Abstract
Background: Cognitive deficits have shown progressive feature in major depressive disorder (MDD). However, it remains unknown which component of cognitive function is progressively impaired across episodes of MDD. Here we aim to identify the progressively impaired cognitive components in patients with MDD.Methods: A comprehensive neurocognitive test battery was used to assess the cognitive components (executive function, attention, processing speed, memory, working memory, inhibition, shifting, and verbal fluency) in 35 patients with first-episode MDD (FED), 60 patients with recurrent MDD (RD) and 111 matched healthy controls (HCs). After 6 months of treatment with antidepressant, 20 FED and 36 RD patients achieved clinical remission and completed their second-time neurocognitive tests. Statistical analyses were conducted to identify the impaired cognitive components in the FED and RD groups before and after treatment, and to assess the relationship between the cognitive components and the number of episodes and total illness duration in the MDD patient group.Results: At baseline, both the FED and RD groups showed impairments in all of the cognitive components; the FED and RD groups showed no significant difference in all of the components except for shifting. After remission, only shifting in the RD group showed no significant improvement and remained in an impaired status. Furthermore, shifting was the only component negatively correlated with the number of episodes as well as the total illness duration.Conclusions: Shifting may serve as the progressive cognitive deficit across episodes of MDD.Clinical Trials Registration: Registry name: HPA function and MRI study of trauma-related depression; Registration number: ChiCTR1800014591; URL: http://www.chictr.org.cn/edit.aspx?pid=24669&htm=4.
Highlights
Major depressive disorder (MDD) is a debilitating mental disorder characterized by life-long recurring episodes
Shifting was the only component negatively correlated with the number of episodes as well as the total illness duration
The progressive nature of MDD may be a major cause of its poor prognosis and chronicity, which have been reported to be associated with impairment in social function and high disease burden [6,7,8,9]
Summary
Major depressive disorder (MDD) is a debilitating mental disorder characterized by life-long recurring episodes. The progressive nature of MDD may be a major cause of its poor prognosis and chronicity, which have been reported to be associated with impairment in social function and high disease burden [6,7,8,9]. It is well-established that cognitive deficits, mainly involving executive function, attention, processing speed, and memory [10, 11], are currently acknowledged as a most pronounced clinical feature of MDD [12,13,14]. We aim to identify the progressively impaired cognitive components in patients with MDD
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