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Study Reveals Significant Cognitive Impairment in Patients With MDD

Meagan Thistle

Individuals with major depressive disorder (MDD) may have significant moderate cognitive deficits in executive function, memory, and attention, but not in reaction time, when compared to healthy subjects. Researchers published their findings from a recent comprehensive review and meta-analysis in Psychotherapy and Psychosomatics. 

In the subgroup analyses, “currently depressed patients who are unmedicated had a small effect size of cognitive deficits, and no significant effect sizes were found among children, but those with treatment resistance and among older adults had moderate to large effect sizes of cognitive deficits across multiple cognitive domains,” researchers said in the study.

Related: Novel Depression Treatments Focus of Psych Congress Regionals Q&A Session

The study, encompassing 33 investigations with 2596 subjects, included neuropsychological assessments utilizing the Cambridge Neuropsychological Test Automated Battery (CANTAB).

Results indicated that individuals with MDD exhibited moderate cognitive deficits compared to healthy controls, with a standardized mean difference (SMD) of -0.39 (95% CI, -0.47 to -0.31). Notably, patients with treatment-resistant depression (TRD) displayed more pronounced cognitive deficits (SMD, -0.56 [95% CI, -0.78 to -0.34]), as did older adults with MDD (SMD, -0.51 [95% CI, -0.66 to -0.36]).

The study also found a small effect size among unmedicated patients with MDD (SMD, -0.19 [95% CI, -0.37 to -0.00]), and no significant differences among children. Cognitive deficits were consistently identified across all domains, except for reaction time. No publication bias was reported.

Cognitive impairment in MDD can persist in remission and can increase the risk of major neurodegenerative disorders. Because of this, researchers urge that remediation of cognitive impairment should be an important goal alongside the alleviation of depressive symptoms when treating patients with MDD.

Impaired cognitive functioning in MDD is also “associated with poor response to antidepressant treatment and deteriorated psychosocial functioning, [and] pharmacological and psychosocial interventions should be tailored to address cognitive impairment in these subgroup populations,” researchers advised.

 

Reference

Rhee TG, Shim SR, Manning KJ, et al. Neuropsychological Assessments of Cognitive Impairment in Major Depressive Disorder: A Systematic Review and Meta-Analysis with Meta-Regression. Psychother Psychosom. 2024;1-16. doi:10.1159/0005

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