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Discrepancy between objective and subjective cognition in major depressive disorder
Maria Serra-Blasco1, Ivan J Torres2, Muriel Vicent-Gil3
1Mental Health Department, Neuroscience and Mental Health Research Area, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, CIBERSAM, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain.
Summary
Cognitive performance in major depressive disorder (MDD) differs between objective tests and self-reports. This discrepancy is linked to depressive symptoms and executive functions, highlighting the need for comprehensive cognitive assessments.
Area of Science:
- Neuroscience
- Psychiatry
- Cognitive Psychology
Background:
- Major depressive disorder (MDD) is associated with cognitive impairments.
- A notable disconnect exists between objective (neuropsychological tests) and subjective (self-report) cognitive measures in MDD patients.
- Understanding this discrepancy is crucial for accurate cognitive assessment in MDD.
Purpose of the Study:
- To investigate the poor correlation between objective and subjective cognitive measures in MDD.
- To identify factors contributing to this discrepancy, focusing on attention and memory.
- To explore the relationship between depressive symptom severity and cognitive self-appraisal.
Main Methods:
- A cohort of 229 MDD patients (acute, partially remitted, remitted) underwent clinical interviews, self-report questionnaires, and neuropsychological assessments.
- Evaluated the association between objective and subjective cognition in attention and memory domains.
- Calculated concordance and self-appraisal measures, with regression analyses to identify predictors.
Main Results:
- Depressive symptoms negatively correlated with both objective and subjective cognition, with a stronger effect on subjective measures.
- Patients in acute episodes showed better concordance but greater underestimation of cognitive performance.
- Lower concordance was observed in patients with fewer depressive symptoms.
- Higher depressive symptoms, IQ, and executive functions predicted lower self-appraisal.
Conclusions:
- Objective and subjective cognition exhibit poor concordance in MDD, particularly in those with residual symptoms.
- Executive functions significantly contribute to the discrepancy between self-perceived and objectively measured cognition.
- Comprehensive cognitive evaluation in MDD requires assessing both subjective complaints and objective performance, as they capture distinct aspects of cognitive functioning.
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