Skip to main content Accessibility help
×
×
Home

Is low cognitive functioning a predictor or consequence of major depressive disorder? A test in two longitudinal birth cohorts

  • Jonathan D. Schaefer (a1), Matthew A. Scult (a1), Avshalom Caspi (a1) (a2), Louise Arseneault (a2), Daniel W. Belsky (a1) (a3), Ahmad R. Hariri (a1), Honalee Harrington (a1), Renate Houts (a1), Sandhya Ramrakha (a4), Richie Poulton (a4) and Terrie E. Moffitt (a1) (a2)...

Abstract

Cognitive impairment has been identified as an important aspect of major depressive disorder (MDD). We tested two theories regarding the association between MDD and cognitive functioning using data from longitudinal cohort studies. One theory, the cognitive reserve hypothesis, suggests that higher cognitive ability in childhood decreases risk of later MDD. The second, the scarring hypothesis, instead suggests that MDD leads to persistent cognitive deficits following disorder onset. We tested both theories in the Dunedin Study, a population-representative cohort followed from birth to midlife and assessed repeatedly for both cognitive functioning and psychopathology. We also used data from the Environmental Risk Longitudinal Twin Study to test whether childhood cognitive functioning predicts future MDD risk independent of family-wide and genetic risk using a discordant twin design. Contrary to both hypotheses, we found that childhood cognitive functioning did not predict future risk of MDD, nor did study members with a past history of MDD show evidence of greater cognitive decline unless MDD was accompanied by other comorbid psychiatric conditions. Our results thus suggest that low cognitive functioning is related to comorbidity, but is neither an antecedent nor an enduring consequence of MDD. Future research may benefit from considering cognitive deficits that occur during depressive episodes from a transdiagnostic perspective.

Copyright

Corresponding author

Address correspondence and reprint requests to: Jonathan D. Schaefer, Department of Psychology and Neuroscience, Duke University, Durham, NC 27708; E-mail: jds116@duke.edu.

Footnotes

Hide All

The first two authors contributed equally to this article. The Dunedin Multidisciplinary Health and Development Research Unit is funded by the New Zealand Health Research Council and the New Zealand Ministry of Business, Innovation, and Employment. Additional support was provided by US National Institute on Aging (NIA) Grants R01AG032282, R01AG049789, and R01AG048895; UK Medical Research Council Grants MR/P005918/1 and MR/K00381X; Economic and Social Research Council Grant ES/M010309/1; and the Jacobs Foundation. The Environmental Risk (E-Risk) Longitudinal Twin Study is funded by UK Medical Research Council Grant G1002190. Additional support was provided by US National Institute of Child Health and Human Development (NICHD) Grant HD077482, the Jacobs Foundation, and the Duke Social Science Research Institute. We thank the Dunedin and E-Risk Study members, their peer informants, and Dunedin Study founder Phil Silva. Support was also provided by NIA Grant T32-AG000139 and NICHD Grant T32-HD007376 (to J.D.S.), by a National Science Foundation Graduate Research Fellowship (to M.A.S.), and by NIA Grant P30-AG028716 (to D.W.B.).

