Psychotic symptoms and neurocognition among patients with major depressive disorder: A chained mediation model of depressive symptoms and socio-occupational functioning

Yexian Zeng; Fan Zhang; Haiyan Liu; Weicheng Li; Yuping Ning; Yanling Zhou

doi:10.1016/j.jad.2023.04.005

Psychotic symptoms and neurocognition among patients with major depressive disorder: A chained mediation model of depressive symptoms and socio-occupational functioning

J Affect Disord. 2023 Jul 1:332:194-200. doi: 10.1016/j.jad.2023.04.005. Epub 2023 Apr 10.

Authors

Yexian Zeng¹, Fan Zhang¹, Haiyan Liu¹, Weicheng Li¹, Yuping Ning², Yanling Zhou³

Affiliations

¹ Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.
² Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China; Department of Psychology, The First School of Clinical Medicine, Southern Medical University, Guangzhou, China. Electronic address: ningjeny@126.com.
³ Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China. Electronic address: zhouylivy@aliyun.com.

PMID: 37044284
DOI: 10.1016/j.jad.2023.04.005

Abstract

Background: Depressive symptom and psychotic symptom have been identified as risk factors for impaired socio-occupational functioning in patients with major depressive disorder (MDD), while neurocognitive functioning is considered to be a potential protective factor against socio-occupational functioning. Nevertheless, little is known about the complex relationship among these factors in patients with MDD. The purpose of this research was to explore whether the relationship between depressive symptom severity and social-occupational functioning is mediated by neurocognitive functioning and psychotic symptom severity in MDD patients.

Methods: A total of 659 eligible MDD patients included male and female, and their depressive symptoms and psychotic symptoms at baseline were assessed by the 17-item Hamilton Depression Scale (HAMD-17) and The Brief Psychiatric Rating Scale (BPRS) respectively. Cognitive domains were assessed by the MATRICS Consensus Cognitive Battery (MCCB), and subjective and objective functioning were measured by the Global Assessment of Functioning (GAF).

Limitation: The analysis is cross-sectional, which limits causal inference.

Result: (1) The correlation between depressive symptoms and thought disturbance was positive (r = 0.125, p = 0.001), whereas the correlations with visual learning and memory (r = -0.146, p < 0.001) and socio-occupational functioning (r = -0.175, p < 0.001) were negative. (2) Depressive symptoms mainly affect the socio-occupational functioning of MDD patients via three indirect effects: the single mediating effect of psychotic symptoms and neurocognitive functioning, and the chain mediating effect of psychotic symptoms and neurocognitive functioning.

Conclusions: The results suggest that the relationship between depressive symptom severity and socio-occupational functioning in MDD patients is partially mediated by psychotic symptom severity and neurocognitive functioning.

Keywords: Chained mediation model; Depressive symptoms; Neurocognition; Psychotic symptoms; Socio-occupational functioning.

MeSH terms

Cross-Sectional Studies
Depression
Depressive Disorder, Major* / diagnosis
Depressive Disorder, Major* / psychology
Female
Humans
Male
Psychotic Disorders* / complications
Psychotic Disorders* / diagnosis
Schizophrenia* / diagnosis