Depression 04 Sep, 2017 Read Time: 3 mins

Assessing cognition in depression

Can cognitive symptoms in depression be quantified? 

We know that depression is made up of emotional, physical and cognitive symptoms.1 The latter are increasingly recognised as a significant component of depression in many patients, but are often poorly understood in clinical practice.2,3 Tools that give you the ability to assess and quantify cognitive dysfunction are essential in determining the severity of your patients’ depression.4

The importance of measuring cognitive dysfunction in depression
The cognitive symptoms of depression can have a devastating effect on patients’ day-to-day lives, and have been implicated as a principal mediator of psychosocial impairment, particularly with regards to performance at work.5,6

Cognitive dysfunction is also associated with the risk of relapse, with one study showing that more than 75% of patients with residual cognitive symptoms relapsed within 10 months of achieving remission.7

Monitoring cognition (as well as emotion) from the initial diagnosis of depression ensures that all aspects of your patient’s condition are duly considered. This in turn enables you take steps to prevent future relapses and help your patients achieve a true and lasting remission.4

In one study, 75% of patients with residual cognitive symptoms relapsed within 10 months of achieving remission7

Using the right tools for the job
THINC-it is a newly validated screening tool, and the first digital screening tool for cognitive dysfunction to be validated as a composite of objective and subjective scales in patients with depression.9

There are also a number of traditional tools available to help you assess and quantify the cognitive symptoms of depression. These include a range of objective neuropsychological assessments, as well as subjective scales and questionnaires.9 Those that are administered by a healthcare practitioner are known as ‘clinician-rated’, while those completed by the patients themselves are termed ‘patient-rated’. 

References

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Health Disorders. 5th Washington, DC: American Psychiatric Association; 2013.
  2. Conradi HJ et al. Psychol Med 2011; 41(6): 1165–1174.
  3. Jarema M et al. Psychiatr Pol 2014; 48(6): 1105–1116.
  4. Greer TL et al. CNS Drugs 2010; 24(4): 267–284.
  5. McIntyre RS et al. Depress Anxiety 2013; 30(6): 515–527.
  6. Lam RW et al. Can J Psychiatry 2014; 59(12): 649–654.
  7. Paykel ES et al. Dialogues Clin Neurosci 2008; 10: 431–437.
  8. McIntyre RS. Validation of the THINC-it® screening tool. Presented at the 29th ECNP Congress 2016; Vienna, Austria.
  9. Cusin C et al. Rating Scales for Depression. In: Handbook of Clinical Rating Scales and Assessment in Psychiatry and Mental Health. Ed: Baer, Lee, Blais, Mark A. (Eds.), 2010. 
  10. McLeod DR et al. Behav Res Methods Instrum 1982; 14(5): 463–466.
  11. Schmidt M. Rey auditory verbal learning test: a handbook. Los Angeles Western Psychological Services 1996.
  12. Barzotti T et al. Arch Gerontol Geriatr Suppl 2004; 9: 57–62.
  13. Cambridge Cognition. Choice Reaction Time (CRT). Available at:http://www.cambridgecognition.com/tests/choice-reaction-time-crt. Accessed July 2015.
  14. Cogtest. Choice Reaction Tim. Available at:http://www.cogtest.com/tests/cognitive_int/crt.html. Accessed July 2015.
  15. Miller KM et al. Arch Clin Neuropsych 2009; 24: 711–717.
  16. Cogtest. Simple Reaction Time Test. Available at: http://www.cogtest.com/tests/cognitive_int/srt.html. Accessed July 2015.
  17. Culpepper L. Cognition in MDD: Implications for primary care. In: Cognitive dysfunction in major depressive disorder. Ed: McIntyre R, Cha D, 2015.
  18. Lovera J et al. J Rehabil Res Dev 2006; 43(1): 73–82.
  19. Fava M et al. Psychother Psychosom 2009; 78: 91–97.
  20. Roffman JL et al. Chapter 6: Diagnostic rating scales and psychiatric instruments. In: Massachusetts General Hospital Comprehensive Clinical Psychiatry. Ed: Stern TA, Fava M, Wilens TE, Rosenbaum JF, 2008.  

Categories

  • Depression