Cognitive impairment based on computerized testing among patients with major depressive disorder after remission

To investigate risk factors associated with cognitive impairment among patients achieving remission from major depressive disorder (MDD).

This study was a retrospective analysis of data that had been prospectively collected from 1,227 patients diagnosed with MDD according to the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). Remission was defined as achieving a total score of 7 or less on the 17-item Hamilton Rating Scale for Depression (HAMD-17) following treatment without the use of any antidepressants. Cognitive impairment was measured at 6 months after discharge using the computerized Testing with THINC-integrated tool. Patients' demographic variables, clinical factors and self-reported rating scores were analyzed using multiple logistic regression model.

25.3% of patients exhibited cognitive impairment. Recurrent MDD (OR = 3.377, 95% CI: 1.629-7.003), increased inflammatory cytokines≥2 (OR = 4.032, 95% CI: 2.751-5.909), decreased dorsolateral prefrontal cortex volume (OR = 2.184, 95% CI: 1.298-3.676), decreased hippocampus volume (OR = 2.232, 95% CI: 1.393-3.576), increased amygdala volume (OR = 2.782, 95% CI: 1.751-4.420), decreased percentage of BOLD change for activity in subcortical network (OR = 2.689, 95% CI: 1.145-6.313) and ventral attention network (OR = 3.834, 95% CI: 1.573-9.345), increased percentage of BOLD change for activity in default mode network (OR = 5.136, 95% CI: 2.198-12.005) and Insomnia Severity Index scores ≥22 points (OR = 2.679, 95% CI: 1.502-4.779) were independent risk factors for cognitive impairment in remission from MDD. Receiver-operating characteristic curve demonstrated good predictive performance with area under the curve of 0.902.

Our results identified factors associated with cognitive impairment in patients with MDD after remission, enabling improved monitoring and management for reducing these risk factors.