Miquel Roca1, Saray Monzón2, Margalida Vives3, Emilio López-Navarro3, Mauro Garcia-Toro3, Caterina Vicens4, Javier Garcia-Campayo5, John Harrison6, Margalida Gili3. 1. Institut Universitari d׳Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain; Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Spain. Electronic address: mroca@uib.es. 2. Institut Universitari d׳Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain. 3. Institut Universitari d׳Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain; Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Spain. 4. Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Spain; Centro de Salud Son Serra-La Vileta, Ib-Salut., Baleares, Spain. 5. Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Institute Carlos III, Spain; Department of Psychiatry, Miguel Servet Hospital, University of Zaragoza, Zaragoza, Spain. 6. Department of Medicine, Imperial College, London, UK.
Abstract
BACKGROUND: Cognitive symptoms are core symptoms with an impact on functioning in depression. Remission is considered as the main objective of the management and treatment of depression. This study was aimed to compare cognitive performance between melancholic (MelD) and non-melancholic depression (NMelD) and to determine whether these cognitive alterations remain after clinical remission. METHODS: We performed a 6 month follow-up study of 88 melancholic and non-melancholic depressive patients. Sociodemographic and clinical characteristics were recorded. Depression was examined using the Hamilton Depression Rating Scale and the CORE Index for Melancholia. Cognitive performance was assessed with the Trail Making Test (TMT), the Digit Span subtest of the WAIS-III, Stroop Colour Word Test (SCWT), the Tower of London (TOL DX), the Controlled Oral Word Association Test (FAS), Semantic Verbal Fluency and Finger Tapping Test (FTT). RESULTS: MelD patients show worse performance than N-MelD at baseline, with significant differences at Digit Span subtest of WAIS Part I and Part II, SCWT Part I and Part II, TOL DX, Total Problem Solving, Total Execution Time and FTT- Preferred hand. Cognitive impairment remains at six months follow-up after clinical remission in MelD. In the comparison between remitted and non-remitted patients, cognitive impairment in Trail Making Test Part B and Verbal and Semantic Fluency (Animals) remains after clinical remission in MelD group but not in non-melancholic patients. LIMITATIONS: The use of psychopharmacological treatment and the small sample of melancholic patients. CONCLUSIONS: Patients with MelD do not improve cognitive performance despite clinical remission compared with remitted NMelD patients. The persistence of some cognitive dysfunctions in MelD remitted patients could represent a trait marker of a different depressive subtype and not be secondary to disease severity.
BACKGROUND: Cognitive symptoms are core symptoms with an impact on functioning in depression. Remission is considered as the main objective of the management and treatment of depression. This study was aimed to compare cognitive performance between melancholic (MelD) and non-melancholic depression (NMelD) and to determine whether these cognitive alterations remain after clinical remission. METHODS: We performed a 6 month follow-up study of 88 melancholic and non-melancholic depressivepatients. Sociodemographic and clinical characteristics were recorded. Depression was examined using the Hamilton Depression Rating Scale and the CORE Index for Melancholia. Cognitive performance was assessed with the Trail Making Test (TMT), the Digit Span subtest of the WAIS-III, Stroop Colour Word Test (SCWT), the Tower of London (TOL DX), the Controlled Oral Word Association Test (FAS), Semantic Verbal Fluency and Finger Tapping Test (FTT). RESULTS: MelD patients show worse performance than N-MelD at baseline, with significant differences at Digit Span subtest of WAIS Part I and Part II, SCWT Part I and Part II, TOL DX, Total Problem Solving, Total Execution Time and FTT- Preferred hand. Cognitive impairment remains at six months follow-up after clinical remission in MelD. In the comparison between remitted and non-remitted patients, cognitive impairment in Trail Making Test Part B and Verbal and Semantic Fluency (Animals) remains after clinical remission in MelD group but not in non-melancholic patients. LIMITATIONS: The use of psychopharmacological treatment and the small sample of melancholic patients. CONCLUSIONS:Patients with MelD do not improve cognitive performance despite clinical remission compared with remitted NMelD patients. The persistence of some cognitive dysfunctions in MelD remitted patients could represent a trait marker of a different depressive subtype and not be secondary to disease severity.
Authors: Kari M Eddington; Chris J Burgin; Paul J Silvia; Niloofar Fallah; Catherine Majestic; Thomas R Kwapil Journal: Cognit Ther Res Date: 2016-10-21
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