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The relationship between cognitive function and clinical and functional outcomes in major depressive disorder

Published online by Cambridge University Press:  04 June 2008

A. Withall ,
L. M. Harris  and
S. R. Cumming
A. Withall*
Affiliation:
Primary Dementia Collaborative Research Centre, University of New South Wales, Coogee, Australia
L. M. Harris
Affiliation:
School of Behavioural and Community Health Sciences, University of Sydney, Lidcombe, Australia
S. R. Cumming
Affiliation:
School of Behavioural and Community Health Sciences, University of Sydney, Lidcombe, Australia
*
*Address for correspondence: A. Withall, Ph.D., Primary Dementia Collaborative Research Centre, Cliffbrook Campus, 45 Beach Street, Coogee, NSW, Australia2034. (Email: a.withall@unsw.edu.au)
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Abstract

Background

Although cognitive variables have been shown to be useful in predicting outcomes in late-life depression, there has not yet been a comprehensive study in younger persons with depression.

Method

The clinical symptoms and cognitive performance of participants were evaluated at admission to one of two university teaching hospitals and again at 3 months after remission and discharge. A total of 52 participants with a DSM-IV diagnosis of major depressive disorder, aged between 20 and 60 years and with a Hamilton Depression Rating Scale score ⩾17 entered the study. The sample for this paper comprises the 48 subjects (mean age 37.9 years, s.d.=10.7) who received admission and follow-up assessments; an attrition rate of 7.7%.

Results

More perseverative errors on the shortened Wisconsin Card Sorting Test at admission predicted a worse clinical outcome at follow-up. Poor event-based prospective memory and more perseverative errors on the shortened Wisconsin Card Sorting Test at admission predicted worse social and occupational outcome at follow-up.

Conclusions

These results suggest that a brief cognitive screen at hospital admission, focusing on executive function, would have a useful prognostic value in depression. Determining early predictors of individuals at risk of poorer outcomes is important for identifying those who may need altered or additional treatment approaches.

Keywords

Depressionexecutive functionneuropsychologicaloutcomepredictor
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 3 , March 2009 , pp. 393 - 402
Copyright
Copyright © 2008 Cambridge University Press

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