Chapter 4 - Cognitive Deficits in Major Depression: From Mechanisms to Management

Abstract

Cognitive deficits, primarily in domains of attention, memory, executive function, and processing speed, are a core feature in major depressive disorder (MDD) yet are commonly underestimated in clinical settings. Although exact mechanisms underlying such deficits remain unclear, several studies point to the role of neuroanatomical, neurochemical, and functional abnormalities in MDD. Hormone imbalances, inflammation, and metabolic factors have also been implicated. Cognitive deficits are a key predictor of functional and occupational outcomes in MDD and are commonly left unresolved by available treatment options. A paucity of studies have demonstrated the potential of antidepressants in the treatment of cognitive deficits in this population. Other studies have investigated the use of psychostimulants, ketamine, incretins, metabolic regulators, and nonpharmacological treatment options such as brain stimulation, cognitive remediation, and exercise. The conduct of further research is required to better understand the potential efficacy of these agents in treating cognitive deficits in major depression.