Evidence for Progressive Cognitive Deficits in Patients With Major Depressive Disorder

Jin Liu; Bangshan Liu; Mi Wang; Yumeng Ju; Qiangli Dong; Xiaowen Lu; Jinrong Sun; Liang Zhang; Hua Guo; Futao Zhao; Weihui Li; Li Zhang; Zexuan Li; Yan Zhang; Mei Liao; Lingjiang Li

doi:10.3389/fpsyt.2021.627695

Evidence for Progressive Cognitive Deficits in Patients With Major Depressive Disorder

Front Psychiatry. 2021 Feb 16:12:627695. doi: 10.3389/fpsyt.2021.627695. eCollection 2021.

Authors

Jin Liu^{1

2}, Bangshan Liu^{1

2}, Mi Wang^{1

2}, Yumeng Ju^{1

2}, Qiangli Dong^{1

2}, Xiaowen Lu^{1

2}, Jinrong Sun^{1

2}, Liang Zhang^{1

2}, Hua Guo³, Futao Zhao³, Weihui Li^{1

2}, Li Zhang^{1

2}, Zexuan Li^{1

2}, Yan Zhang^{1

2}, Mei Liao^{1

2}, Lingjiang Li^{1

2}

Affiliations

¹ Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.
² Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China.
³ Zhumadian Psychiatric Hospital, Zhumadian, China.

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.

Keywords: cognitive deficit; executive function; major depressive disorder; progression; recurrent depression; shifting; the number of episodes.