Q2

Is there a link between cognitive function and daily function in patients with depression?

Answered by Bernhard Baune

Patients with depression frequently experience cognitive deficits and a decline in general, social and occupational function. Cognitive deficits are found to be a principal mediator of psychosocial impairment and workforce performance in depression. More specifically, various clinical studies show that cognitive domains such as memory (including delayed verbal recall and language), psychomotor speed (including visuo-spatial/constructional abilities) and executive function (including planning) are associated with general and occupational function.

Moreover, cognitive deficits at baseline, such as impaired working memory, verbal memory retention, visual memory, attentional switching, event-based prospective memory, executive function, non-verbal learning and motor measures, are associated with future general functioning and social and occupational functioning. Importantly, this relationship between cognitive function and general function not only holds true in acute depression but also in remitted phases of depression. Addressing these cognitive deficits provides further opportunity to prevent and treat poor daily function in patients with depression.

Q3a

Answered by Tracy Greer

Studies are beginning to link specific cognitive functions with functional outcomes, although a clear pattern is yet to be established. With respect to daily function, measures of activities of daily living and instrumental activities of daily living have been evaluated in the context of cognitive function in depression, with mixed results. For example, McCall and Dunn1 found that instrumental activities of daily living were correlated with measures of both verbal and non-verbal memory. In contrast, Baune et al2 found no relationship between cognitive performance and measures of activities of daily living.

Q3b
References
  1. McCall WV, Dunn AG. Cognitive deficits are associated with functional impairment in severely depressed patients. Psychiatry Res 2003; 121: 179-184.
  2. Baune BT, Miller R, McAfoose J, Johnson M, Quirk F, Mitchell D. The role of cognitive impairment in general functioning in major depression. Psychiatry Res 2010; 176: 183-189.
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