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Published in: Annals of General Psychiatry 1/2015

Open Access 01-12-2015 | Review

The role of cognitive dysfunction in the symptoms and remission from depression

Authors: Xenia Gonda, Maurizio Pompili, Gianluca Serafini, Andre F. Carvalho, Zoltan Rihmer, Peter Dome

Published in: Annals of General Psychiatry | Issue 1/2015

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Abstract

The disability and burden associated with major depression comes only in part from its affective symptoms; cognitive dysfunctions associated with depression also play a crucial role. Furthermore, these cognitive impairments during depression are manifold and multilevel affecting elementary and more complex cognitive processes equally. Several models from different directions tried to evaluate, conceptualize and understand the depth and magnitude of cognitive dysfunctions in depression and their bidirectional interactions with other types of depressive symptomatology including mood symptoms. In the current review, we briefly overview different types of cognitive symptoms and deficits related to major depression including hot and cold as well as trait- and state-like cognitive alterations and we also describe current knowledge related to the impact of cognitive impairments on the course and outcomes of depression including remission, residual symptoms, function, and response to treatment. We also emphasize shortcomings of currently available treatments for depression in sufficiently improving cognitive dysfunctions and point out the need for newer pharmacological approaches especially in cooperation with psychotherapeutic interventions.
Literature
1.
go back to reference Naismith SL, Longley WA, Scott EM, Hickie IB. Disability in major depression related to self-rated and objectively measured cognitive deficits: a preliminary study. BMC Psychiatry. 2007;7:32.PubMedCentralCrossRefPubMed Naismith SL, Longley WA, Scott EM, Hickie IB. Disability in major depression related to self-rated and objectively measured cognitive deficits: a preliminary study. BMC Psychiatry. 2007;7:32.PubMedCentralCrossRefPubMed
2.
go back to reference Hammar A, Ardal G. Cognitive functioning in major depression—a summary. Front Hum Neurosci 2009;3(26):1–7. Hammar A, Ardal G. Cognitive functioning in major depression—a summary. Front Hum Neurosci 2009;3(26):1–7.
3.
go back to reference Marazziti D, Consoli G, Picchetti M, Carlini M, Faravelli L. Cognitive impairment in major depression. Eur J Pharmacol. 2010;626(1):83–6.CrossRefPubMed Marazziti D, Consoli G, Picchetti M, Carlini M, Faravelli L. Cognitive impairment in major depression. Eur J Pharmacol. 2010;626(1):83–6.CrossRefPubMed
5.
go back to reference Burt DB, Zembar MJ, Niederehe G. Depression and memory impairment: a meta-analysis of the association, its pattern, and specificity. Psychol Bull. 1995;117(2):285–305.CrossRefPubMed Burt DB, Zembar MJ, Niederehe G. Depression and memory impairment: a meta-analysis of the association, its pattern, and specificity. Psychol Bull. 1995;117(2):285–305.CrossRefPubMed
6.
go back to reference Castaneda AE, Suvisaari J, Marttunen M, Perala J, Saarni SI, Aalto-Setala T, Aro H, Koskinen S, Lonnqvist J, Tuulio-Henriksson A. Cognitive functioning in a population-based sample of young adults with a history of non-psychotic unipolar depressive disorders without psychiatric comorbidity. J Affect Disord. 2008;110(1–2):36–45.CrossRefPubMed Castaneda AE, Suvisaari J, Marttunen M, Perala J, Saarni SI, Aalto-Setala T, Aro H, Koskinen S, Lonnqvist J, Tuulio-Henriksson A. Cognitive functioning in a population-based sample of young adults with a history of non-psychotic unipolar depressive disorders without psychiatric comorbidity. J Affect Disord. 2008;110(1–2):36–45.CrossRefPubMed
7.
go back to reference Austin MP, Mitchell P, Goodwin GM. Cognitive deficits in depression: possible implications for functional neuropathology. Br J Psychiatry. 2001;178:200–6.CrossRefPubMed Austin MP, Mitchell P, Goodwin GM. Cognitive deficits in depression: possible implications for functional neuropathology. Br J Psychiatry. 2001;178:200–6.CrossRefPubMed
8.
