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Zhu X, Ding R, Chen X, Wang X, He P, Wang G. Discrepancy between objective and subjective cognition and its association with the trajectory of symptoms and functioning in depressive patients. Psychol Med 2024; 54:808-822. [PMID: 37921011 DOI: 10.1017/s0033291723002556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
BACKGROUND Discrepancy between objective and subjective cognitive deficit is common among patients with major depressive disorders (MDDs) and may play a key role in the mechanism linking cognition with recovery of symptom and psychosocial function. This study, therefore, explores the cognitive discrepancy, and its association with the trajectory of symptoms and functioning over a 6-month period. METHODS We used data from the Prospective Research Observation to Assess Cognition in Treated patients with MDD (PROACT) study, from which 598 patients were included. Cognitive discrepancy scores were computed using a novel methodology, with positive values indicating more subjective than objective deficit (i.e. 'underestimation') and negative values indicating more objective than subjective difficulties (i.e. 'overestimation'). Linear growth curve models were employed to examine the association of the cognitive discrepancy with the trajectory of depressive symptoms, psychosocial function, and quality of life. RESULTS About 68% of patients displayed disproportionately more objective than subjective cognitive deficit at baseline, and the mean cognitive discrepancy score was -1.4 (2.7). Overestimation was associated with a faster decrease of HDRS-17 (β = -0.46, p = 0.002) and a faster decrease of psychosocial function in social life (β = -0.13, p = 0.013) and family life (β = -0.12, p = 0.026), and a greater improvement of EQ-5D utility score (β = 0.01, p < 0.001). CONCLUSION We found a lower sensitivity of cognitive deficit at baseline and its decrease was associated with better health outcomes. Our findings have clinical implications of the necessity to assess both subjective and objective cognition for identification and categorization and to incorporate cognitive and psychological therapies for optimized treatment outcomes.
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Affiliation(s)
- Xuequan Zhu
- National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Ruoxi Ding
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Health Commission Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Xu Chen
- National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xiaoyi Wang
- Zhejiang BrainAu Medical Technology Co., Ltd, Shaoxing, China
| | - Ping He
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Gang Wang
- National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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Thibaut P, Mwamuka R, Nyamayaro P, Rubin LH, Nakasujja N, Langenecker S, Abas M. Cognitive performance in depression in low- and middle-income countries: A systematic review with meta-analytic components. J Affect Disord 2023; 342:16-32. [PMID: 37690541 DOI: 10.1016/j.jad.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 08/22/2023] [Accepted: 09/05/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Depression is highly prevalent in low- and middle- income countries (LMIC) and associated with significant cognitive dysfunction across multiple domains. However, little is known about neurocognitive tests used in people with depression in LMIC. We aimed to investigate cognitive performance and cognitive tests in depression research in LMIC. METHODS APA PsycInfo, Embase, Ovid MEDLINE, and Global Health were systematically searched for studies that implemented a cognitive performance test in a depressed, LMIC population. Tool quality was assessed using an adapted scale for quality of measures in cross-cultural settings. Data extracted included demographics, depression and cognitive performance measures, and cognitive performance comparisons between depression and control groups. RESULTS 29 studies met eligibility criteria, involving a total of 19,100 participants from 11 LMIC. 93.1 % of studies were conducted in upper middle-income countries. 67 cognitive performance tools were implemented. Reliability was reported for 5.6 % of cognitive performance tests and validity was reported for 8.3 %. 36.1 % of tests used were culturally adapted. 75.9 % of included studies implemented at least one memory test. Cognitive deficits were observed in all depressed groups, especially in memory (Cohen's d = -1.60, 95 % CI -2.02 to -1.18). LIMITATIONS Heterogeneity between studies; averaged results across memory subtypes; no assessment of depression severity and cognitive deficits associations; restrictive search terms. CONCLUSIONS Cognitive impairments in depression, especially in memory, are prevalent in LMIC. This research has drawn attention to the burden of cognitive dysfunction in depression in LMIC, and to the disparate research gap in LMIC. PROSPERO registration CRD42022315397.
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Affiliation(s)
- Pauline Thibaut
- Department of Health Service & Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Rukudzo Mwamuka
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Primrose Nyamayaro
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Leah H Rubin
- Department of Psychiatry and Behavioural Sciences, John Hopkins University, MD, USA
| | - Noeline Nakasujja
- Department of Psychiatry, College of Health Sciences, Makerere University, Uganda
| | | | - Melanie Abas
- Department of Health Service & Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Vicent-Gil M, Trujols J, Serra-Blasco M, Navarra-Ventura G, Puigdemont D, Alemany C, Crivillés S, de Diego-Adeliño J, Cardoner N, Portella MJ. If you feel you can't, you won't: the role of subjective and objective cognitive competence on psychosocial functioning in depression. Eur Psychiatry 2023; 66:e83. [PMID: 37855104 PMCID: PMC10755570 DOI: 10.1192/j.eurpsy.2023.2454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/27/2023] [Accepted: 08/21/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The purpose of this exploratory study is to examine the role of sociodemographic, clinical, and cognitive - both objective and subjective - factors in overall and in specific domains of psychosocial functioning, in patients with depression at different clinical states of the disease (remitted and non-remitted). METHODS A sample of 325 patients with major depressive disorder, 117 in remission and 208 in non-remission, were assessed with a semi-structured interview collecting sociodemographic, clinical, cognitive (with neuropsychological tests and the Perceived Deficit Questionnaire), and functional (Functioning Assessment Short Test) characteristics. Backward regression models were conducted to determine associations of global and specific areas of functioning with independent factors, for both clinical states. RESULTS Residual depressive symptomatology and self-appraisal of executive competence were significantly associated with psychosocial functioning in remitted patients, in overall and some subdomains of functioning, particularly cognitive and interpersonal areas. While depressive symptoms, executive deficits and self-appraisal of executive function were significantly related to functional outcomes in non-remitted patients, both in overall functioning and in most of subdomains. DISCUSSION This study evidences the strong association of one's appraisal of executive competence with psychosocial functioning, together with depressive symptoms, both in remitted and non-remitted patients with depression. Therefore, to achieve full recovery, clinical management of patients should tackle not only the relief of core depressive symptoms, but also the cognitive ones, both those that are objectified with neuropsychological tests and those that are reported by the patients themselves.
