Abstract
Background: Deficits in executive functioning are frequently associated with poor psychosocial outcomes in Major Depressive Disorder (MDD). However, there is a poor understanding of the domain-specific relationships between executive subdomains (e.g., forward planning, decision making) and specific psychosocial issues (e.g., occupational functioning, social relationships). The current study explored these relationships across currently depressed and remitted MDD patients, as well as a healthy control group.Methods: Data from 142 participants were obtained from the Cognitive Functioning and Mood Study (CoFaM-S), a cross sectional study of mood, cognition, and psychosocial functioning in mood disorders. Participants' [current depression n = 31, remitted depression n = 52, healthy controls (HC) n = 59] executive functioning was evaluated with well-established tests of executive subdomains (i.e., Tower of London, card sorting, Stroop task). The Functioning Assessment Short Test (FAST) was employed to clinically evaluate psychosocial dysfunction.Results: The results indicated that forward planning was most strongly associated with psychosocial issues in the current depression group as compared to HCs, while cognitive updating was primary in the remitted group vs. HC.Conclusions: These findings suggest that executive subdomains are deferentially associated with psychosocial issues across different stages of depressive illness, and that forward planning and cognitive updating should be considered in adjunctive cognitive treatment.
Highlights
While Major Depression is characterized by negative mood, cognitive dysfunction is increasingly recognized as a primary symptom [1, 2]
The profile of cognitive domains affected by Major Depressive Disorder (MDD) is yet to be fully explored, recent evidence suggests that deficits in executive functioning, attention, working memory, processing speed, and verbal/linguistic fluency are common [3,4,5,6] and present in acute as well as remitted depression [7,8,9]
The results indicated that executive dysfunction in subdomains of inhibition, cognitive flexibility, and updating was prevalent at baseline and was maintained at 1-year follow-up
Summary
While Major Depression is characterized by negative mood, cognitive dysfunction is increasingly recognized as a primary symptom [1, 2]. Executive Subdomains in Major Depression to other symptoms of MDD, and the resistance of cognitive deficits to current treatment approaches (e.g., CBT, SSRIs). There is a clear need to determine which domains of cognition most are most strongly associated with psychosocial outcomes, and which domains are appropriate treatment targets for adjunctive and developing therapies [13, 14]. This significant gap in our understanding is addressed by the current research [15], which investigates the role of specific cognitive issues in functional disability in MDD. The current study explored these relationships across currently depressed and remitted MDD patients, as well as a healthy control group
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