New study of functional and biological aspects of cognition in depression

Clinical, functional and biological: an innovative prospective study will assess all three correlates of the cognitive dysfunction that frequently accompanies major depression.

The cognitive dimensions of depression and their long-term evolution in response to treatment are important to functional outcome but have been relatively little researched.

To help remedy this situation, Bernhard Baune and colleagues from the University of Adelaide, Australia, have begun the Adelaide Cognitive Function and Mood Study (CoFaMS). This will prospectively chart cognitive performance, emotional processing and social cognitive functioning in patients with a primary Diagnostic and Statistical Manual of Mental Disorders 4th Edition diagnosis of major depressive disorder (MDD) or bipolar disorder. A control group of people without mental health issues is included in the study.

CoFaMS will also collect blood samples for discovery analyses of the potential biological correlates – genes, gene expression, proteomics, and serum and plasma biomarkers – of cognitive dimensions in depression. This aspect of the study is attempting to identify the biological bases of cognitive impairment in the disease.

Worldwide, MDD is a leading cause of morbidity and disability. Although characterised by low mood, impaired cognition is commonly also present, even in young patients, and is evident in problems with concentration, memory and decision making.

Participants are screened using the NMNI600 Neuropsychiatric Diagnostic Interview. Factors in the study include:

  • psychiatric history
  • symptom severity, as assessed by the Structured Interview Guide of the Hamilton Anxiety and Depression Scale
  • treatment response
  • functioning in daily life, as assessed by the Functioning Assessment Short Test
  • employment and occupational function
  • general functioning, rated using the Clinical Global Impression Severity Scale and the Global Assessment of Functioning.

Aspects related specifically to cognition will be assessed by computer-based game-like activities that evaluate memory and learning, attention, working memory, executive function and social cognition. Measures include the Wisconsin Card Sorting Test, the Stroop test and the THINC-it® tool, which has recently been developed in response to the need for a brief instrument to screen for cognitive dysfunction in patients with depression.

Assessments are being made at baseline and at 6 weeks and 12 months of follow-up.

Study recruitment has started but will continue until December 2018. The University of Adelaide has provided seed-funding for the project, which is based in Australia, but international researchers are invited to collaborate and should contact bernhard.baune@adelaide.edu.au. An additional sister-study has already begun in Germany. Depression is estimated to affect 300 million people worldwide: we all have a part to play in reducing its burden.

References
  1. Baune BT, Air T.  Clinical, functional, and biological correlates of cognitive dimensions in major depressive disorder – rationale, design, and characteristics of the Cognitive Function and Mood Study (CoFaM-Study). Front Psychiatry 2016; 7: 150.
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