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Affiliation(s)
- Muriel Vicent-Gil
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Joan Trujols
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Maria Serra-Blasco
- eHealth ICOnnecta’t Program and Psycho-Oncology Service, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Spain
| | - Guillem Navarra-Ventura
- Institut d’Investigació Sanitària Illes Balears (IdISBa), Hospital Universitari Son Espases, Palma, Spain
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS), Universitat de les Illes Balears, Palma, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III (CIBERES-ISCIII), Madrid, Spain
| | - Dolors Puigdemont
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Carlo Alemany
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Sara Crivillés
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Javier de Diego-Adeliño
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Narcís Cardoner
- Department of Psychiatry and Legal Medicine, Institute of Neuroscience, Universitat Autònoma de Barcelona (UAB)
| | - Maria J. Portella
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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4
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Pan WG, Hu XY, Zhu DD, Li L, Bao F, Ren L, Mao PX, Ma X, Ren YP, Tang YL. The cognitive effects of adjunctive repetitive transcranial magnetic stimulation for late-onset depression: a randomized controlled trial with 4 week follow-up. Front Psychiatry 2023; 14:1240261. [PMID: 37614650 PMCID: PMC10442575 DOI: 10.3389/fpsyt.2023.1240261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/27/2023] [Indexed: 08/25/2023] Open
Abstract
Objectives Cognitive impairment is common and linked to poor outcomes in patients with late-onset depression (LOD). The cognitive effects of repetitive transcranial magnetic stimulation (rTMS) for LOD are not well understood. This study aimed to investigate the effects of rTMS on cognitive function in elderly patients with LOD. Methods In total, 58 elderly patients (aged 60 to 75 years) with depression were enrolled and randomly assigned to an active rTMS group or a sham group. The participants received active or sham rTMS over the left dorsolateral prefrontal cortex for 4 weeks, 5 days a week, at a frequency of 10 Hz rTMS and 120% of the motor threshold (MT). Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) at baseline, the end of the 4 week treatment period, and at the 4 week follow-up. Results The active rTMS group showed significant improvements in immediate memory and attention scores on the RBANS compared to the sham group. However, no significant differences were observed between the two groups in other cognitive domains assessed by the RBANS. No serious adverse events related to rTMS treatment were observed. Conclusion Treatment with 120% MT rTMS was associated with improvement in cognitive defects related to the active phase of LOD. These findings suggest that rTMS could provide early improvements in cognitive function in clinical settings for elderly patients with LOD.Clinical trial registration: https://www.chictr.org.cn/showproj.html?proj=40698, identifier ChiCTR1900024445.
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Affiliation(s)
- Wei-gang Pan
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiao-yue Hu
- Department of Psychiatry, Xicheng District Pingan Hospital, Beijing, China
| | - Dan-di Zhu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Li Li
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Feng Bao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Li Ren
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Pei-xian Mao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xin Ma
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yan-ping Ren
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yi-lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GE, United States
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, GE, United States
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Ahorsu DK, Chung KHM, Wong HH, Yiu MGC, Mok YF, Lei KS, Tsang HWH. Mechanisms in Emotional Information Processing in Individuals with Major Depressive Disorder: An Event-Related Potential Study of an Information Processing Model. PSYCHIAT CLIN PSYCH 2023; 33:94-107. [PMID: 38765927 PMCID: PMC11082572 DOI: 10.5152/pcp.2023.22471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 02/22/2023] [Indexed: 05/22/2024] Open
Abstract
Background Individuals with major depressive disorder have a cognitive bias toward emotional stimuli, which influences the quality and speed of emotional information processing. This study aimed to understand the factors underlying this bias by identifying when it occurs during information processing using an information processing model. Methods A total of 57 participants-19 each [ (16 (84.21%) females and 3 (15.79%) males per group)], for the first-episode MDD (FMDD), recurrent episodes MDD (RMDD), and healthy controls (HCs) - matched for sex and hand preference, completed event-related potentials (ERP) to perform psychological function and a choice response time task. Results Results revealed that recurrent episodes major depressive disorder participants had decreased N2b and P3b amplitudes but increased contingent negative variation during the processing of happy and neutral facial stimuli, relative to their counterparts. Both recurrent episodes major depressive disorder and first-episode major depressive disorder participants used a parallel information processing strategy for happy information at P3a latency, while healthy controls used a linear information processing strategy. Conclusion The use of a parallel processing strategy among individuals with major depressive disorder may have led to impaired "happy" information processes, possibly explaining why individuals with major depressive disorder are less efficient than healthy controls. The results suggest the possibility that biases related to the processing of "happy" information among individuals with major depressive disorder may be related to a tendency for these individuals to engage in superficial decision-making. Future research is needed to examine the processes contributing to people with major depressive disorder having challenges with inhibition-facilitation of emotional stimuli.
