Abstract
Cognitive disturbances are common and disabling features of major depressive disorder (MDD). Previous studies provide limited insight into the co-occurrence of hot (emotion-dependent) and cold (emotion-independent) cognitive disturbances in MDD. Therefore, we here map both hot and cold cognition in depressed patients compared to healthy individuals. We collected neuropsychological data from 92 antidepressant-free MDD patients and 103 healthy controls. All participants completed a comprehensive neuropsychological test battery assessing hot cognition including emotion processing, affective verbal memory and social cognition as well as cold cognition including verbal and working memory and reaction time. The depressed patients showed small to moderate negative affective biases on emotion processing outcomes, moderate increases in ratings of guilt and shame and moderate deficits in verbal and working memory as well as moderately slowed reaction time compared to healthy controls. We observed no correlations between individual cognitive tasks and depression severity in the depressed patients. Lastly, an exploratory cluster analysis suggested the presence of three cognitive profiles in MDD: one characterised predominantly by disturbed hot cognitive functions, one characterised predominantly by disturbed cold cognitive functions and one characterised by global impairment across all cognitive domains. Notably, the three cognitive profiles differed in depression severity. We identified a pattern of small to moderate disturbances in both hot and cold cognition in MDD. While none of the individual cognitive outcomes mapped onto depression severity, cognitive profile clusters did. Overall cognition-based stratification tools may be useful in precision medicine approaches to MDD.
Highlights
Disturbance of cognitive functioning is a common feature of major depressive disorder (MDD) and has been proposed as an important treatment target (Collins et al, 2011)
MDD diagnosis was confirmed by a certified psychiatrist and corroborated by a Mini-International Neuropsychiatric Interview (MINI)
Data from 100 healthy participants were collected as part of a validation study of the EMOTICOM test battery, a novel neuropsychological battery designed to assess hot cognitive functions (Dam et al, 2019), and three healthy controls were recruited via internet advertisements and flyers posted around the greater Copenhagen area (52 females)
Summary
Disturbance of cognitive functioning is a common feature of major depressive disorder (MDD) and has been proposed as an important treatment target (Collins et al, 2011). In particular negative affective biases, i.e. the subconscious allocation of more attention and mental resources to the processing of negative information over positive information, have been associated with MDD psychopathology (Elliott, Zahn, Deakin, & Anderson, 2011; Miskowiak & Carvalho, 2014) and may play a key role in the onset and maintenance of depressive symptoms (Roiser, Elliott, & Sahakian, 2012) Another hot cognitive domain which may be impaired in MDD is social cognition which includes functions such as seeing oneself in the ‘other’, i.e. Theory of Mind (Bora & Berk, 2015; Wolkenstein, Schonenberg, Schirm, & Hautzinger, 2011), interpretation of social situations and excessive experiences of negative social emotions such as shame and guilt (Kim et al, 2015). Overall cognition-based stratification tools may be useful in precision medicine approaches to MDD
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