Footnotes

References

Hide All
Adler, D. A., McLaughlin, T. J., Rogers, W. H., Chang, H., Lapitsky, L., & Lerner, D. (2006). Job performance deficits due to depression. American Journal of Psychiatry, 163, 15691576. doi:10.1176/ajp.2006.163.9.1569
Airaksinen, E., Larsson, M., & Forsell, Y. (2005). Neuropsychological functions in anxiety disorders in population-based samples: Evidence of episodic memory dysfunction. Journal of Psychiatric Research, 39, 207214. doi:10.1016/j.jpsychires.2004.06.001
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders: DSM-III-R (3rd ed., rev.). Washington, DC: Author.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Barnett, J. H., Salmond, C. H., Jones, P. B., & Sahakian, B. J. (2006). Cognitive reserve in neuropsychiatry. Psychological Medicine, 36, 10531064. doi:10.1017/S0033291706007501
Batty, G. D., Mortensen, E. L., & Osler, M. (2005). Childhood IQ in relation to later psychiatric disorder: Evidence from a Danish birth cohort study. British Journal of Psychiatry, 187, 180181.
Bora, E., Harrison, B. J., Yücel, M., & Pantelis, C. (2013). Cognitive impairment in euthymic major depressive disorder: A meta-analysis. Psychological Medicine, 43, 20172026. doi:10.1017/S0033291712002085
Bortolato, B., Miskowiak, K. W., Köhler, C. A., Maes, M., Fernandes, B. S., Berk, M., & Carvalho, A. F. (2016). Cognitive remission: A novel objective for the treatment of major depression? BMC Medicine, 14, 9. doi:10.1186/s12916-016-0560-3
Carlin, J. B., Gurrin, L. C., Sterne, J. A., Morley, R., & Dwyer, T. (2005). Regression models for twin studies: A critical review. International Journal of Epidemiology, 34, 10891099. doi:10.1093/ije/dyi153
Cassano, P., & Fava, M. (2002). Depression and public health: An overview. Journal of Psychosomatic Research, 53, 849857. doi:10.1016/S0022-3999(02)00304-5
Christensen, H., Griffiths, K., Mackinnon, A., & Jacomb, P. (1997). A quantitative review of cognitive deficits in depression and Alzheimer-type dementia. Journal of the International Neuropsychological Society, 3, 631651.
Cummings, P. (2009). The relative merits of risk ratios and odds ratios. Archives of Pediatrics and Adolescent Medicine, 163, 438445. doi:10.1001/archpediatrics.2009.31
Farmer, R. F., Kosty, D. B., Seeley, J. R., Olino, T. M., & Lewinsohn, P. M. (2013). Aggregation of lifetime axis I psychiatric disorders through age 30: Incidence, predictors, and associated psychosocial outcomes. Journal of Abnormal Psychology, 122, 573586. doi:10.1037/a0031429
Feehan, M., McGee, R., Raja, S. N., & Williams, S. M. (1994). DSM-III-R disorders in New Zealand 18-year-olds. Australian and New Zealand Journal of Psychiatry, 28, 8799. doi:10.3109/00048679409075849
Fergusson, D. M., Horwood, J. L., & Ridder, E. M. (2005). Show me the child at seven: II. Childhood intelligence and later outcomes in adolescence and young adulthood. Journal of Child Psychology and Psychiatry , 46, 850858. doi:10.1111/j.1469-7610.2005.01472.x
Gale, C. R., Batty, G. D., Tynelius, P., Deary, I. J., & Rasmussen, F. (2010). Intelligence in early adulthood and subsequent hospitalization for mental disorders. Epidemiology, 21, 7077.
Gale, C. R., Deary, I. J., Boyle, S. H., Barefoot, J., Mortensen, L. H., & Batty, G. (2008). Cognitive ability in early adulthood and risk of 5 specific psychiatric disorders in middle age: The Vietnam Experience study. Archives of General Psychiatry, 65, 14101418. doi:10.1001/archpsyc.65.12.1410
Hirschfeld, R. M. A., Montgomery, S. A., Keller, M. B., Kasper, S., Schatzberg, A. F., Moller, H.-J., … Versiani, M. (2000). Social functioning in depression: A review. Journal of Clinical Psychiatry, 61, 268275.
Horner, M. D., & Hamner, M. B. (2002). Neurocognitive functioning in posttraumatic stress disorder. Neuropsychology Review, 12, 1530. doi:10.1023/A:1015439106231
