Cognitive Impairment in Patients With Depression: Awareness, Assessment, and Management
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Cognitive impairment is a common, often persistent, symptom of major depressive disorder (MDD) that is disproportionately represented in patients who have not returned to full psychosocial functioning. The ultimate goal of treatment in depression is full functional recovery, and assessing patients for cognitive impairment and selecting treatments that address cognitive dysfunction should lead to improved functional outcomes. Unfortunately, many clinicians use screening and assessment tools that are not suited for measuring cognitive impairment in patients with depression. The new THINC-it assessment tool is the first instrument that provides objective and subjective data on dysfunction in all the cognitive domains commonly affected by depression. In regard to treatment, several pharmacologic and nonpharmacologic interventions have been investigated as treatments for cognitive dysfunction in individuals with MDD. However very few studies of treatments for cognitive function in patients with MDD have been adequate, in terms of sample size and study methods, to guide clinical practice. The best evidence supports the moderate efficacy of some antidepressants, cognitive-behavioral therapy, and exercise.
From the Department of Family Medicine, Boston University, Massachusetts (Dr Culpepper); the Department of Mood and Anxiety Disorders, The University of British Columbia, Vancouver, Canada (Dr Lam); and the Mood Disorders Psychopharmacology Unit, University of Toronto, Ontario, Canada (Dr McIntyre).
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J Clin Psychiatry 2017;78(9):1383-1394Related Articles