@article{4e95bd02d08b470a994ab4695d534425,
title = "The association between persistent cognitive difficulties and depression and functional outcomes in people with major depressive disorder",
abstract = "Background Cognitive symptoms are common during and following episodes of depression. Little is known about the persistence of self-reported and performance-based cognition with depression and functional outcomes. Methods This is a secondary analysis of a prospective naturalistic observational clinical cohort study of individuals with recurrent major depressive disorder (MDD; N = 623). Participants completed app-based self-reported and performance-based cognitive function assessments alongside validated measures of depression, functional disability, and self-esteem every 3 months. Participants were followed-up for a maximum of 2-years. Multilevel hierarchically nested modelling was employed to explore between- and within-participant variation over time to identify whether persistent cognitive difficulties are related to levels of depression and functional impairment during follow-up. Results 508 individuals (81.5%) provided data (mean age: 46.6, s.d.: 15.6; 76.2% female). Increasing persistence of self-reported cognitive difficulty was associated with higher levels of depression and functional impairment throughout the follow-up. In comparison to low persistence of objective cognitive difficulty (<25% of timepoints), those with high persistence (>75% of timepoints) reported significantly higher levels of depression (B = 5.17, s.e. = 2.21, p = 0.019) and functional impairment (B = 4.82, s.e. = 1.79, p = 0.002) over time. Examination of the individual cognitive modules shows that persistently impaired executive function is associated with worse functioning, and poor processing speed is particularly important for worsened depressive symptoms. Conclusions We replicated previous findings of greater persistence of cognitive difficulty with increasing severity of depression and further demonstrate that these cognitive difficulties are associated with pervasive functional disability. Difficulties with cognition may be an indicator and target for further treatment input.",
keywords = "Cognitive function, epidemiology, longitudinal, major depressive disorder, predictive, remote measurement",
author = "F. Matcham and Simblett, {S. K.} and D. Leightley and M. Dalby and S. Siddi and Haro, {J. M.} and F. Lamers and Penninx, {B. W. H. J.} and S. Bruce and R. Nica and S. Zormpas and G. Gilpin and White, {K. M.} and C. Oetzmann and P. Annas and Brasen, {J. C.} and Narayan, {V. A.} and M. Hotopf and T. Wykes",
note = "Funding Information: The RADAR-CNS project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 115902. This Joint Undertaking receives support from the European Union's Horizon 2020 research and innovation programme and EFPIA ( www.imi.europa.eu ). This communication reflects the views of the RADAR-CNS consortium and neither IMI nor the European Union and EFPIA are liable for any use that may be made of the information contained herein. Funding Information: Participant recruitment in Amsterdam was partially accomplished through Hersenonderzoek.nl, a Dutch online registry that facilitates participant recruitment for neuroscience studies ( https://hersenonderzoek.nl/ ). Hersenonderzoek.nl is funded by ZonMw-Memorabel (project no 73305095003), a project in the context of the Dutch Deltaplan Dementie, Gieskes-Strijbis Foundation, the Alzheimer's Society in the Netherlands and Brain Foundation Netherlands. Participants in Spain were recruited through the following institutions: Parc Sanitari Sant Joan de {\'D}eu network of mental health services (Barcelona); Institut Catala ` de la Salut primary care services (Barcelona); Institut Pere Mata-Mental Health Care (Terrassa); Hospital Cl{\'i}nico San Carlos (Madrid). We thank all the members of the RADAR-CNS patient advisory board for their contribution to the device selection procedures, and their invaluable advice throughout the study protocol design. CO is supported by the UK Medical Research Council (MR/N013700/1) and King's College London member of the MRC Doctoral Training Partnership in Biomedical Sciences. This research was reviewed by a team with experience of mental health problems and their carers who have been specially trained to advise on research proposals and documentation through the Feasibility and Acceptability Support Team for Researchers (FAST-R): a free, confidential service in England provided by the National Institute for Health Research Maudsley Biomedical Research Centre via King's College London and South London and Maudsley NHS Foundation Trust. We thank all GLAD Study volunteers for their participation, and gratefully acknowledge the NIHR BioResource, NIHR BioResource centres, NHS Trusts and staff for their contribution. We also acknowledge NIHR BRC, King's College London, South London and Maudsley NHS Trust and King's Health Partners. We thank the National Institute for Health Research, NHS Blood and Transplant, and Health Data Research UK as part of the Digital Innovation Hub Programme. Funding Information: JCB and PA are full-time employees of H. Lundbeck A/S. VN is an employee of Janssen Research and Development, LLC and holds company stocks/stock options. JMH has received economic compensation for participating in advisory boards or giving educational lectures from Eli Lilly & Co, Sanofi, Lundbeck, and Otsuka. CO is supported by the UK Medical Research Council (MR/N013700/1) and King{\textquoteright}s College London member of the MRC Doctoral Training Partnership in Biomedical Sciences. No other authors have competing interests to declare. Publisher Copyright: Copyright {\textcopyright} The Author(s), 2022. Published by Cambridge University Press.",
year = "2023",
month = oct,
day = "13",
doi = "https://doi.org/10.1017/S0033291722003671",
language = "English",
volume = "53",
pages = "6334--6344",
journal = "Psychological Medicine",
issn = "0033-2917",
publisher = "Cambridge University Press",
number = "13",
}