Hsu, K. J., & Davison, G. C. (2017). Compounded deficits: The association between neuropsychological impairment and attention biases in currently depressed, formerly depressed, and never depressed individuals. Clinical Psychological Science, 5, 286298. doi:10.1177/2167702617692998
Iverson, G. L., Lange, R. T., Brooks, B. L., & Rennison, V. L. A. (2010). “Good old days” bias following mild traumatic brain injury. Clinical Neuropsychologist, 24, 1737. doi:10.1080/13854040903190797
Jaeger, J., Berns, S., Uzelac, S., & Davis-Conway, S. (2006). Neurocognitive deficits and disability in major depressive disorder. Psychiatry Research, 145, 3948. doi:10.1016/j.psychres.2005.11.011
Kendler, K. S., Ohlsson, H., Sundquist, J., & Sundquist, K. (2014). IQ and schizophrenia in a Swedish national sample: Their causal relationship and the interaction of IQ with genetic risk. American Journal of Psychiatry, 172, 259265. doi:10.1176/appi.ajp.2014.14040516
Kennedy, N., Foy, K., Sherazi, R., McDonough, M., & McKeon, P. (2007). Long-term social functioning after depression treated by psychiatrists: A review. Bipolar Disorders, 9, 2537. doi:10.1111/j.1399-5618.2007.00326.x
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., … Wang, P. S. (2003). The epidemiology of major depressive disorder: Results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association, 289, 30954105. doi:10.1001/jama.289.23.3095
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593602. doi:10.1001/archpsyc.62.6.593
Keyes, K. M., Platt, J., Kaufman, A. S., & McLaughlin, K. A. (2016). Association of fluid intelligence and psychiatric disorders in a population-representative sample of U.S. adolescents. JAMA Psychiatry. Advance online publication. doi:10.1001/jamapsychiatry.2016.3723
Kim-Cohen, J., Caspi, A., Moffitt, T. E., Harrington, H., Milne, B. J., & Poulton, R. (2003). Prior juvenile diagnoses in adults with mental disorder: Developmental follow-back of a prospective-longitudinal cohort. Archives of General Psychiatry, 60, 709717. doi:10.1001/archpsyc.60.7.709
Koenen, K. C., Moffitt, T. E., Roberts, A. L., Martin, L. T., Kubzansky, L., Harrington, H., … Caspi, A. (2009). Childhood IQ and adult mental disorders: A test of the cognitive reserve hypothesis. American Journal of Psychiatry, 166, 5057. doi:10.1176/appi.ajp.2008.08030343
Ledford, H. (2016). Drugmakers target depression's cognitive fog. Nature, 530, 17. doi:10.1038/530017a
Lee, R. S. C., Hermens, D. F., Porter, M. A., & Redoblado-Hodge, M. A. (2012). A meta-analysis of cognitive deficits in first-episode major depressive disorder. Journal of Affective Disorders, 140, 113124. doi:10.1016/j.jad.2011.10.023
Lewinsohn, P. M., Steinmetz, J. L., Larson, D. W., & Franklin, J. (1981). Depression-related cognitions: Antecedent or consequence? Journal of Abnormal Psychology, 90, 213219. doi:10.1037//0021-843X.90.3.213
Majer, M., Ising, M., Künzel, H., Binder, E. B., Holsboer, F., Modell, S., & Zihl, J. (2004). Impaired divided attention predicts delayed response and risk to relapse in subjects with depressive disorders. Psychological Medicine, 34, 14531463. doi:10.1017/S0033291704002697
Mann-Wrobel, M. C., Carreno, J. T., & Dickinson, D. (2011). Meta-analysis of neuropsychological functioning in euthymic bipolar disorder: An update and investigation of moderator variables. Bipolar Disorders, 13, 334342. doi:10.1111/j.1399-5618.2011.00935.x
McDermott, L. M., & Ebmeier, K. P. (2009). A meta-analysis of depression severity and cognitive function. Journal of Affective Disorders, 119, 18. doi:10.1016/j.jad.2009.04.022
Meier, M. H., Caspi, A., Ambler, A., Harrington, H., Houts, R., Keefe, R. S. E., … Moffitt, T. E. (2012). Persistent cannabis users show neuropsychological decline from childhood to midlife. Proceedings of the National Academy of Sciences, 109, E2657E2664. doi:10.1073/pnas.1206820109
