Residual cognitive impairments in remitted depressed patients

Abstract

Depressive disorders are associated with various cognitive impairments. Studies on whether or not these impairments persist into the euthymic phase have shown conflicting results, due to differences in test versions and in study samples. In this paper, we aimed to compare the cognitive performance of remitted depressed patients with that of age-and gender-matched healthy volunteers across a wide range of cognitive domains. In two studies, we found few differences on neutral as well as emotional information processing tests. The findings indicate that remitted depressed patients who use antidepressant medication still show an increased recognition of facial expression of fear compared to healthy controls. Patients also performed worse on a test of recognition of abstract visual information from long-term memory. No other residual cognitive impairments were found. These results indicate that most of the cognitive impairments associated with depression resolve with recovery through medication, even when recovery is incomplete. Considering the finding that remitted depressed patients have higher levels of cognitive reactivity, future studies may investigate the possibility that these cognitive impairments have not resolved but have become latent, and may therefore easily be triggered by small changes in mood state.

A review of selected candidate endophenotypes for depression

“…Several studies failed to find differences between depressed individuals in remission and healthy controls on threat/sadness-based dot-probe tasks (Merens, Booij, & Van Der Does, 2008), and the emotional Stroop (e.g. Fritzsche et al, 2010).…”

Neurobiological mechanisms in major depressive disorder

“…[53][54][55] These too may persist during remission and might help explain why patients in remission continue to overreact to threatening stimuli. 56 This cognitive reactivity contributes to the risk of future relapse.…”

The Impact of Residual Symptoms in Major Depression

“…Common residual somatic symptoms include backache, muscle ache, stomach aches and joint pain [14,25,26,27]. In addition to physical and emotional residual symptoms, cognitive deficits may remain in patients who otherwise appear to have reached remission, such as impaired memory processes and increased cognitive reactivity [28]. Residual symptoms are a predictor of relapse regardless of whether the patient was treated with medications or with psychotherapy [23].…”