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      Cognitive Impairment and Neurocognitive Profiles in Major Depression—A Clinical Perspective

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          Abstract

          Increasingly, studies have investigated cognitive functioning from the perspective of acute state- to remitted phases of Major Depressive Disorder (MDD). Some cognitive deficits observed in the symptomatic phase persist in remission as traits or scars. The etiological origin and clinical consequences of the neurocognitive profiles reported in the literature are still unclear and may vary across populations. Deficits are suspected to influence the association between MDD and neurodegenerative disorders and could thus be of particular clinical consequence. The aim of this review is to describe the clinical neuropsychological profile in MDD and how it is related to research during the past decade on cognitive deficits in MDD from a state, trait, and scar perspective. This review, with a clinical perspective, investigates research from the past decade regarding cognitive functioning in MDD in a long-term perspective. We focus on the clinical manifestation of deficits, and the potential neurodegenerative consequences of the neurocognitive profile in MDD. Searches in Medline, PsycINFO and Embase were conducted targeting articles published between 2010 and 2020. Examination of the evidence for long-lasting neurocognitive deficits in major depression within the cognitive domains of Memory, Executive Functions, Attention, and Processing Speed was conducted and was interpreted in the context of the State, Scar and Trait hypotheses. Defining the neurocognitive profiles in MDD will have consequences for personalized evaluation and treatment of residual cognitive symptoms, and etiological understanding of mood disorders, and treatments could potentially reduce or delay the development of neurodegenerative disorders.

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          The unity and diversity of executive functions and their contributions to complex "Frontal Lobe" tasks: a latent variable analysis.

          This individual differences study examined the separability of three often postulated executive functions-mental set shifting ("Shifting"), information updating and monitoring ("Updating"), and inhibition of prepotent responses ("Inhibition")-and their roles in complex "frontal lobe" or "executive" tasks. One hundred thirty-seven college students performed a set of relatively simple experimental tasks that are considered to predominantly tap each target executive function as well as a set of frequently used executive tasks: the Wisconsin Card Sorting Test (WCST), Tower of Hanoi (TOH), random number generation (RNG), operation span, and dual tasking. Confirmatory factor analysis indicated that the three target executive functions are moderately correlated with one another, but are clearly separable. Moreover, structural equation modeling suggested that the three functions contribute differentially to performance on complex executive tasks. Specifically, WCST performance was related most strongly to Shifting, TOH to Inhibition, RNG to Inhibition and Updating, and operation span to Updating. Dual task performance was not related to any of the three target functions. These results suggest that it is important to recognize both the unity and diversity of executive functions and that latent variable analysis is a useful approach to studying the organization and roles of executive functions. Copyright 2000 Academic Press.
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            The epidemiology of depression across cultures.

            Epidemiological data are reviewed on the prevalence, course, socio-demographic correlates, and societal costs of major depression throughout the world. Major depression is estimated in these surveys to be a commonly occurring disorder. Although estimates of lifetime prevalence and course vary substantially across countries for reasons that could involve both substantive and methodological processes, the cross-national data are clear in documenting meaningful lifetime prevalence with wide variation in age-of-onset and high risk of lifelong chronic-recurrent persistence. A number of sociodemographic correlates of major depression are found consistently across countries, and cross-national data also document associations with numerous adverse outcomes, including difficulties in role transitions (e.g., low education, high teen childbearing, marital disruption, unstable employment), reduced role functioning (e.g., low marital quality, low work performance, low earnings), elevated risk of onset, persistence and severity of a wide range of secondary disorders, and increased risk of early mortality due to physical disorders and suicide.
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              Avoidable waste in the production and reporting of research evidence.

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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                08 March 2022
                2022
                : 13
                : 764374
                Affiliations
                [1] 1Department of Biological and Medical Psychology, University of Bergen , Bergen, Norway
                [2] 2Division of Psychiatry, Haukeland University Hospital, University of Bergen , Bergen, Norway
                Author notes

                Edited by: Marie-Christine Gely-Nargeot, Université Paul Valéry, Montpellier III, France

                Reviewed by: Gabriele Nibbio, University of Brescia, Italy; Jin Liu, Central South University, China

                *Correspondence: Åsa Hammar aasa.hammar@ 123456uib.no

                This article was submitted to Psychopathology, a section of the journal Frontiers in Psychiatry

                Article
                10.3389/fpsyt.2022.764374
                8957205
                35345877
                c804c868-39ca-45cc-8f4e-52a8d5b89d8c
                Copyright © 2022 Hammar, Ronold and Rekkedal.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 25 August 2021
                : 03 January 2022
                Page count
                Figures: 2, Tables: 4, Equations: 0, References: 100, Pages: 21, Words: 12865
                Funding
                Funded by: Universitetet i Bergen, doi 10.13039/501100005036;
                Categories
                Psychiatry
                Review

                Clinical Psychology & Psychiatry
                mdd,cognitive functioning,scar,trait,state,remission,relapse,residual cognitive symptoms

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