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Affiliation(s)
- Daniel Kwasi Ahorsu
- Department of Rehabilitation Sciences, Neuropsychiatric Rehabilitation Laboratory, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Ken Ho Ming Chung
- Department of Rehabilitation Sciences, Neuropsychiatric Rehabilitation Laboratory, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | | | - Yat Fung Mok
- Department of Rehabilitation Sciences, Neuropsychiatric Rehabilitation Laboratory, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Ka Shun Lei
- Department of Rehabilitation Sciences, Neuropsychiatric Rehabilitation Laboratory, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Hector Wing Hong Tsang
- Department of Rehabilitation Sciences, Neuropsychiatric Rehabilitation Laboratory, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Wang M, Wei Z, Huang Q, Yang W, Wu C, Cao T, Zhao J, Lyu D, Wang F, Zhou N, Huang H, Zhang M, Chen Y, Xu Y, Ma W, Chen Z, Hong W. Prognostic prediction of subjective cognitive decline in major depressive disorder based on immune biomarkers: a prospective observational study. BMC Psychiatry 2023; 23:54. [PMID: 36658505 PMCID: PMC9850523 DOI: 10.1186/s12888-022-04513-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/30/2022] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Subjective cognitive decline (SCD) is highlighted in patients with major depressive disorder (MDD), which impairs objective cognitive performance and worsens the clinical outcomes. Immune dysregulation is supposed to be the potential mechanism of cognitive impairment. However, the peripheral immune biomarkers in patients troubled with MDD and SCD are not conventionally described. METHODS A prospective-observational study was conducted for 8 weeks. Subjective cognitive function was measured using the Chinese version of the 20-item perceived deficits questionnaire-depression (PDQ-D) and depression symptoms were evaluated with Hamilton Depression Rating Scale-17 (HDRS-17). Luminex assays were used to measure 48 immune cytokines in plasma at baseline. Integrating these results and clinicopathological features, a logistic regression model was used to develop a prognostic prediction. RESULTS Totally, 114 patients were enrolled in this study. Among the patients who completed follow-up, 56% (N = 50) had residual subjective cognitive decline, and 44% (N = 50) did not. The plasma levels of FGF basic, INF-γ, IL-1β, MCP-1, M-CSF and SCF were increased and the levels of IL-9, RANTES and PDGF-BB were decreased in the SCD group. Additionally, Basic FGF, IFN-γ, IL-1β, and SCF were positively correlated and IL-9, RANTES, and PDGF-BB were negatively correlated with the PDQ-D scores after treatment. Notably, combinations of cytokines (SCF and PDGF-BB) and PDQ-D scores at baseline showed good performance (The area under the receiver operating characteristic curve = 0.818) in the prediction of subjective cognitive decline. CONCLUSION A prognostic model based on protein concentrations of SCF, PDGF-BB, and scores of PDQ-D showed considerable accuracy in predicting residual subjective cognitive decline in depression.
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Affiliation(s)
- Meiti Wang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Zheyi Wei
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Qinte Huang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Weijie Yang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Chenglin Wu
- grid.24516.340000000123704535Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, 200120 China
| | - Tongdan Cao
- Shanghai Huangpu District Mental Health Center, Shanghai, 200040 China
| | - Jie Zhao
- Shanghai Huangpu District Mental Health Center, Shanghai, 200040 China
| | - Dongbin Lyu
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Fan Wang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Ni Zhou
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Haijing Huang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Mengke Zhang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Yiming Chen
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Yi Xu
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Weiliang Ma
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Zheng Chen
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Wu Hong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China. .,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 201108, China.
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Association between baseline cognitive symptoms and the subsequent presenteeism and global function in patients with major depressive disorder. J Psychiatr Res 2022; 154:324-331. [PMID: 36027860 DOI: 10.1016/j.jpsychires.2022.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 07/07/2022] [Accepted: 07/20/2022] [Indexed: 11/21/2022]
Abstract
Cognitive symptoms in major depressive disorder (MDD) contribute to impaired functional abilities and work productivity, particularly presenteeism. We investigated the association between baseline cognitive symptoms and subsequent presenteeism, and global functional impairment in Japanese patients with MDD from PERFORM-J (Prospective Epidemiological Research on Functioning Outcomes Related to Major Depressive Disorder in Japan) - a 6-month, multicenter, epidemiological study data. A total of 518 patients initiating antidepressant monotherapy (first-line or switched from another drug) were enrolled. Assessments include Perceived Deficits Questionnaire - Depression (PDQ-D) for cognitive complaints, Sheehan Disability Scale (SDS) for global function (analysed n = 318), and Work Productivity and Activity Impairment Questionnaire for presenteeism (analysed n = 122). A strong association between changes in presenteeism and changes in SDS scores (r: total = 0.636; work/school = 0.686) was observed. After adjusting for sociodemographic and MDD-related factors, patients without cognitive complaints at baseline showed lower odds of impaired presenteeism at 6 months versus patients with cognitive complaints (0.243, 95% CI: 0.079 to 0.747, p = 0.014) and also in patients with first episode of MDD against with recurrent MDD (0.327 (95% CI: 0.136 to 0.787). Similarly, patients without cognitive complaints had healthier global functioning (lower mean SDS total score) than patients with cognitive complaints (8.3 vs 11.2; 95% CI, -5.189 to -0.578; p = 0.014). First depressive episode (lower risk of presenteeism), being male, and low baseline SDS total score (better global functioning) were also associated with improved outcomes. These results highlight the potential value of baseline PDQ-D scores in predicting subsequent workplace and global functioning in patients undergoing treatment for MDD.