go back to reference Beats BC, Sahakian BJ, Levy R. Cognitive performance in tests sensitive to frontal lobe dysfunction in the elderly depressed. Psychol Med. 1996;26(3):591–603.CrossRefPubMed Beats BC, Sahakian BJ, Levy R. Cognitive performance in tests sensitive to frontal lobe dysfunction in the elderly depressed. Psychol Med. 1996;26(3):591–603.CrossRefPubMed
9.
go back to reference Tavares JVT, Clark L, Furey ML, Williams GB, Sahakian BJ, Drevets WC. Neural basis of abnormal response to negative feedback in unmedicated mood disorders. Neuroimage. 2008;42(3):1118–26.CrossRef Tavares JVT, Clark L, Furey ML, Williams GB, Sahakian BJ, Drevets WC. Neural basis of abnormal response to negative feedback in unmedicated mood disorders. Neuroimage. 2008;42(3):1118–26.CrossRef
10.
go back to reference Robinson OJ, Cools R, Carlisi CO, Sahakian BJ, Drevets WC. Ventral striatum response during reward and punishment reversal learning in unmedicated major depressive disorder. Am J Psychiatry. 2012;169(2):152–9.CrossRefPubMed Robinson OJ, Cools R, Carlisi CO, Sahakian BJ, Drevets WC. Ventral striatum response during reward and punishment reversal learning in unmedicated major depressive disorder. Am J Psychiatry. 2012;169(2):152–9.CrossRefPubMed
11.
go back to reference Harmer CJ, Goodwin GM, Cowen PJ. Why do antidepressants take so long to work? A cognitive neuropsychological model of antidepressant drug action. Br J Psychiatry. 2009;195(2):102–8.CrossRefPubMed Harmer CJ, Goodwin GM, Cowen PJ. Why do antidepressants take so long to work? A cognitive neuropsychological model of antidepressant drug action. Br J Psychiatry. 2009;195(2):102–8.CrossRefPubMed
12.
go back to reference Hollon SD, Jarrett RB, Nierenberg AA, Thase ME, Trivedi M, Rush AJ. Psychotherapy and medication in the treatment of adult and geriatric depression: which monotherapy or combined treatment? J Clin Psychiatry. 2005;66(4):455–68.CrossRefPubMed Hollon SD, Jarrett RB, Nierenberg AA, Thase ME, Trivedi M, Rush AJ. Psychotherapy and medication in the treatment of adult and geriatric depression: which monotherapy or combined treatment? J Clin Psychiatry. 2005;66(4):455–68.CrossRefPubMed
13.
go back to reference Conradi HJ, Ormel J, de Jonge P. Presence of individual (residual) symptoms during depressive episodes and periods of remission: a 3-year prospective study. Psychol Med. 2011;41(6):1165–74.CrossRefPubMed Conradi HJ, Ormel J, de Jonge P. Presence of individual (residual) symptoms during depressive episodes and periods of remission: a 3-year prospective study. Psychol Med. 2011;41(6):1165–74.CrossRefPubMed
14.
go back to reference Biringer E, Lundervold A, Stordal K, Mykletun A, Egeland J, Bottlender R, Lund A. Executive function improvement upon remission of recurrent unipolar depression. Eur Arch Psychiatry Clin Neurosci. 2005;255(6):373–80.CrossRefPubMed Biringer E, Lundervold A, Stordal K, Mykletun A, Egeland J, Bottlender R, Lund A. Executive function improvement upon remission of recurrent unipolar depression. Eur Arch Psychiatry Clin Neurosci. 2005;255(6):373–80.CrossRefPubMed
15.
go back to reference Smith DJ, Muir WJ, Blackwood DHR. Neurocognitive impairment in euthymic young adults with bipolar spectrum disorder and recurrent major depressive disorder. Bipolar Disord. 2006;8(1):40–6.CrossRefPubMed Smith DJ, Muir WJ, Blackwood DHR. Neurocognitive impairment in euthymic young adults with bipolar spectrum disorder and recurrent major depressive disorder. Bipolar Disord. 2006;8(1):40–6.CrossRefPubMed
16.
