Discrepancy between objective and subjective cognition in major depressive disorder

Eur Neuropsychopharmacol. 2019 Jan;29(1):46-56. doi: 10.1016/j.euroneuro.2018.11.1104. Epub 2018 Nov 28.

Abstract

Objective and subjective cognitive measures are altered in major depressive disorder (MDD), but there is a poor correlation between them. This study aims to explore such discrepancy and the characteristics explaining this phenomenon. 229 patients with MDD subdivided into remitted (n = 57), partially remitted (n = 90) and acute (n = 82) underwent a clinical interview, completed self-report questionnaires and a neuropsychological assessment. The association between objective and subjective cognition was evaluated in the areas of attention and memory. Also, dependent measures of concordance and self-appraisal were calculated for each patient. Potential predictors of these outcomes were evaluated through regression analysis. Depressive symptoms correlated negatively with objective but especially with subjective cognition. Patients in an acute episode showed a significant correlation between objective and subjective attention/memory measures, but also the greatest underestimation of their cognitive performance. In those with fewer depressive symptoms, objective and subjective cognition showed poor correspondence between them. In the regression analyses with the full MDD sample, higher scores on depressive symptoms, intelligence quotient and executive functions predicted lower self-appraisal. Objective and subjective cognition show poor concordance in MDD patients, especially in those with residual mood symptoms. Higher executive functions also explain this discrepancy. Assessments of both subjective cognitive complaints and objective performance seem necessary as they may be measuring different aspects of cognitive functioning.

Keywords: Affective disorders; Cognitive functioning; Depression; Neurocognition; Self report.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Attention
  • Cognition*
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / psychology*
  • Diagnostic Self Evaluation
  • Executive Function
  • Female
  • Humans
  • Intelligence Tests
  • Male
  • Memory
  • Middle Aged
  • Neuropsychological Tests
  • Remission Induction
  • Young Adult