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Waters K. The clinical utility of newer antidepressant agents: Understanding the role in management of MDD. Ment Health Clin 2022; 12:309-319. [PMID: 36405509 PMCID: PMC9645287 DOI: 10.9740/mhc.2022.10.309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/07/2022] [Indexed: 11/06/2022] Open
Abstract
Abstract
Whereas MDD is characterized in part by changes in mood, other symptoms can also cause significant impairment, including sexual dysfunction, cognitive impairment, and fatigue. Newer antidepressants are explored with the goal of more optimally treating these non–mood-related symptoms of MDD. The 3 oral antidepressants that have been FDA-approved most recently include vortioxetine, vilazodone, and levomilnacipran. Unique features of these antidepressants are explored through 3 patient cases.
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Affiliation(s)
- Kristin Waters
- 1 (Corresponding author) Assistant Clinical Professor, University of Connecticut, Storrs, Connecticut,
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9
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In pursuit of full recovery in major depressive disorder. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01487-5. [PMID: 36085532 DOI: 10.1007/s00406-022-01487-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/29/2022] [Indexed: 11/03/2022]
Abstract
Many individuals with major depression disorder (MDD) who achieve remission of depressive symptoms, do not perceive themselves as fully recovered. This study explores whether clinical remission is related to functional remission and to patient's perception of recovery, as well as, which factors are associated with their functional and subjective remission. 148 patients with MDD in partial clinical remission were included. Demographics and clinical variables were collected through semi-structured interviews. Objective cognition was evaluated through a neuropsychological battery and subjective cognition through a specific questionnaire. The patient's psychosocial functioning and the perception of their remission were also assessed. Apart from descriptive analysis, Pearson correlations and backward stepwise regression models explored the relationship between demographic, clinical, and cognitive factors with patients' functional and self-perceived remission. From the whole sample, 57 patients (38.5%) were considered to achieve full clinical remission, 38 patients (25.7%) showed functional remission, and 55 patients (37.2%) perceived themselves as remitted. Depressive symptoms and objective and subjective executive function were the factors associated with psychosocial functioning. Besides, depressive symptoms, objective and subjective attention, and subjective executive function were the significant explanatory variables for self-perception of remission. The concept of full recovery from an episode of MDD should not only include the clinician's perspective but also the patient's psychosocial functioning along with their self-perceived remission. As residual depressive symptoms and cognition (objective and subjective) are factors with great contribution to a full recovery, clinicians should specifically address them when choosing therapeutic strategies.
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Liu S, Tong Y, Wang X, Yu X, Xu Y. Baseline cognitive functioning can predict the trajectory of acute treatment in first-episode major depressive disorder. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01475-9. [PMID: 35969275 DOI: 10.1007/s00406-022-01475-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 08/02/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This study aims to investigate the role of cognitive function in the efficacy prediction of selective serotonin reuptake inhibitors (SSRIs) for depression patients and to further the understanding of the relationship between baseline cognitive function and depression trajectory. METHODS This was part of a multicenter study for major depressive disorder. The study included 172 first-episode depression patients and 93 recurrent depression patients who had their cognitive function assessed at baseline and followed up for 8 weeks of SSRI treatment. RESULTS After constructing a 2-level hierarchical linear model with depression change- and cognitive function-level variables, the processing speed at baseline was the best predictor for the improvement of depression at each follow-up in first-episode patients (G11 = 0.03, P = 0.042). The treatment prediction model slope varied across patients depending on the processing speed scores at baseline. With the receiver operating characteristic curve, the combination of sociodemographic characteristics, sedative hypnotics, baseline 17-item Hamilton Rating Scale for Depression (HAMD17), and cognitive function showed the highest predictive power in major depressive disorder remission, resulting in a classification accuracy of 71.5%, a sensitivity of 82.5%, and a specificity of 55.1% (AUC = 0.713; P < 0.001). CONCLUSION Baseline cognitive function could help clinicians to better understand the trajectory of first-episode depression patients during acute treatment with SSRIs.
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Affiliation(s)
- Sha Liu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, 030001, China.,Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, 030001, China
| | - Yujie Tong
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, 030001, China.,Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, 030001, China
| | - Xiao Wang
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, 030001, China.,Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, 030001, China
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, 030001, China. .,Shanxi Provincial Key Laboratory of Brain Science and Neuropsychiatric Diseases, Shanxi Medical University, Taiyuan, 030001, China. .,Department of Mental Health, Shanxi Medical University, Taiyuan, 030001, China.
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11
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Sumiyoshi T, Hoshino T, Mishiro I, Hammer-Helmich L, Ge H, Moriguchi Y, Fujikawa K, Fernandez JL. Prediction of residual cognitive disturbances by early response of depressive symptoms to antidepressant treatments in patients with major depressive disorder. J Affect Disord 2022; 296:95-102. [PMID: 34597893 DOI: 10.1016/j.jad.2021.09.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/16/2021] [Accepted: 09/12/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Patients with major depressive disorder (MDD) frequently retain cognitive disturbances after recovery from mood symptoms. We investigated the relationship between early response of mood symptoms and/or remission, and residual cognitive disturbances after 6 months of antidepressant treatment. METHODS 518 patients with MDD were followed up for 6 months after antidepressant treatment initiation (first-line or switch from a previous drug). Subjective and objective cognitive disturbances were assessed by the Perceived Deficits Questionnaire - Depression (PDQ-D) and digit symbol substitution test (DSST), respectively. Depressive symptoms, as well as remission and early response to treatment, were assessed using the Montgomery-Asberg Depression Rating Scale (MADRS). Multivariable linear and logistic regression models were used to adjust for confounders. RESULTS Early response of depressive mood (≥50% reduction in MADRS score at month 1) was related with fewer residual subjective cognitive symptoms, as evaluated by the PDQ-D at month 6 (p<0.001). Likewise, early remission status at month 2 was inversely associated with PDQ-D scores at month 6 (p<0.001). Among patients with baseline DSST scores of ≥1 standard deviation below the norm, early response/remission was associated with better performance on the DSST at month 6 (p<0.05). LIMITATIONS The cohort may not be representative of the general MDD patient population, and the possible influence of concomitant medications was not evaluated. CONCLUSIONS These findings suggest that early improvements in depressive symptoms predict better cognitive outcomes in patients with MDD. Grouping of patients by mood and cognition status in early stages of antidepressant treatments may facilitate efforts to improve long-term functional outcomes.
