Cognitive impairments in treatment-resistant depression: Results from the French cohort of outpatients (FACE-DR)

Abstract

• Patients suffering from treatment resistant-depression present cognitive impairments in executive function, verbal memory and processing speed. • Depression intensity is associated with poorer performance in processing speed and verbal memory. • Impairments in executive function and attention are associated with poorer daily functioning. • Adjusted psychotherapy and cognitive remediation should be proposed to patients suffering from treatment resistant-depression. Previous studies set out cognitive impairments in major depression. However, only two studies were performed among patients suffering from treatment-resistant depression (TRD) and conducted on limited sample sizes. Here, we aimed to characterize cognitive impairments in TRD, and their association with the severity of depression and daily functioning. We included 288 patients suffering from TRD (178 women, 52.5 ± 13.1 years old). They undertook sociodemographic, clinical, daily functioning and neuropsychological testing (TMT, Baddeley task, verbal fluencies, WAIS-4 subtests, D2 and RLRI-16). We compared our patients’ performances to theoretical performances of the general population. TRD was associated with poorer neuropsychological performances, except for similarities task. We found an effect of depression severity on processing speed and memory, and an impact on daily functioning affecting memory, selective attention and executive function. Patients suffering from TRD have significant cognitive impairments. Therapeutic interventions should be developed to manage such impairments.