Abstract
BackgroundResearch suggests that young people with major depressive disorder (MDD) experience neurocognitive deficits and that these are associated with poorer functional and clinical outcomes. However, we are yet to understand how young people experience such difficulties. The aim of the current study was to explore the subjective experiences of neurocognitive functioning among young people with MDD.MethodsSemi-structured qualitative interviews were conducted with 11 young people (aged 17–24 years) attending a specialist clinic for youth experiencing moderate-severe depression. Interview transcripts were analysed via Thematic Analysis to identify patterns and themes representing how young people with MDD subjectively experience neurocognitive deficits.ResultsFive main themes were identified: (1) experience of neurocognitive complaints; (2) relationship between neurocognitive complaints and depression; (3) impact on functioning; (4) strategies and supports; and (5) neurocognitive complaints and treatment. Overall, young people with MDD commonly experienced a range of subjective neurocognitive complaints. These appeared to have a bidirectional relationship with depressive symptomatology and significantly disrupted vocational, social and independent functioning, and aspects of psychological well-being including self-esteem. Neurocognitive difficulties represented an experiential barrier to psychological therapeutic engagement and were perceived as variably responsive to psychotropic medications, highlighting the need for targeted intervention.DiscussionNeurocognitive difficulties are a common and pervasive experience for young people with MDD, with perceived impacts on depressive symptoms, attitudinal beliefs, everyday functioning and therapeutic engagement. Subjective neurocognitive complaints may therefore contribute to or exacerbate personal challenges faced by young people with MDD and thus, require early identification, consideration in psychological formulation, and treatment. Further research into the mechanisms of neurocognitive impairment in MDD is also needed.
Highlights
Research suggests that young people with major depressive disorder (MDD) experience neurocognitive deficits and that these are associated with poorer functional and clinical outcomes
Whether neurocognitive impairments are: pre-existing traits or risk markers that predict later onset of MDD; state-related deficits that fluctuate with depressive symptoms; and/or ‘scar’ impairments that remain during periods of remission and worsen with illness progression [7]
Exploration of the subjective experience of neurocognition in young people with MDD revealed five main themes, capturing the: 1) experience of neurocognitive complaints; 2) temporal relationship between depression and neurocognition; 3) impact of neurocognition on functioning; 4) strategies and supports used to cope with neurocognitive difficulties; and 5) relationship between neurocognitive difficulties and treatment engagement and efficacy
Summary
Research suggests that young people with major depressive disorder (MDD) experience neurocognitive deficits and that these are associated with poorer functional and clinical outcomes. Deficits in younger cohorts of children (aged 9–15 years) with MDD are reported, with evidence of compromised sustained attention, working memory, verbal memory and executive functions [11]. It remains unclear, whether neurocognitive impairments are: pre-existing traits or risk markers that predict later onset of MDD; state-related deficits that fluctuate with depressive symptoms; and/or ‘scar’ impairments that remain during periods of remission and worsen with illness progression [7]
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