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Affiliation(s)
- Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Tatsuya Hoshino
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Izumi Mishiro
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | | | - Holly Ge
- Health Economics & Epidemiology Statistics, Lundbeck Singapore Pte Limited, Singapore
| | | | - Keita Fujikawa
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
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12
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Morrens M, Overloop C, Coppens V, Loots E, Van Den Noortgate M, Vandenameele S, Leboyer M, De Picker L. The relationship between immune and cognitive dysfunction in mood and psychotic disorder: a systematic review and a meta-analysis. Mol Psychiatry 2022; 27:3237-3246. [PMID: 35484245 PMCID: PMC9708549 DOI: 10.1038/s41380-022-01582-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 12/18/2022]
Abstract
BACKGROUND In psychotic and mood disorders, immune alterations are hypothesized to underlie cognitive symptoms, as they have been associated with elevated blood levels of inflammatory cytokines, kynurenine metabolites, and markers of microglial activation. The current meta-analysis synthesizes all available clinical evidence on the associations between immunomarkers (IMs) and cognition in these psychiatric illnesses. METHODS Pubmed, Web of Science, and Psycinfo were searched for peer-reviewed studies on schizophrenia spectrum disorder (SZ), bipolar disorder (BD), or major depressive disorder (MDD) including an association analysis between at least one baseline neuropsychological outcome measure (NP) and one IM (PROSPERO ID:CRD42021278371). Quality assessment was performed using BIOCROSS. Correlation meta-analyses, and random effect models, were conducted in Comprehensive Meta-Analysis version 3 investigating the association between eight cognitive domains and pro-inflammatory and anti-inflammatory indices (PII and AII) as well as individual IM. RESULTS Seventy-five studies (n = 29,104) revealed global cognitive performance (GCP) to be very weakly associated to PII (r = -0.076; p = 0.003; I2 = 77.4) or AII (r = 0.067; p = 0.334; I2 = 38.0) in the combined patient sample. Very weak associations between blood-based immune markers and global or domain-specific GCP were found, either combined or stratified by diagnostic subgroup (GCP x PII: SZ: r = -0.036, p = 0.370, I2 = 70.4; BD: r = -0.095, p = 0.013, I2 = 44.0; MDD: r = -0.133, p = 0.040, I2 = 83.5). We found evidence of publication bias. DISCUSSION There is evidence of only a weak association between blood-based immune markers and cognition in mood and psychotic disorders. Significant publication and reporting biases were observed and most likely underlie the inflation of such associations in individual studies.
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Affiliation(s)
- M. Morrens
- grid.5284.b0000 0001 0790 3681Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium ,Scientific Initiative of Neuropsychiatric and Psychopharmacological Studies (SINAPS), University Psychiatric Centre Duffel, Duffel, Belgium
| | - C. Overloop
- Scientific Initiative of Neuropsychiatric and Psychopharmacological Studies (SINAPS), University Psychiatric Centre Duffel, Duffel, Belgium
| | - V. Coppens
- grid.5284.b0000 0001 0790 3681Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium ,Scientific Initiative of Neuropsychiatric and Psychopharmacological Studies (SINAPS), University Psychiatric Centre Duffel, Duffel, Belgium
| | - E. Loots
- grid.5284.b0000 0001 0790 3681Faculty of Medicine and Health Sciences, Nursing and obstetrics, University of Antwerp, Antwerp, Belgium
| | - M. Van Den Noortgate
- grid.5284.b0000 0001 0790 3681Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
| | - S. Vandenameele
- grid.5284.b0000 0001 0790 3681Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium ,grid.411326.30000 0004 0626 3362University Hospital Brussels, Brussels Health Campus, Jette, Belgium
| | - M. Leboyer
- grid.462410.50000 0004 0386 3258INSERM U955, Equipe Psychiatrie Translationnelle, Créteil, France ,grid.484137.d0000 0005 0389 9389Fondation FondaMental, Créteil, France ,grid.412116.10000 0001 2292 1474AP-HP, Hôpitaux Universitaires Henri Mondor, DHU Pepsy, Pôle de Psychiatrie et d’Addictologie, Créteil, France ,grid.410511.00000 0001 2149 7878Université Paris Est Créteil, Faculté de Médecine, Creteil, France
| | - L. De Picker
- grid.5284.b0000 0001 0790 3681Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium ,Scientific Initiative of Neuropsychiatric and Psychopharmacological Studies (SINAPS), University Psychiatric Centre Duffel, Duffel, Belgium
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13
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Pan W, Liu C, Zhu D, Liu Y, Mao P, Ren Y, Ma X. Prediction of Antidepressant Efficacy by Cognitive Function in First-Episode Late-Life Depression: A Pilot Study. Front Psychiatry 2022; 13:916041. [PMID: 35669268 PMCID: PMC9163406 DOI: 10.3389/fpsyt.2022.916041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/02/2022] [Indexed: 11/17/2022] Open
Abstract
UNLABELLED The response rate of treatment for late-life depression (LLD) is only 25-60%. The cognitive impairment associated with LLD often affects the effectiveness of antidepressants and may has the potential ability to predict response. This study seeks a biomarker for baseline cognitive function to predict efficacy of antidepressants. Sixty patients diagnosed with LLD received escitalopram or sertraline treatment for 8 weeks. Clinical symptom was measured using Hamilton Depression Rating Scale-17 (HAMD-17) and cognitive function was measured using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Trail Making Test (TMT) before and after 8-week treatment. Patients were divided into treatment effective group (TE) and treatment ineffective group (TI) according to reduction rate in scores of HAMD-17 after treatment. Thirty-eight matched healthy controls (HC) were assessed using RBANS and TMT. There was significant decrease of score of RBANS and increase of score of TMT in patients with LLD compared with HC. Regression analysis revealed that change in HAMD-17 score was significantly positively associated with baseline score of picture naming, figure copy, digit span, and delayed memory. The preliminary findings suggested that working memory, attention, visuospatial, language function, and delayed memory should be examined further as a means of providing the useful objective biomarkers of treatment response. CLINICAL TRIALS REGISTRATION [www.ClinicalTrials.gov], identifier [ChiCTR2100042370].
