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The cumulative load of depressive illness is associated with cognitive function in the remitted state of unipolar depressive disorder

Published online by Cambridge University Press:  15 April 2020

B.J. Hasselbalch*
Affiliation:
Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
U. Knorr
Affiliation:
Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
S.G. Hasselbalch
Affiliation:
Neurobiology Research Unit and Memory Disorders Research Group, Department of Neurology, Neuroscience Centre, Copenhagen University Hospital, Rigshospitalet, Denmark
A. Gade
Affiliation:
Department of Psychology, University of Copenhagen, Denmark
L.V. Kessing
Affiliation:
Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
*
*Corresponding author. Tel.: +45 35456147; fax: +45 35456238. E-mail address:[email protected] (B.J. Hasselbalch).
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Abstract

Objective:

To investigate whether the cumulative number, duration and subtypes (severity and presence of psychotic features) of previous episodes of depression in patients with unipolar depressive disorder in a remitted state are associated with decreased global cognitive function.

Methods:

Via the Danish registers individuals between 40 and 80 years of age were identified: (1) patients with a diagnosis of unipolar disorder at their first discharge from a psychiatric hospital in the period 1994 to 2002, and (2) gender and age matched control individuals. The participants were assessed with the Cambridge Cognitive Examination (CAMCOG), which provides a composite measure of global cognitive function.

Results:

A total of 88 patients and 50 controls accepted our invitation to participate, fulfilled the selection criteria and were included in the study. The cumulative duration of depressive episodes was associated with a decreased CAMCOG score adjusted for age, gender, education, premorbid IQ and residual depressive symptoms (B = −0.14, 95% C.I. (−0.26, −0.02), R2adj = 0.31, P = .02). Significant associations were also found between CAMCOG score and the cumulative duration and total number of depressive episodes with psychotic features, respectively.

Conclusion:

Our findings suggest that cognitive dysfunction is associated with the cumulative duration of depressive episodes, and that, in particular, depressive episodes with psychotic features in the course of illness may be a significant predictor of future impairment of cognitive function.