go back to reference Airaksinen E, Larsson M, Lundberg I, Forsell Y. Cognitive functions in depressive disorders: evidence from a population-based study. Psychol Med. 2004;34(1):83–91.CrossRefPubMed Airaksinen E, Larsson M, Lundberg I, Forsell Y. Cognitive functions in depressive disorders: evidence from a population-based study. Psychol Med. 2004;34(1):83–91.CrossRefPubMed
17.
go back to reference Lee RS, Hermens DF, Porter MA, Redoblado-Hodge MA. A meta-analysis of cognitive deficits in first-episode major depressive disorder. J Affect Disord. 2012;140(2):113–24.CrossRefPubMed Lee RS, Hermens DF, Porter MA, Redoblado-Hodge MA. A meta-analysis of cognitive deficits in first-episode major depressive disorder. J Affect Disord. 2012;140(2):113–24.CrossRefPubMed
18.
go back to reference Jaeger J, Berns S, Uzelac S, Davis-Conway S. Neurocognitive deficits and disability in major depressive disorder. Psychiatry Res. 2006;145(1):39–48.CrossRefPubMed Jaeger J, Berns S, Uzelac S, Davis-Conway S. Neurocognitive deficits and disability in major depressive disorder. Psychiatry Res. 2006;145(1):39–48.CrossRefPubMed
19.
go back to reference Kessing LV. Cognitive impairment in the euthymic phase of affective disorder. Psychol Med. 1998;28(5):1027–38.CrossRefPubMed Kessing LV. Cognitive impairment in the euthymic phase of affective disorder. Psychol Med. 1998;28(5):1027–38.CrossRefPubMed
20.
go back to reference Sweeney JA, Kmiec JA, Kupfer DJ. Neuropsychologic impairments in bipolar and unipolar mood disorders on the CANTAB neurocognitive battery. Biol Psychiatry. 2000;48(7):674–84.CrossRefPubMed Sweeney JA, Kmiec JA, Kupfer DJ. Neuropsychologic impairments in bipolar and unipolar mood disorders on the CANTAB neurocognitive battery. Biol Psychiatry. 2000;48(7):674–84.CrossRefPubMed
21.
go back to reference Martinez-Aran A, Vieta E, Torrent C, Sanchez-Moreno J, Goikolea JM, Salamero M, Malhi GS, Gonzalez-Pinto A, Daban C, Alvarez-Grandi S, et al. Functional outcome in bipolar disorder: the role of clinical and cognitive factors. Bipolar Disord. 2007;9(1–2):103–13.CrossRefPubMed Martinez-Aran A, Vieta E, Torrent C, Sanchez-Moreno J, Goikolea JM, Salamero M, Malhi GS, Gonzalez-Pinto A, Daban C, Alvarez-Grandi S, et al. Functional outcome in bipolar disorder: the role of clinical and cognitive factors. Bipolar Disord. 2007;9(1–2):103–13.CrossRefPubMed
22.
go back to reference Kennedy N, Foy K, Sherazi R, McDonough M, McKeon P. Long-term social functioning after depression treated by psychiatrists: a review. Bipolar Disord. 2007;9(1–2):25–37.CrossRefPubMed Kennedy N, Foy K, Sherazi R, McDonough M, McKeon P. Long-term social functioning after depression treated by psychiatrists: a review. Bipolar Disord. 2007;9(1–2):25–37.CrossRefPubMed
23.
go back to reference Papakostas GI, Petersen T, Mahal Y, Mischoulon D, Nierenberg AA, Fava M. Quality of life assessments in major depressive disorder: a review of the literature. Gen Hosp Psychiatry. 2004;26(1):13–7.CrossRefPubMed Papakostas GI, Petersen T, Mahal Y, Mischoulon D, Nierenberg AA, Fava M. Quality of life assessments in major depressive disorder: a review of the literature. Gen Hosp Psychiatry. 2004;26(1):13–7.CrossRefPubMed
24.
go back to reference Withall A, Harris LM, Cumming SR. The relationship between cognitive function and clinical and functional outcomes in major depressive disorder. Psychol Med. 2009;39(3):393–402.CrossRefPubMed Withall A, Harris LM, Cumming SR. The relationship between cognitive function and clinical and functional outcomes in major depressive disorder. Psychol Med. 2009;39(3):393–402.CrossRefPubMed
25.