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Affiliation(s)
- Weigang Pan
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Chaomeng Liu
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Dandi Zhu
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yi Liu
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Peixian Mao
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yanping Ren
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xin Ma
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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14
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Ingulfsvann Hagen B, Landrø NI, Hoorelbeke K, Lau B, Stubberud J. Characteristics associated with the discrepancy between subjective and objective executive functioning in depression. APPLIED NEUROPSYCHOLOGY-ADULT 2021:1-10. [PMID: 34523373 DOI: 10.1080/23279095.2021.1969398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Major depressive disorder (MDD) is associated with both self-reported (subjective) cognitive complaints and deficits in neurocognitive (objective) measures, but the correspondence between subjective and objective measures of cognition is low. This cross-sectional study aimed to (1) assess the association between subjective and objective measures of executive functions (EFs), and (2) explore factors associated with the discrepancy between subjective and objective EFs in MDD. Sixty-two participants with current or previous mild to moderate MDD and subjective EF complaints completed a clinical trial baseline assessment. An objective EF composite score was drawn from six neurocognitive measures, while the Behavior Rating Inventory of Executive Function-Adult version was applied as a measure of subjective EF. The association between the subjective and objective composites was evaluated using Spearman's rank order correlation. A discrepancy score was calculated to quantify the difference between subjective and objective EF. Factors associated with the discrepancy score were analyzed using regression analysis (p < .05). Participants reported extensive EF difficulties, but most performed in the normal range on objective EF measures. A weak correlation was detected between the subjective and objective measures (rs = .015). More rumination (β = -.364) and higher IQ (β = -.420) were associated with reporting more subjective complaints than was evident from objective measures of EF (i.e., underestimation). Subjective and objective EF measures are weakly overlapping in MDD. Findings underscore recommendations to include both subjective and objective measures when assessing EFs in depression. In addition, findings suggest that targeting ruminative processes could help correct underestimation.
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Affiliation(s)
- Bjørn Ingulfsvann Hagen
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Kristof Hoorelbeke
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Bjørn Lau
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Jan Stubberud
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
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15
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Cochrane S, Dale AM, Buckner-Petty S, Sobel AD, Lippold B, Calfee RP. Relevance of Diagnosed Depression and Antidepressants to PROMIS Depression Scores Among Hand Surgical Patients. J Hand Surg Am 2021; 46:99-105. [PMID: 33277101 DOI: 10.1016/j.jhsa.2020.10.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 07/31/2020] [Accepted: 10/13/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE We aimed to test the utility of screening for depressive symptoms in the hand surgical office focusing on chances of heightened depressive symptoms in patients with no history of diagnosed depression and by quantifying ongoing depressive symptoms among patients diagnosed with depression accounting for antidepressant use. The clinical importance of this study was predicated on the documented negative association between depressive symptoms and hand surgical outcomes. METHODS This cross-sectional study analyzed 351 patients presenting to a tertiary hand center between April 21, 2016, and November 22, 2017. Adult patients completed self-administered Patient-Reported Outcomes Measurement Information System (PROMIS) Depression computer adaptive tests at registration. Health records were examined for a past medical history of diagnosed depression and whether patients reported current use of prescription antidepressants. Mean PROMIS Depression scores were compared by analysis of variance (groups: no diagnosed depression, depression without medication, depression with medication). Four points represented a clinically relevant difference in PROMIS Depression scores between groups and Depression scores greater than 59.9 were categorized as having heightened depressive symptoms. RESULTS Sixty-two patients (18%) had been diagnosed with depression. Thirty-four of these patients (55%) reported taking antidepressant medications. The PROMIS Depression scores indicated greater current depressive symptoms among patients with a history of diagnosed depression when not taking antidepressants (11 points worse than unaffected) and also among patients taking antidepressants (7 points worse than unaffected). Heightened depressive symptoms were detected in all groups but were more prevalent among those diagnosed with depression (36% with no medication, 29% with antidepressant medication) compared with unaffected patients (7%). CONCLUSIONS Depression screening for heightened depressive symptoms identifies 1 in 14 patients without diagnosed depression and 1 in 3 patients diagnosed with depression as having currently heightened depressive symptoms. Hand surgeons can use PROMIS Depression screening in all patients and using this to guide referrals for depression treatment to ameliorate one confounder of hand surgical outcomes. TYPE OF STUDY/LEVEL OF EVIDENCE Symptom prevalence study II.