Type
Original article
Copyright
Copyright © European Psychiatric Association

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References

Altman, DGPractical Statistics For Medical Research London: Chapman & Hall; 1997.Google Scholar
Altshuler, LLBipolar disorder: are repeated episodes associated with neuroanatomic and cognitive changes?. Biol Psychiatry 1993;33:563565.CrossRefGoogle ScholarPubMed
Andersen, KLolk, ANielsen, HAndersen, JOlsen, CKragh-Sorensen, PPrevalence of very mild to severe dementia in Denmark. Acta Neurol Scand 1997;96:8287.CrossRefGoogle ScholarPubMed
Andersen, KNielsen, HLolk, AAndersen, JBecker, IKragh-Sorensen, PIncidence of very mild to severe dementia and Alzheimer's disease in Denmark: the Odense study. Neurology 1999;52:8590.CrossRefGoogle ScholarPubMed
Angst, J.Depressive disorders, WPA Series, evidence and experience in psychiatry, Third ed. Commentary 1.4: severity and subtypes of depression; 2009.Google Scholar
Arts, BJabben, NKrabbendam, LVan, OJMeta-analyses of cognitive functioning in euthymic bipolar patients and their first-degree relatives. Psychol Med 2008;38:771785.CrossRefGoogle ScholarPubMed
Beats, BCSahakian, BJLevy, RCognitive performance in tests sensitive to frontal lobe dysfunction in the elderly depressed. Psychol Med 1996;26:591603.CrossRefGoogle ScholarPubMed
Behnken, ASchoning, SGerss, JKonrad, Cde Jong-Meyer, RZwanzger, P, et al.Persistent non-verbal memory impairment in remitted major depression – caused by encoding deficits?. J Affect Disord 2010;122:144148.CrossRefGoogle ScholarPubMed
Bhardwaj, AWilkinson, PSrivastava, CSharm, MCognitive deficits in euthymic patients with recurrent depression. J Nerv Ment Dis 2010;198:513515.CrossRefGoogle ScholarPubMed
Biringer, ELundervold, AStordal, KMykletun, AEgeland, JBottlender, R, et al.Executive function improvement upon remission of recurrent unipolar depression. Germany; Springer; 2005.CrossRefGoogle ScholarPubMed
Bock, CBukh, JDVinberg, MGether, UKessing, LVValidity of the diagnosis of a single depressive episode in a case register. Clin Pract Epidemol Ment Health 2009;5:4.CrossRefGoogle Scholar
Bora, EYucel, MPantelis, CCognitive endophenotypes of bipolar disorder: a meta-analysis of neuropsychological deficits in euthymic patients and their first-degree relatives. J Affect Disord 2009;113:120.CrossRefGoogle ScholarPubMed
Crawford, JRBesson, JAParker, DMSutherland, KMKeen, PLEstimation of premorbid intellectual status in depression. Br J Clin Psychol 1987;26(Pt 4):313314.CrossRefGoogle ScholarPubMed
David, ASZammit, SLewis, GDalman, CAllebeck, PImpairments in cognition across the spectrum of psychiatric disorders: evidence from a Swedish conscript cohort. Schizophr Bull 2008;34:10351041.CrossRefGoogle ScholarPubMed
Frank, EPrien, RFJarrett, RBKeller, MBKupfer, DJLavori, PW, et al.Conceptualization and rationale for consensus definitions of terms in major depressive disorder. Remission, recovery, relapse, and recurrence. Arch Gen Psychiatry 1991;48:851855.CrossRefGoogle ScholarPubMed
Goddard, GVMcIntyre, DCLeech, CKA permanent change in brain function resulting from daily electrical stimulation. Exp Neurol 1969;25:295330.CrossRefGoogle ScholarPubMed
Goldberg, JFChengappa, KNIdentifying and treating cognitive impairment in bipolar disorder. Bipolar Disord 2009;11(Suppl. 2):123137.CrossRefGoogle ScholarPubMed
Goswami, USharma, AVarma, AGulrajani, CFerrier, INYoung, AH, et al.The neurocognitive performance of drug-free and medicated euthymic bipolar patients do not differ. Acta Psychiatr Scand 2009;120:456463.CrossRefGoogle Scholar
Hamilton, MA rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:5662.CrossRefGoogle ScholarPubMed
Hasselbalch, BJKnorr, UBennike, BHasselbalch, SGSondergaard, MHKessing, LVDecreased levels of brain-derived neurotrophic factor in the remitted state of unipolar depressive disorder. Acta Psychiatr Scand 2012. http://doi:10.1111/j.1600-0447.2012.01831.x.CrossRefGoogle ScholarPubMed
Hasselbalch, BJKnorr, UKessing, LVCognitive impairment in the remitted state of unipolar depressive disorder: a systematic review. J Affect Disord 2011;134:2031.CrossRefGoogle ScholarPubMed
Kessing, LVCognitive impairment in the euthymic phase of affective disorder. Psychol Med 1998;28:10271038.CrossRefGoogle ScholarPubMed
Lewandowski, KECohen, BMOngur D0 Evolution of neuropsychological dysfunction during the course of schizophrenia and bipolar disorder. Psychol Med 2011;41:225241.CrossRefGoogle Scholar
Li, CTLin, CPChou, KHChen, IYHsieh, JCWu, CL, et al.Structural and cognitive deficits in remitting and non-remitting recurrent depression: a voxel-based morphometric study. NeuroImage 2010;50:347356.CrossRefGoogle ScholarPubMed
Lolk, ANielsen, HAndersen, KAndersen, JKragh-Sorensen, PCAMCOG as a screening instrument for dementia: the Odense study. Cambridge Cognitive Examination. Acta Psychiatr Scand 2000;102:331335.CrossRefGoogle ScholarPubMed
Martinez-Aran, ATorrent, CTabares-Seisdedos, RSalamero, MDaban, CBalanza-Martinez, V, et al.Neurocognitive impairment in bipolar patients with and without history of psychosis. J Clin Psychiatry 2008;69:233239.CrossRefGoogle ScholarPubMed
