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Cognitive impairment in depression: a systematic review and meta-analysis

Published online by Cambridge University Press:  29 October 2013

P. L. Rock ,
J. P. Roiser ,
W. J. Riedel  and
A. D. Blackwell
P. L. Rock*
Affiliation:
Cambridge Cognition, Bottisham, Cambridge, UK Department of Psychiatry, University of Oxford, UK
J. P. Roiser
Affiliation:
UCL Institute of Cognitive Neuroscience, London, UK
W. J. Riedel
Affiliation:
Cambridge Cognition, Bottisham, Cambridge, UK Department of Psychiatry, University of Cambridge, UK Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
A. D. Blackwell
Affiliation:
Cambridge Cognition, Bottisham, Cambridge, UK Department of Psychiatry, University of Cambridge, UK
*
* Address for correspondence: P. L. Rock, D.Phil., Cambridge Cognition, Tunbridge Court, Tunbridge Lane, Bottisham, Cambridge CB25 9TU, UK. (Email: philippa.rock@gmail.com)
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Abstract

Background

This review aimed to address the question of whether cognitive impairment should be considered a core feature of depression that may be a valuable target for treatment.

Method

We conducted a systematic review and meta-analysis of cognitive function, assessed with a single neuropsychological test battery, the Cambridge Neuropsychological Test Automated Battery (CANTAB), in patients with depression during symptomatic and remitted states. Inclusion of studies comparing patients remitted from depression and controls enabled us to investigate whether cognitive impairment persists beyond episodes of low mood in depression.

Results

Our meta-analysis revealed significant moderate cognitive deficits in executive function, memory and attention in patients with depression relative to controls (Cohen's d effect sizes ranging from −0.34 to −0.65). Significant moderate deficits in executive function and attention (Cohen's d ranging from −0.52 to −0.61) and non-significant small/moderate deficits in memory (Cohen's d ranging from −0.22 to −0.54) were found to persist in patients whose depressive symptoms had remitted, indicating that cognitive impairment occurs separately from episodes of low mood in depression.

Conclusions

Both low mood and cognitive impairment are associated with poor psychosocial functioning. Therefore, we argue that remediation of cognitive impairment and alleviation of depressive symptoms each play an important role in improving outcome for patients with depression. In conclusion, this systematic review and meta-analysis demonstrates that cognitive impairment represents a core feature of depression that cannot be considered an epiphenomenon that is entirely secondary to symptoms of low mood and that may be a valuable target for future interventions.

Keywords

AttentionCANTABcognitiondepressionexecutive functionmemory

Information

Type
Review Article
Information
Psychological Medicine , Volume 44 , Issue 10 , July 2014 , pp. 2029 - 2040
Copyright
Copyright © Cambridge University Press 2013 

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