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COGNITIVE DEFICITS AND FUNCTIONAL OUTCOMES IN MAJOR DEPRESSIVE DISORDER: DETERMINANTS, SUBSTRATES, AND TREATMENT INTERVENTIONS

2013; Wiley; Volume: 30; Issue: 6 Linguagem: Inglês

10.1002/da.22063

1520-6394

Roger S. McIntyre, S. Danielle, Joanna K. Soczynska, Hanna O. Woldeyohannes, Laura Ashley Gallaugher, Paul Kudlow, Mohammad Alsuwaidan, Anusha Baskaran,

Attention Deficit Hyperactivity Disorder

Depression and AnxietyVolume 30, Issue 6 p. 515-527 Review COGNITIVE DEFICITS AND FUNCTIONAL OUTCOMES IN MAJOR DEPRESSIVE DISORDER: DETERMINANTS, SUBSTRATES, AND TREATMENT INTERVENTIONS Roger S. McIntyre MD, FRCPC, Corresponding Author Roger S. McIntyre MD, FRCPC Institute of Medical Science, University of Toronto, Toronto, Canada Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, Canada Department of Pharmacology, University of Toronto, Toronto, CanadaCorrespondence to: Roger S. McIntyre, MD, FRCPC, Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, ON, Canada M5T 2S8. E-mail: roger.mcintyre@uhn.caSearch for more papers by this authorDanielle S. Cha HBSc, Danielle S. Cha HBSc Department of Psychiatry, University of Toronto, Toronto, Canada Department of Pharmacology, University of Toronto, Toronto, CanadaSearch for more papers by this authorJoanna K. Soczynska HBSc, Joanna K. Soczynska HBSc Department of Psychiatry, University of Toronto, Toronto, Canada Department of Pharmacology, University of Toronto, Toronto, CanadaSearch for more papers by this authorHanna O. Woldeyohannes HBSc, Hanna O. Woldeyohannes HBSc Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, CanadaSearch for more papers by this authorLaura Ashley Gallaugher HBSc, Laura Ashley Gallaugher HBSc Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, CanadaSearch for more papers by this authorPaul Kudlow BSc, MD, Paul Kudlow BSc, MD Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, CanadaSearch for more papers by this authorMohammad Alsuwaidan MD, MPH, FRCPC, Dip ABPN, Mohammad Alsuwaidan MD, MPH, FRCPC, Dip ABPN Department of Psychiatry, University of Toronto, Toronto, CanadaSearch for more papers by this authorAnusha Baskaran HBSc, MSc, Anusha Baskaran HBSc, MSc Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada Centre for Neuroscience Studies, Queen's University, Kingston, CanadaSearch for more papers by this author Roger S. McIntyre MD, FRCPC, Corresponding Author Roger S. McIntyre MD, FRCPC Institute of Medical Science, University of Toronto, Toronto, Canada Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, Canada Department of Pharmacology, University of Toronto, Toronto, CanadaCorrespondence to: Roger S. McIntyre, MD, FRCPC, Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, ON, Canada M5T 2S8. E-mail: roger.mcintyre@uhn.caSearch for more papers by this authorDanielle S. Cha HBSc, Danielle S. Cha HBSc Department of Psychiatry, University of Toronto, Toronto, Canada Department of Pharmacology, University of Toronto, Toronto, CanadaSearch for more papers by this authorJoanna K. Soczynska HBSc, Joanna K. Soczynska HBSc Department of Psychiatry, University of Toronto, Toronto, Canada Department of Pharmacology, University of Toronto, Toronto, CanadaSearch for more papers by this authorHanna O. Woldeyohannes HBSc, Hanna O. Woldeyohannes HBSc Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, CanadaSearch for more papers by this authorLaura Ashley Gallaugher HBSc, Laura Ashley Gallaugher HBSc Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, CanadaSearch for more papers by this authorPaul Kudlow BSc, MD, Paul Kudlow BSc, MD Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, CanadaSearch for more papers by this authorMohammad Alsuwaidan MD, MPH, FRCPC, Dip ABPN, Mohammad Alsuwaidan MD, MPH, FRCPC, Dip ABPN Department of Psychiatry, University of Toronto, Toronto, CanadaSearch for more papers by this authorAnusha Baskaran HBSc, MSc, Anusha Baskaran HBSc, MSc Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada Centre for Neuroscience Studies, Queen's University, Kingston, CanadaSearch for more papers by this author First published: 06 March 2013 https://doi.org/10.1002/da.22063Citations: 423 Contract grant sponsor: Takeda Pharmaceutical Company, Ltd. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Background Few reports have aimed to describe the mediational effect of cognitive deficits on functional outcomes in major depressive disorder (MDD), and relatively few interventions are demonstrated to mitigate cognitive deficits in MDD. Methods Studies enrolling subjects between the ages of 18–65 were selected for review. Bibliographies from identified articles were reviewed to identify additional original reports aligned with our objectives. Results Cognitive deficits in MDD are consistent, replicable, nonspecific, and clinically significant. The aggregated estimated effect size of cognitive deficits in MDD is small to medium. Pronounced deficits in executive function (≥1 SD below the normative mean) are evident in ∼20–30% of individuals with MDD). Other replicated abnormalities are in the domains of working memory, attention, and psychomotor processing speed. Mediational studies indicate that cognitive deficits may account for the largest percentage of variance with respect to the link between psychosocial dysfunction (notably workforce performance) and MDD. No conventional antidepressant has been sufficiently studied and/or demonstrated robust procognitive effects in MDD. Conclusions Cognitive deficits in MDD are a principal mediator of psychosocial impairment, notably workforce performance. The hazards posed by cognitive deficits in MDD underscore the need to identify a consensus-based neurocognitive battery for research and clinical purposes. Interventions (pharmacological, behavioral, neuromodulatory) that engage multiple physiological systems implicated in cognitive deficits hold promise to reduce, reverse, and prevent cognitive deficits. Citing Literature Volume30, Issue6June 2013Pages 515-527 RelatedInformation