Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Mar 8:13:764374.
doi: 10.3389/fpsyt.2022.764374. eCollection 2022.

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

Åsa Hammar  1   2 , Eivind Haga Ronold  1   2 , Guro Årdal Rekkedal  2
Affiliations
Review

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

Åsa Hammar et al. Front Psychiatry. .

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.

Keywords: MDD; cognitive functioning; relapse; remission; residual cognitive symptoms; scar; state; trait.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Illustrates three hypotheses regarding the neurocognitive profile in depression. (I) The state hypothesis: cognitive impairment is state dependent and follows mood symptoms. See "I". (II) The scar hypothesis: cognitive impairment is a result of a scarring effect from the neurotoxic effects of depression. See "II". (III) The trait hypothesis: cognitive impairment is related to stable persistent features. See "III". This figure is adapted from Hammar and Årdal (2) and Frank et al. (22).
Figure 2
Figure 2
This figure shows a conceptual model of the levels of cognitive functioning, with cognitive functioning as a composite concept (level 1) having three major sub-concepts as domains (level 2) and several specific aspects within each domain (level 3). In this model, psychomotor tempo/processing speed is illustrated as interrelated with all the other domains.
See this image and copyright information in PMC

References

    1. Douglas KM, Porter RJ. Longitudinal assessment of neuropsychological function in major depression. Austral N Zeal J Psychiatry. (2009) 43:1105–17. 10.3109/00048670903279887 - DOI - PubMed
    1. Hammar Å, Årdal G. Cognitive functioning in major depression – a summary. Front Hum Neurosci. (2009) 3:26. 10.3389/neuro.09.026.2009 - DOI - PMC - PubMed
    1. Goodall J, Fisher C, Hetrick S, Phillips L, Parrish EM, Allott K. Neurocognitive functioning in depressed young people: a systematic review and meta-analysis. Neuropsychol Rev. (2018) 28:216–31. 10.1007/s11065-018-9373-9 - DOI - PubMed
    1. Tran T, Milanovic M, Holshausen K, Bowie CR. What is normal cognition in depression? Prevalence and functional correlates of normative versus idiographic cognitive impairment. Neuropsychology. (2021) 35:33. 10.1037/neu0000717 - DOI - PubMed
    1. Wagner S, Doering B, Helmreich I, Lieb K, Tadic A. A meta-analysis of executive dysfunctions in unipolar major depressive disorder without psychotic symptoms and their changes during antidepressant treatment. Acta Psychiatr Scand. (2012) 125:281–92. 10.1111/j.1600-0447.2011.01762.x - DOI - PubMed