Meier, M. H., Caspi, A., Reichenberg, A., Keefe, R. S. E., Fisher, H. L., Harrington, H., … Moffitt, T. E. (2014). Neuropsychological decline in schizophrenia from the premorbid to the post-onset period: Evidence from a population-representative longitudinal study. American Journal of Psychiatry, 171, 91101. doi:10.1176/appi.ajp.2013.12111438
Melartin, T. K., Rytsälä, H. J., Leskelä, U. S., Lestelä-Mielonen, P. S., Sokero, T. P., & Isometsä, E. T. (2002). Current comorbidity of psychiatric disorders among DSM-IV major depressive disorder patients in psychiatric care in the Vantaa Depression Study. Journal of Clinical Psychiatry, 63, 126134.
Moffitt, T. E., Caspi, A., Taylor, A., Kokaua, J., Milne, B. J., Polanczyk, G., & Poulton, R. (2010). How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment. Psychological Medicine, 40, 899909. doi:10.1017/S0033291709991036
Moffitt, T. E., & the E-Risk Study Team. (2002). Teen-aged mothers in contemporary Britain. Journal of Child Psychology and Psychiatry, 43, 727742. doi:10.1111/1469-7610.00082
Moffitt, T. E., Harrington, H., Caspi, A., Kim-Cohen, J., Goldberg, D., Gregory, A. M., & Poulton, R. (2007). Depression and generalized anxiety disorder: Cumulative and sequential comorbidity in a birth cohort followed prospectively to age 32 years. Archives of General Psychiatry, 64, 651660. doi:10.1001/archpsyc.64.6.651
Mullard, A. (2016). FDA rejects first cognitive claim for antidepressant. Nature Reviews Drug Discovery, 15, 299299. doi:10.1038/nrd.2016.92
Muller, J., & Roberts, J. E. (2005). Memory and attention in obsessive-compulsive disorder: A review. Journal of Anxiety Disorders, 19, 128. doi:10.1016/j.janxdis.2003.12.001
National Academies of Sciences, Engineering, and Medicine. (2015). Enabling discovery, development, and translation of treatments for cognitive dysfunction in depression: Workshop summary. Washington, DC: National Academies Press.
Newman, D. L., Moffitt, T. E., Caspi, A., Magdol, L., Silva, P. A., & Stanton, W. R. (1996). Psychiatric disorder in a birth cohort of young adults: Prevalence, comorbidity, clinical significance, and new case incidence from ages 11 to 21. Journal of Consulting and Clinical Psychology, 64, 552562. doi:10.1037/0022-006X.64.3.552
Odgers, C. L., Caspi, A., Bates, C. J., Sampson, R. J., & Moffitt, T. E. (2012). Systematic social observation of children's neighborhoods using Google Street View: A reliable and cost-effective method. Journal of Child Psychology and Psychiatry, 53, 10091017. doi:10.1111/j.1469-7610.2012.02565.x
Philipp, M., Maier, W., & Delmo, C. D. (1991). The concept of major depression. European Archives of Psychiatry and Clinical Neuroscience, 240, 258265. doi:10.1007/BF02189537
Poulton, R., Moffitt, T. E., & Silva, P. A. (2015). The Dunedin Multidisciplinary Health and Development Study: Overview of the first 40 years, with an eye to the future. Social Psychiatry and Psychiatric Epidemiology, 50, 679693. doi:10.1007/s00127-015-1048-8
Rajput, S., Hassiotis, A., Richards, M., Hatch, S. L., & Stewart, R. (2011). Associations between IQ and common mental disorders: The 2000 British National Survey of Psychiatric Morbidity. European Psychiatry, 26, 390395. doi:10.1016/j.eurpsy.2010.07.002
Reichenberg, A., Caspi, A., Harrington, H., Houts, R., Keefe, R. S. E., Murray, R. M., … Moffitt, T. E. (2010). Static and dynamic cognitive deficits in childhood preceding adult schizophrenia: A 30-year study. American Journal of Psychiatry, 167, 160169.
Robins, L., Cottler, L., Bucholz, K., & Compton, W. (1995). Diagnostic Interview Schedule for DSM-IV. St. Louis, MO: Washington University School of Medicine.
Rock, P. L., Roiser, J. P., Riedel, W. J., & Blackwell, A. D. (2014). Cognitive impairment in depression: A systematic review and meta-analysis. Psychological Medicine, 44, 20292040. doi:10.1017/S0033291713002535
