Answered by Harry Barry
Depression is a multidimensional disorder involving a combination of physical, emotional and cognitive symptoms. Cognition can be categorised as having affective ‘hot’ and logic-based ‘cold’ components. Many clinicians will identify ‘hot’ cognitions (associated with emotions) in depression, such as shame, anxiety and guilt, but are less likely to identify ‘cold’ cognitive dysfunction. Clinicians are more likely to identify daily functional difficulties, the cause of which may be unrecognised ‘cold’ cognitive dysfunction. The following five simple questions are useful to screen for such functional difficulties and the most likely cognitive domain involved.
- Do you have difficulties making decisions either at home or work and, if so, why? (Decision making)
- Do you have difficulties reading newspapers, lecture notes or data at work, or following TV programmes or conversations? (Concentration/attention)
- Do you find yourself misplacing items such as keys, or have difficulties remembering names or shopping items, or lose track of tasks at home or at work? (Memory)
- Do you struggle to start or, in particular, finish common tasks, either at home or at work, due to these problems? (Motivation, problem solving, indecision, organisation)
- How do all of above affect you in your day-to-day life? (Consequences of cognitive dysfunction)