Baseline cognitive functioning can predict the trajectory of acute treatment in first-episode major depressive...

This study aims to investigate the role of cognitive function in the efficacy prediction of selective serotonin reuptake inhibitors (SSRIs) for depression patients and to further the understanding of the relationship between baseline cognitive function and depression trajectory.

This was part of a multicenter study for major depressive disorder. The study included 172 first-episode depression patients and 93 recurrent depression patients who had their cognitive function assessed at baseline and followed up for 8 weeks of SSRI treatment.

After constructing a 2-level hierarchical linear model with depression change- and cognitive function-level variables, the processing speed at baseline was the best predictor for the improvement of depression at each follow-up in first-episode patients (G11 = 0.03, P = 0.042). The treatment prediction model slope varied across patients depending on the processing speed scores at baseline. With the receiver operating characteristic curve, the combination of sociodemographic characteristics, sedative hypnotics, baseline 17-item Hamilton Rating Scale for Depression (HAMD₁₇), and cognitive function showed the highest predictive power in major depressive disorder remission, resulting in a classification accuracy of 71.5%, a sensitivity of 82.5%, and a specificity of 55.1% (AUC = 0.713; P < 0.001).

Baseline cognitive function could help clinicians to better understand the trajectory of first-episode depression patients during acute treatment with SSRIs.