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Affiliation(s)
- Shannon Cochrane
- Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Ann Marie Dale
- Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Skye Buckner-Petty
- Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Andrew D Sobel
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO
| | - Brandon Lippold
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO
| | - Ryan P Calfee
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO.
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16
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Sumiyoshi T, Watanabe K, Noto S, Sakamoto S, Moriguchi Y, Hammer-Helmich L, Fernandez J. Relationship of Subjective Cognitive Impairment with Psychosocial Function and Relapse of Depressive Symptoms in Patients with Major Depressive Disorder: Analysis of Longitudinal Data from PERFORM-J. Neuropsychiatr Dis Treat 2021; 17:945-955. [PMID: 33814911 PMCID: PMC8009536 DOI: 10.2147/ndt.s288108] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/11/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Accumulating evidence suggests the presence of cognitive impairment in patients with major depressive disorder (MDD), which affects their psychosocial function and quality of life (QoL). PERFORM-J (Prospective Epidemiological Research on Functioning Outcomes Related to MDD in Japan) is an observational, multicenter study to assess longitudinal changes in depressive symptoms, psychomotor speed, subjective cognitive function, and psychosocial function. METHODS Five hundred and eighteen Japanese outpatients with MDD initiating new antidepressant monotherapy (first-line or switch from previous drug) as part of their routine medical care participated in this study. Assessments at baseline and over the 6-month observation period included physician-rated depression severity (Montgomery-Åsberg Depression Rating Scale), psychomotor speed (Digit Symbol Substitution Test; DSST), subjective cognition (Perceived Deficits Questionnaire-Depression), psychosocial function (Sheehan Disability Scale), and QoL (EuroQol-5 Dimension-5 Level). RESULTS Antidepressant treatment for 6 months improved depressive symptoms and subjective cognitive impairment (cognitive complaints), whereas psychomotor speed remained impaired (ie, DSST total score was >1 standard deviation below the norm) in 35.6% of patients at 6 months. Impairment of subjective cognition, but not psychomotor speed at month 2 was associated with poor psychosocial function and QoL at 6 months. There was a trend for higher relapse rates at 6 months in patients with greater subjective cognitive impairment at 2 months. CONCLUSION These findings highlight the importance of evaluating cognitive difficulties to predict long-term outcomes in patients with MDD. Early intervention for cognitive complaints may decrease the relapse rate, which warrants further study.
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Affiliation(s)
- Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Koichiro Watanabe
- Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan
| | - Shinichi Noto
- Faculty of Rehabilitation, Niigata University of Health and Welfare, Niigata, Japan
| | - Shigeru Sakamoto
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | | | | | - Jovelle Fernandez
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
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17
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Tsang HH, Ahorsu D, Chung K, Wong H, Yiu MC, Mok Y, Lei K. Neuropsychological correlates of community function among major depressive disorder outpatients without comorbidity in Hong Kong: An exploratory cross-Sectional study. ASIAN JOURNAL OF SOCIAL HEALTH AND BEHAVIOR 2021. [DOI: 10.4103/shb.shb_66_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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18
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Cho SE, Geem ZW, Na KS. Prediction of depression among medical check-ups of 433,190 patients: A nationwide population-based study. Psychiatry Res 2020; 293:113474. [PMID: 33198046 DOI: 10.1016/j.psychres.2020.113474] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 09/19/2020] [Indexed: 12/19/2022]
Abstract
Depression is a mental illness that causes significant disturbances in daily life. Depression is commonly associated with low mood, severe health problems, and substantial socioeconomic burden; hence, it is necessary to be able to detect depression earlier. We utilized the medical check-up cohort database of the National Health Insurance Sharing Service in Korea. We split the total dataset into training (70%) and test (30%) sets. Subsequently, five-fold cross validation was performed in the training set. The holdout test set was only used in the last step to evaluate the performance of the predictive model. Random forest algorithm was used for the predictive model. The analysis included 433,190 individuals who had a national medical check-up from 2009-2015, which included 10,824 (2.56%) patients in the depression group. The area under the receiver-operating curve was 0.849. Other performance metrics included a sensitivity of 0.737, specificity of 0.824, positive predictive value of 0.097, negative predictive value of 0.992, and accuracy of 0.780. Our predictive model could contribute to proactively reducing depression prevalence by administering interventions to prevent depression in patients receiving medical check-up. Future studies are needed to prospectively validate the predictability of this model.
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Affiliation(s)
- Seo-Eun Cho
- Department of Psychiatry, Gil Medical Center, Incheon, Korea
| | - Zong Woo Geem
- Department of Energy and Information Technology, Gachon University, Seongnam-si, Republic of Korea
| | - Kyoung-Sae Na
- Department of Psychiatry, Gachon University College of Medicine, Gil Medical Center, Incheon, Republic of Korea.
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19
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Improvements in Workplace Productivity in Working Patients With Major Depressive Disorder: Results From the AtWoRC Study. J Occup Environ Med 2020; 62:e94-e101. [PMID: 31895735 DOI: 10.1097/jom.0000000000001805] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess changes in workplace productivity and functioning in an open-label study in working patients receiving vortioxetine (10 to 20 mg/d) for major depressive disorder (MDD). METHODS Associations between items in the Work Limitations Questionnaire (WLQ), the Sheehan Disability Scale (SDS), and the Work Productivity and Activity Impairment (WPAI) questionnaire were assessed at 12 and 52 weeks by Pearson correlation coefficients. RESULTS Significant improvements were observed across all domains of workplace productivity and functioning after 12 and 52 weeks' vortioxetine treatment. Strong correlations were seen between improvements in WLQ mental domains and WPAI presenteeism and SDS work/school items. Presenteeism showed stronger correlations with other workplace productivity measures than absenteeism. CONCLUSIONS Presenteeism and absenteeism impact productivity in working patients with MDD. Vortioxetine confers long-term benefits across all workplace functioning domains.
