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Clinical Synthesis
Published Online: 13 April 2016

Cognitive Dysfunction in Major Depressive Disorder: Assessment, Impact, and Management

Abstract

Cognitive dysfunction is increasingly being recognized as an important clinical dimension in major depressive disorder. This review summarizes the existing data on the epidemiology, assessment, and treatment of cognitive dysfunction among nonelderly adults with the disorder. Overall, cognitive dysfunction is prevalent, persists through periods of symptom remission, and may be independently associated with functional outcomes. However, although the evidence increasingly suggests that clinicians should be heedful of their patients’ cognitive functioning, there is as yet no consensus on how best to monitor cognition clinically. In addition, although most studies have reported improved cognition with antidepressant medications, psychotherapy, and neuromodulation, the clinical significance of these improvements is unclear, and high-level evidence to guide decision making is limited. Nonetheless, given the important functional implications, clinicians should assess and monitor cognition and optimize both medication and psychological treatments to mitigate cognitive dysfunction among patients with major depressive disorder.

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Published in print: Spring 2016
Published online: 13 April 2016

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Trisha Chakrabarty, M.D.
The authors are with the Department of Psychiatry, University of British Columbia, and the Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada. Send correspondence to Dr. Lam (e-mail: [email protected]).
George Hadjipavlou, M.D., M.A.
The authors are with the Department of Psychiatry, University of British Columbia, and the Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada. Send correspondence to Dr. Lam (e-mail: [email protected]).
Raymond W. Lam, M.D.
The authors are with the Department of Psychiatry, University of British Columbia, and the Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada. Send correspondence to Dr. Lam (e-mail: [email protected]).

Competing Interests

Dr. Lam has received speaker fees, advisory board honoraria, or research funds from AstraZeneca, Brain Canada, Bristol-Myers Squibb, Canadian Depression Research and Intervention Network, Canadian Institutes of Health Research, Canadian Network for Mood and Anxiety Treatments, Canadian Psychiatric Association, Eli Lilly, Janssen, Lundbeck, Lundbeck Institute, Medscape, Merck, Movember Foundation, Pfizer, Servier, St. Jude Medical, Takeda, University of British Columbia Institute of Mental Health/Coast Capital Savings, and University Health Network Foundation. Dr. Chakrabarty and Dr. Hadjipavlou report no financial relationships with commercial interests.

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