Rogers, M. A., Kasai, K., Koji, M., Fukuda, R., Iwanami, A., Nakagome, K., … Kato, N. (2004). Executive and prefrontal dysfunction in unipolar depression: A review of neuropsychological and imaging evidence. Neuroscience Research, 50, 111. doi:10.1016/j.neures.2004.05.003
Salmond, C. H., Menon, D. K., Chatfield, D. A., Pickard, J. D., & Sahakian, B. J. (2006). Cognitive reserve as a resilience factor against depression after moderate/severe head injury. Journal of Neurotrauma, 23, 10491058. doi:10.1089/neu.2006.23.1049
Sattler, J. M. (2008). Assessment of children: Cognitive foundations (5th ed.). San Diego, CA: Author.
Schaefer, J. D., Caspi, A., Belsky, D. W., Harrington, H., Houts, R., Horwood, L. J., … Moffitt, T. E. (2017). Enduring mental health: Prevalence and prediction. Journal of Abnormal Psychology. Advance online publication. doi:10.1037/abn0000232
Schaefer, J., Giangrande, E., Weinberger, D. R., & Dickinson, D. (2013). The global cognitive impairment in schizophrenia: Consistent over decades and around the world. Schizophrenia Research, 150, 4250. doi:10.1016/j.schres.2013.07.009
Scult, M. A., Knodt, A. R., Swartz, J. R., Brigidi, B. D., & Hariri, A. R. (2016). Thinking and feeling individual differences in habitual emotion regulation and stress-related mood are associated with prefrontal executive control. Clinical Psychological Science, 5, 150157. doi:10.1177/2167702616654688
Scult, M. A., Paulli, A. R., Mazure, E. S., Moffitt, T. E., Hariri, A. R., & Strauman, T. J. (2017). The association between cognitive function and subsequent depression: A systematic review and meta-analysis. Psychological Medicine, 47, 117. doi:10.1017/S0033291716002075
Snyder, H. R. (2013). Major depressive disorder is associated with broad impairments on neuropsychological measures of executive function: A meta-analysis and review. Psychological Bulletin, 139, 81132. doi:10.1037/a0028727
Sørensen, H. J., Sæbye, D., Urfer-Parnas, A., Mortensen, E. L., & Parnas, J. (2012). Premorbid intelligence and educational level in bipolar and unipolar disorders: A Danish draft board study. Journal of Affective Disorders, 136, 11881191. doi:10.1016/j.jad.2011.12.007
Stavro, K., Pelletier, J., & Potvin, S. (2013). Widespread and sustained cognitive deficits in alcoholism: A meta-analysis. Addiction Biology, 18, 203213. doi:10.1111/j.1369-1600.2011.00418.x
Takayanagi, Y., Spira, A. P., Roth, K. B., Gallo, J. J., Eaton, W. W., & Mojtabai, R. (2014). Accuracy of reports of lifetime mental and physical disorders: Results from the Baltimore Epidemiological Catchment Area Study. JAMA Psychiatry, 71, 273280. doi:10.1001/jamapsychiatry.2013.3579
Trouton, A., Spinath, F. M., & Plomin, R. (2002). Twins Early Development Study (TEDS): A multivariate, longitudinal genetic investigation of language, cognition and behavior problems in childhood. Twin Research, 5, 444448. doi:10.1375/136905202320906255
Wechsler, D. (1974). Manual for the Wechsler Intelligence Scale for Children (rev.). New York: Psychological Corporation.
Wechsler, D. (2008). Wechsler Adult Intelligence Scale (4th ed.). San Antonio, TX: Pearson Assessment.
Whiteford, H. A., Degenhardt, L., Rehm, J., Baxter, A. J., Ferrari, A. J., Erskine, H. E., … Vos, T. (2013). Global burden of disease attributable to mental and substance use disorders: Findings from the Global Burden of Disease Study 2010. Lancet, 382, 15751586. doi:10.1016/S0140-6736(13)61611-6
Zou, G. (2004). A modified Poisson regression approach to prospective studies with binary data. American Journal of Epidemiology, 159, 702706. doi:10.1093/aje/kwh090
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Development and Psychopathology
  • ISSN: 0954-5794
  • EISSN: 1469-2198
  • URL: /core/journals/development-and-psychopathology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×
Type Description Title
WORD
Supplementary materials

Schaefer et al supplementary material
Schaefer et al supplementary material 1

 Word (28 KB)
28 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed