Frequency and characteristics of recurrent major depressed patients with unimpaired executive functions

Major depression is associated with impairment of cognitive functions, and especially higher-order cognitive processes referred to as executive functions (EF). Whether this is a general finding is unclear. Patients without EF impairment may have different treatment needs than patients with EF impairment, and will probably have a better everyday functioning. Thus, it is important to identify the prevalence and characteristics of depressed patients without EF impairment. Forty-three patients with recurrent major depressive disorder (19-51 years) and 50 healthy controls were included in the study. The subjects were assessed with neuropsychological tests selected to measure central areas of EF, and screened on clinical and demographic variables. Within the depressed group, a total of 56% were defined as EF unimpaired. These patients were characterised by higher intellectual abilities and fewer depression episodes than the subgroup of patients with EF impairment. The subgroups were similar in age at debut of illness, severity of depression, general psychopathology and global level of functioning. In conclusion, about half of patients with recurrent major depression have normal EF. Since cognitive impairment and depressive symptomatology seem to be distinct dimensions, a neuropsychological investigation could help to ensure optimal treatment in patients with recurrent major depression.