Martinez-Aran, AVieta, EReinares, MColom, FTorrent, CSanchez-Moreno, J, et al.Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. Am J Psychiatry 2004;161:262270.CrossRefGoogle ScholarPubMed
McEwen, BSWingfield, JCThe concept of allostasis in biology and biomedicine. Horm Behav 2003;43:215.CrossRefGoogle ScholarPubMed
McKinnon, MCYucel, KNazarov, AMacQueen, GMA meta-analysis examining clinical predictors of hippocampal volume in patients with major depressive disorder. J Psychiatry Neurosci 2009;34:4154.Google ScholarPubMed
Munk-Jorgensen, PKastrup, MMortensen, PBThe Danish psychiatric register as a tool in epidemiology. Acta Psychiatr Scand Suppl 1993;370:2732.CrossRefGoogle ScholarPubMed
Nelson, HEO’Connell, ADementia: the estimation of premorbid intelligence levels using the New Adult Reading Test. Cortex 1978;14:234244.CrossRefGoogle ScholarPubMed
Neu, PBajbouj, MSchilling, AGodemann, FBerman, RMSchlattmann, PCognitive function over the treatment course of depression in middle-aged patients: correlation with brain MRI signal hyperintensities. J Psychiatr Res 2005;39:129135.CrossRefGoogle ScholarPubMed
Paelecke-Habermann, YPohl, JLeplow, BAttention and executive functions in remitted major depression patients. J Affect Disord 2005;89:125135.CrossRefGoogle ScholarPubMed
Pedersen, AKuppers, KBehnken, AKroker, KSchoning, SBaune, BT, et al.Implicit and explicit procedural learning in patients recently remitted from severe major depression. Psychiatry Res 2009;169:16.CrossRefGoogle ScholarPubMed
Porter, RJBourke, CGallagher, PNeuropsychological impairment in major depression: its nature, origin and clinical significance. Aust N Z J Psychiatry 2007;41:115128.CrossRefGoogle ScholarPubMed
Post, RMRoy-Byrne, PPUhde, TWGraphic representation of the life course of illness in patients with affective disorder. Am J Psychiatry 1988;145:844848.Google ScholarPubMed
Preiss, MKucerova, HLukavsky, JStepankova, HSos, PKawaciukova, RCognitive deficits in the euthymic phase of unipolar depression. Psychiatry Res 2009;169:235239.CrossRefGoogle ScholarPubMed
Quraishi, SFrangou, SNeuropsychology of bipolar disorder: a review. J Affect Disord 2002;72(3):209226.CrossRefGoogle ScholarPubMed
Reisberg, BFerris, SHde Leon, MJCrook, TGlobal Deterioration Scale (GDS). Psychopharmacol Bull 1988;24:661663.Google Scholar
Reppermund, SIsing, MLucae, SZihl, JCognitive impairment in unipolar depression is persistent and non-specific: further evidence for the final common pathway disorder hypothesis. Psychol Med 2009;39:603614.CrossRefGoogle ScholarPubMed
Robinson, LJFerrier, INEvolution of cognitive impairment in bipolar disorder: a systematic review of cross-sectional evidence. Bipolar Disord 2006;8:103116.CrossRefGoogle ScholarPubMed
Robinson, LJThompson, JMGallagher, PGoswami, UYoung, AHFerrier, IN, et al.A meta-analysis of cognitive deficits in euthymic patients with bipolar disorder. J Affect Disord 2006;93:105115.CrossRefGoogle ScholarPubMed
Roth, MHuppert RM0 CAMDEX-R: the cambridge cognitive examination for the elderly -revised. Copenhagen: Psykologisk Forlag; 2002.Google Scholar
Roth, MTym, EMountjoy, CQHuppert, FAHendrie, HVerma, S, et al.CAMDEX. A standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. Br J Psychiatry 1986;149:698709.CrossRefGoogle Scholar
Sheline, YISanghavi, MMintun, MAGado, MHDepression duration but not age predicts hippocampal volume loss in medically healthy women with recurrent major depression. J Neurosci 1999;19:50345043.CrossRefGoogle Scholar
The Danish National Board of Health. Classification of diseases. The Danish edition of ICD-10. http://www%sst%dk; 1992.Google Scholar
The Danish National Board of Health. Reference program for unipolar depression (guidelines for treatment of unipolar disorder). http://www%sst%dk; 2007.Google Scholar
van Gorp, WGAltshuler, LTheberge, DCWilkins, JDixon, WCognitive impairment in euthymic bipolar patients with and without prior alcohol dependence. A preliminary study. Arch Gen Psychiatry 1998;55:4146.CrossRefGoogle ScholarPubMed
Veiel, HOA preliminary profile of neuropsychological deficits associated with major depression. J Clin Exp Neuropsychol 1997;19:587603.CrossRefGoogle ScholarPubMed
Weiss, SRPost, RMKindling:, separate vs. shared mechanisms in affective disorders and epilepsy. Neuropsychobiology 1998;38:167180.CrossRefGoogle ScholarPubMed
Wing, JKBabor, TBrugha, TBurke, JCooper, JEGiel, R, et al.SCAN. Schedules for clinical assessment in neuropsychiatry. Arch Gen Psychiatry 1990;47:589593.CrossRefGoogle ScholarPubMed
Wouters, Hvan Gool, WASchmand, BZwinderman, AHLindeboom, RThree sides of the same coin: measuring global cognitive impairment with the MMSE, ADAS-cog and CAMCOG. Int J Geriatr Psychiatry 2010;25:770779.CrossRefGoogle ScholarPubMed
Zammit, SAllebeck, PDavid, ASDalman, CHemmingsson, TLundberg, I, et al.A longitudinal study of premorbid IQ score and risk of developing schizophrenia, bipolar disorder, severe depression, and other nonaffective psychoses. Arch Gen Psychiatry 2004;61:354360.CrossRefGoogle ScholarPubMed
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