go back to reference Bolling MY, Kohlenberg RJ. Reasons for quitting serotonin reuptake inhibitor therapy: paradoxical psychological side effects and patient satisfaction. Psychother Psychosom. 2004;73(6):380–5.CrossRefPubMed Bolling MY, Kohlenberg RJ. Reasons for quitting serotonin reuptake inhibitor therapy: paradoxical psychological side effects and patient satisfaction. Psychother Psychosom. 2004;73(6):380–5.CrossRefPubMed
26.
go back to reference Gualtieri CT, Johnson LG, Benedict KB. Neurocognition in depression: patients on and off medication versus healthy comparison subjects. J Neuropsychiatry Clin Neurosci. 2006;18(2):217–25.CrossRefPubMed Gualtieri CT, Johnson LG, Benedict KB. Neurocognition in depression: patients on and off medication versus healthy comparison subjects. J Neuropsychiatry Clin Neurosci. 2006;18(2):217–25.CrossRefPubMed
27.
go back to reference Booij L, Van der Does AJ, Haffmans PM, Riedel WJ, Fekkes D, Blom MJ. The effects of high-dose and low-dose tryptophan depletion on mood and cognitive functions of remitted depressed patients. J Psychopharmacol. 2005;19(3):267–75.CrossRefPubMed Booij L, Van der Does AJ, Haffmans PM, Riedel WJ, Fekkes D, Blom MJ. The effects of high-dose and low-dose tryptophan depletion on mood and cognitive functions of remitted depressed patients. J Psychopharmacol. 2005;19(3):267–75.CrossRefPubMed
28.
go back to reference Jensen JB, du Jardin KG, Song D, Budac D, Smagin G, Sanchez C, Pehrson AL. Vortioxetine, but not escitalopram or duloxetine, reverses memory impairment induced by central 5-HT depletion in rats: evidence for direct 5-HT receptor modulation. Eur Neuropsychopharmacol. 2014;24(1):148–59.CrossRefPubMed Jensen JB, du Jardin KG, Song D, Budac D, Smagin G, Sanchez C, Pehrson AL. Vortioxetine, but not escitalopram or duloxetine, reverses memory impairment induced by central 5-HT depletion in rats: evidence for direct 5-HT receptor modulation. Eur Neuropsychopharmacol. 2014;24(1):148–59.CrossRefPubMed
29.
go back to reference Sobczak S, Riedel WJ, Booij I, Aan het Rot M, Deutz NEP, Honig A. Cognition following acute tryptophan depletion: difference between first-degree relatives of bipolar disorder patients and matched healthy control volunteers. Psychol Med. 2002;32(3):503–15.CrossRefPubMed Sobczak S, Riedel WJ, Booij I, Aan het Rot M, Deutz NEP, Honig A. Cognition following acute tryptophan depletion: difference between first-degree relatives of bipolar disorder patients and matched healthy control volunteers. Psychol Med. 2002;32(3):503–15.CrossRefPubMed
30.
go back to reference Cassano GB, Puca F, Scapicchio PL, Trabucchi M. Italian Study Group on Depression in Elderly Patients: paroxetine and fluoxetine effects on mood and cognitive functions in depressed nondemented elderly patients. J Clin Psychiatry. 2002;63(5):396–402.CrossRefPubMed Cassano GB, Puca F, Scapicchio PL, Trabucchi M. Italian Study Group on Depression in Elderly Patients: paroxetine and fluoxetine effects on mood and cognitive functions in depressed nondemented elderly patients. J Clin Psychiatry. 2002;63(5):396–402.CrossRefPubMed
31.
go back to reference Herrera-Guzman I, Herrera-Abarca JE, Gudayol-Ferre E, Herrera-Guzman D, Gomez-Carbajal L, Pena-Olvira M, Villuendas-Gonzalez E, Joan GO. Effects of selective serotonin reuptake and dual serotonergic–noradrenergic reuptake treatments on attention and executive functions in patients with major depressive disorder. Psychiatry Res. 2010;177(3):323–9.CrossRefPubMed Herrera-Guzman I, Herrera-Abarca JE, Gudayol-Ferre E, Herrera-Guzman D, Gomez-Carbajal L, Pena-Olvira M, Villuendas-Gonzalez E, Joan GO. Effects of selective serotonin reuptake and dual serotonergic–noradrenergic reuptake treatments on attention and executive functions in patients with major depressive disorder. Psychiatry Res. 2010;177(3):323–9.CrossRefPubMed
32.
