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Cognitive deficits in depression: Possible implications for functional neuropathology

  • Marie-Paule Austin (a1), Philip Mitchell (a2) and Guy M. Goodwin (a3)



While depression is known to involve a disturbance of mood, movement and cognition, its associated cognitive deficits are frequently viewed as simple epiphenomena of the disorder.


To review the status of cognitive deficits in depression and their putative neurobiological underpinnings.


Selective computerised review of the literature examining cognitive deficits in depression and their brain correlates.


Recent studies report both mnemonic deficits and the presence of executive impairment – possibly selective for set-shifting tasks – in depression. Many studies suggest that these occur independent of age, depression severity and subtype, task ‘difficulty’, motivation and response bias: some persist upon clinical ‘recovery’.


M nemonic and executive deficits do not appear to be epiphenomena of depressive disorder. A focus on the interactions between motivation, affect and cognitive function may allow greater understanding of the interplay between key aspects of the dorsal and ventral aspects of the prefrontal cortex in depression.

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Corresponding author

Dr Marie-Paule Austin, Department of Liaison Psychiatry, Prince of Wales Hospital, Randwick 2031, Australia. Tel: +61 2 93822796; fax: +61 293822177; e-mail:


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Declaration of interest

This paper was supported by an Australian National Health and Medical Research Council Program Grant (993208).



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Cognitive deficits in depression: Possible implications for functional neuropathology

  • Marie-Paule Austin (a1), Philip Mitchell (a2) and Guy M. Goodwin (a3)
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Cognitive Motivation Delay Deficits

Karen B Frank, occupational therapist in MH
30 March 2011


Informally studying patients with depression, together with the dailygroup treatment, I appreciate the many angles and factors being consideredin your Cognitive Deficits article.

Toward motivation - A logic that appears to me in people is that while an immediate inappropriate response is produced and observed within low hedonic states, attentional set-shifting issues as well as perseveration are also noted.

My thought is to order the sypmtoms and in a sense combine them. That an appropriate response is not necessarily absent, but rather requires time to develop, due to slowed thought processes. That, [in manycases] if the stimulus were to not require the response to be instantaneous, the response provided would be considerably closer to appropriate. Keeping the stimulus active long enough to build intrinsic interest/ reward seems like the real challenge.

And, as a therapist with treatment options on my mind, it would seem that, as with any behavior, the less it gets practiced the rustier it gets. Persistance at motivating and gaining of experience have to augmentthe retaining/ regaining of skills and of hedonic capacity. Motivation itself being in real time. And with dancing and joy, at that. I love thatpeople are reported to learn better when fun is involved.

~ karen.b.frank
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