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The Association Between Cognitive Functioning and Depression Severity: A Multiwave Longitudinal Remote Assessment

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Cognitive difficulties in depression are common. Smartphone assessments show promise for monitoring, but self-reports better track within-person changes in depression severity over time.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Digital Health

Background:

  • Cognitive impairments are a significant issue in major depressive disorder (MDD), impacting recovery and quality of life.
  • Remote assessment using smartphones offers a novel approach to track cognitive functioning in real-world settings.
  • The utility of smartphone-based cognitive assessments for monitoring depression severity requires further investigation.

Purpose of the Study:

  • To investigate the associations between performance-based and self-report cognitive functioning measures and depression severity.
  • To explore within-person and between-person relationships in a longitudinal cohort of individuals with MDD.
  • To evaluate the potential of smartphone-based cognitive assessments for remote patient monitoring in depression.

Main Methods:

  • Utilized the THINC-it mobile application for remote cognitive assessments (attention, working memory, processing speed, attention switching) and self-report measures.
  • Analyzed data from 475 participants in the RADAR-MDD study with 2036 observations over 14 months.
  • Employed statistical models to examine within-person and between-person associations between cognitive measures and depression severity.

Main Results:

  • Between-person analyses revealed stronger negative associations between self-reported cognitive function and depression severity compared to performance-based measures.
  • Within-person analyses showed negative associations between depression severity and self-reported cognition, processing speed, and attention.
  • The THINC-it tool effectively detected poorer cognitive performance correlating with higher depressive symptoms but struggled to track within-person changes over time.

Conclusions:

  • Smartphone-based cognitive assessments, like THINC-it, can remotely identify cognitive deficits associated with depression severity.
  • Self-report measures of cognitive functioning demonstrate greater potential for tracking within-person changes in depression severity over time.
  • Repeated self-assessments of cognition may be valuable for monitoring patients with major depressive disorder.