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20
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Wang G, Tan KHX, Ren H, Hammer-Helmich L. Impact of Cognitive Symptoms on Health-Related Quality of Life and Work Productivity in Chinese Patients with Major Depressive Disorder: Results from the PROACT Study. Neuropsychiatr Dis Treat 2020; 16:749-759. [PMID: 32214816 PMCID: PMC7081063 DOI: 10.2147/ndt.s230403] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 02/15/2020] [Indexed: 01/10/2023] Open
Abstract
PURPOSE This post hoc analysis was undertaken to further explore the association of cognitive symptoms with health-related quality of life (HRQoL) and work productivity at the time of treatment initiation in Chinese patients with major depressive disorder (MDD) in the Prospective Research Observation to Assess Cognition in Treated patients with MDD (PROACT) study. PATIENTS AND METHODS This was an epidemiological, non-interventional, prospective cohort study in adult outpatients with moderate-to-severe MDD initiating antidepressant monotherapy (first or second line). Crude and adjusted analyses of covariance were performed to assess the association of perceived cognitive symptoms (20-item Perceived Deficits Questionnaire-Depression [PDQ-D] total score) or observed cognitive performance (Digit Symbol Substitution Test [DSST] score) with HRQoL (EuroQoL 5-Dimensions Questionnaire index) and work productivity (Work Productivity and Activity Impairment [WPAI] or Sheehan Disability Scale [SDS] absenteeism and presenteeism scores). Adjusted analyses included depression severity, age, sex, residential area (urban/rural), and educational level. RESULTS Of 1008 patients enrolled in the PROACT study, 986 were included in this analysis. Severity of perceived cognitive symptoms (ie, higher PDQ-D total score) was significantly associated with worse HRQoL (P<0.001) and higher levels of absenteeism (P=0.020 for the WPAI and P=0.002 for the SDS) and presenteeism (P<0.001 for both scales). The association of perceived cognitive symptoms with HRQoL and presenteeism was independent of depression severity. The association between observed cognitive performance (DSST score) and HRQoL was less robust. No association was seen between observed cognitive performance and levels of absenteeism or presenteeism assessed by either scale. CONCLUSION Results of this real-world study illustrate the impact of cognitive symptoms on HRQoL and work productivity in Chinese patients with MDD, and highlight the importance of assessing and targeting cognitive symptoms in order to improve functional outcomes when treating patients with MDD.
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Affiliation(s)
- Gang Wang
- Psychiatry Department, Beijing an Ding Hospital, Capital Medical University, China National Clinical Research Center for Mental Disorders, Beijing, People's Republic of China
| | - Kristin Hui Xian Tan
- Health Economics & Epidemiology Statistics, Lundbeck Singapore Pte Ltd, Singapore
| | - Hongye Ren
- Medical Affairs Value Evidence, H. Lundbeck A/S, Valby, Denmark
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21
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Christensen MC, Wong CMJ, Baune BT. Symptoms of Major Depressive Disorder and Their Impact on Psychosocial Functioning in the Different Phases of the Disease: Do the Perspectives of Patients and Healthcare Providers Differ? Front Psychiatry 2020; 11:280. [PMID: 32390877 PMCID: PMC7193105 DOI: 10.3389/fpsyt.2020.00280] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/23/2020] [Indexed: 12/12/2022] Open
Abstract
This analysis was undertaken to examine the relationship between different symptoms of major depressive disorder (MDD) and psychosocial functioning from the perspectives of patients and healthcare providers (HCPs) across the different phases of the disease (acute, post-acute, and remission). Data regarding symptoms of MDD and psychosocial functioning, assessed by an adapted version of the Functioning Assessment Short Test (FAST) scale, were elicited via an online survey from 2,008 patients diagnosed with MDD (based on their personal experience of the disease) and 3,138 patients observed by 1,046 HCPs (based on individual patient records). Correlations between patient-reported and HCP-reported MDD symptoms and impairment of psychosocial functioning were assessed by multivariate regression analysis. The population comprised 1,946 patient respondents and 3,042 HCP-reported patients. Patients reported experiencing a wider range of symptoms and greater impairment of functioning than reported by HCPs across all phases of the disease. At the domain level, only cognitive symptoms were found to be significantly associated with functioning during the acute phase from the perspective of patients, while from the HCPs' perspective both mood and cognitive symptoms significantly impacted functioning in this phase. Significant associations were seen between mood, physical, and cognitive symptom domains and functioning in both cohorts during the post-acute and remission phases. Differences in associations between individual MDD symptoms and functioning were also observed between the two cohorts across all disease phases; in particular, HCPs found that more physical symptoms impacted functioning during remission than did patients. In summary, the results suggest that perceptions of MDD symptoms and the associations between these symptoms and functioning differ significantly between patients and HCPs across all phases of the disease. These findings further highlight the need for improved communication between patients and HCPs in order to set appropriate treatment goals and promote symptomatic and functional recovery in MDD.
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Affiliation(s)
| | | | - Bernhard T Baune
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany.,Department of Psychiatry, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia.,The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
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