorders and regularly consulting in the psychiatry department of Farhat Hached University Hospital, Sousse, Tunisia. Patients were in state of clinical remission for at least three months with HDRS score below 7 at the time of assessment. They were compared to thirty control subjects matched for age, sex, level of instruction and IQ. Participants were assessed for attention and processing-speed, working memory, verbal fluency, non-verbal memoryand executive functions.
Results:Remitted MDD patients displayed cognitive dysfunction in attention and processing-speed, non-verbal memory and executive functions. Patients with a single depressive episode showed a general intact cognitive performance. A positive correlation was found between number of previous depressive episodes and longer duration of the illness respectively with attention and processing-speed, mental flexibility and non-verbal memory performance.
Conclusions:Our results further reinforce the hypothesis of long-lasting cognitive impairment in remitted MDD patients.Findings suggest that cognitive dysfunction cannot be considered as trait marker but appears to be sensitive to depressive recurrence.