go back to reference Herrera-Guzman I, Gudayol-Ferre E, Herrera-Guzman D, Guardia-Olmos J, Hinojosa-Calvo E, Herrera-Abarca JE. Effects of selective serotonin reuptake and dual serotonergic–noradrenergic reuptake treatments on memory and mental processing speed in patients with major depressive disorder. J Psychiatr Res. 2009;43(9):855–63.CrossRefPubMed Herrera-Guzman I, Gudayol-Ferre E, Herrera-Guzman D, Guardia-Olmos J, Hinojosa-Calvo E, Herrera-Abarca JE. Effects of selective serotonin reuptake and dual serotonergic–noradrenergic reuptake treatments on memory and mental processing speed in patients with major depressive disorder. J Psychiatr Res. 2009;43(9):855–63.CrossRefPubMed
33.
go back to reference Herrera-Guzman I, Gudayol-Ferre E, Herrera-Abarca JE, Herrera-Guzman D, Montelongo-Pedraza P, Blazquez FP, Pero-Cebollero M, Guardia-Olmos J. Major depressive disorder in recovery and neuropsychological functioning: effects of selective serotonin reuptake inhibitor and dual inhibitor depression treatments on residual cognitive deficits in patients with major depressive disorder in recovery. J Affect Disord. 2010;123(1–3):341–50.CrossRefPubMed Herrera-Guzman I, Gudayol-Ferre E, Herrera-Abarca JE, Herrera-Guzman D, Montelongo-Pedraza P, Blazquez FP, Pero-Cebollero M, Guardia-Olmos J. Major depressive disorder in recovery and neuropsychological functioning: effects of selective serotonin reuptake inhibitor and dual inhibitor depression treatments on residual cognitive deficits in patients with major depressive disorder in recovery. J Affect Disord. 2010;123(1–3):341–50.CrossRefPubMed
34.
go back to reference Mork A, Pehrson A, Brennum LT, Nielsen SM, Zhong H, Lassen AB, Miller S, Westrich L, Boyle NJ, Sanchez C, et al. Pharmacological effects of Lu AA21004: a novel multimodal compound for the treatment of major depressive disorder. J Pharmacol Exp Ther. 2012;340(3):666–75.CrossRefPubMed Mork A, Pehrson A, Brennum LT, Nielsen SM, Zhong H, Lassen AB, Miller S, Westrich L, Boyle NJ, Sanchez C, et al. Pharmacological effects of Lu AA21004: a novel multimodal compound for the treatment of major depressive disorder. J Pharmacol Exp Ther. 2012;340(3):666–75.CrossRefPubMed
35.
go back to reference Katona C, Hansen T, Olsen CK. A randomized, double-blind, placebo-controlled, duloxetine-referenced, fixed-dose study comparing the efficacy and safety of Lu AA21004 in elderly patients with major depressive disorder. Int Clin Psychopharmacol. 2012;27(4):215–23.CrossRefPubMed Katona C, Hansen T, Olsen CK. A randomized, double-blind, placebo-controlled, duloxetine-referenced, fixed-dose study comparing the efficacy and safety of Lu AA21004 in elderly patients with major depressive disorder. Int Clin Psychopharmacol. 2012;27(4):215–23.CrossRefPubMed
36.
go back to reference Burns DD. The feeling good handbook. Rev. edn. New York: Plume; 1999. Burns DD. The feeling good handbook. Rev. edn. New York: Plume; 1999.
Metadata
Title
The role of cognitive dysfunction in the symptoms and remission from depression
Authors
Xenia Gonda
Maurizio Pompili
Gianluca Serafini
Andre F. Carvalho
Zoltan Rihmer
Peter Dome
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Annals of General Psychiatry / Issue 1/2015
Electronic ISSN: 1744-859X
DOI
https://doi.org/10.1186/s12991-015-0068-9

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