Hostname: page-component-8448b6f56d-c47g7 Total loading time: 0 Render date: 2024-04-19T22:43:24.271Z Has data issue: false hasContentIssue false
  • English
  • Français

Cognitive function in depression: its relationship to the presence and severity of intellectual decline

Published online by Cambridge University Press:  09 July 2009

R. G. Brown ,
L. C. Scott ,
C. J. Bench  and
R. J. Dolan
R. G. Brown*
Affiliation:
MRC Human Movement and Balance Unit, Institute of Neurology; Academic Department of Psychiatry, Royal Free School of Medicine; MRC Cyclotron Unit, Hammersmith Hospital; National Hospital for Neurology and Neurosurgery, London
L. C. Scott
Affiliation:
MRC Human Movement and Balance Unit, Institute of Neurology; Academic Department of Psychiatry, Royal Free School of Medicine; MRC Cyclotron Unit, Hammersmith Hospital; National Hospital for Neurology and Neurosurgery, London
C. J. Bench
Affiliation:
MRC Human Movement and Balance Unit, Institute of Neurology; Academic Department of Psychiatry, Royal Free School of Medicine; MRC Cyclotron Unit, Hammersmith Hospital; National Hospital for Neurology and Neurosurgery, London
R. J. Dolan
Affiliation:
MRC Human Movement and Balance Unit, Institute of Neurology; Academic Department of Psychiatry, Royal Free School of Medicine; MRC Cyclotron Unit, Hammersmith Hospital; National Hospital for Neurology and Neurosurgery, London
*
1Address for correspondence: Dr R. G. Brown, MRC Human Movement and Balance Unit, Institute of Neurology, Queen Square, London WC1N 3BG
Get access Rights & Permissions [Opens in a new window]

Synopsis

Cognitive dysfunction is an integral feature of depression, in some cases of sufficient severity to warrant a diagnosis of dementia. There has been little systematic investigation of whether cognitive dysfunction is an inevitable consequence of depression, or is specific to a subgroup of depressed patients. Related to this is the distribution of cognitive dysfunction, whether there is a continuum of impairment or a distinct demented subgroup. Finally, there is the question of which aspects of cognitive function are most sensitive to the intellectual decline seen in depression. A study is described which addresses these issues. The distribution of global cognition was found to be normally distributed in the sample of 29 patients assessed. Based on this distribution and the scores of a control sample, the patients were classified as unimpaired, borderline or impaired. Two sets of independent comparisons were carried out. First, the unimpaired depressed patients were compared to matched non-depressed controls. Significant deficits were found on a range of neuropsychological measures covering aspects of language function, memory, both recall and recognition, attention and behavioural regulation. These same patients were also compared with two groups of matched depressed patients, with varying degrees of global cognitive impairment. In general, the cognitive measures showed a gradient of dysfunction across the three patient groups. Significant differences between the depressed groups were shown on measures of immediate recall, attention and behavioural regulation. The possible significance of attentional factors for the observed memory dysfunction is discussed.

Type
Original Articles
Information
Psychological Medicine , Volume 24 , Issue 4 , November 1994 , pp. 829 - 847
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bench, C. J., Friston, K. J., Brown, R. G., Scott, L. C., Frackowiak, R. S. J. & Dolan, R. J. (1992). The anatomy of melancholia – focal abnormalities of cerebral blood flow in major depression. Psychological Medicine 22, 607–615.CrossRefGoogle ScholarPubMed
Bench, C. J., Friston, K. J., Brown, R. G., Frackowiak, R. S. J. & Dolan, R. J. (1993). Regional cerebral blood flow in depression measured by Positron Emission Tomography: the relationship with clinical dimensions. Psychological Medicine 23, 579–590.CrossRefGoogle ScholarPubMed
Braff, D. L. & Beck, A. T. (1974). Thinking disorder in depression. Archives of General Psychiatry 31, 456–459.CrossRefGoogle ScholarPubMed
Breslow, R., Kocsis, J. & Belkin, B. (1980). Memory deficits in depression: evidence utilizing the Wechsler Memory Scale. Perceptual and Motor Skills 51, 541–542.CrossRefGoogle ScholarPubMed
Brown, J. (1958). Some tests of the decay theory of immediate memory. Quarterly Journal of Experimental Psychology 10, 12–21.Google Scholar
Calev, A. & Erwin, P. G. (1985). Recall and recognition in depressives: use of matched tests. British Journal of Clinical Psychology 24, 127–128.CrossRefGoogle Scholar
Calev, A., Korin, Y, Shapira, B., Kugelmass, S. & Lerer, B. (1986). Verbal and non-verbal recall by depressed and euthymic affective patients. Psychological Medicine 16, 789–794.CrossRefGoogle ScholarPubMed
Cohen, R. M., Weingartner, H., Smallberg, S. A., Pickar, D. & Murphy, D. L. (1982). Effort and cognition in depression. Archives of General Psychiatry 39, 593–597.CrossRefGoogle ScholarPubMed
Cole, K. D. & Zarit, S. H. (1984). Psychological deficits in depressed medical patients. Journal of Nervous and Mental Diseases 172, 150–155.CrossRefGoogle ScholarPubMed
Cornell, D. G., Suarez, R. & Berent, S. (1984). Psychomotor retardation in melancholic and non-melancholic depression: cognitive and motor components. Journal of Abnormal Psychology 93, 152–157.CrossRefGoogle Scholar
Corwin, J., Peselow, E., Feenan, K., Rotrosen, J. & Fieve, R. (1990). Disorders of decision in affective disease: an effect of β-adrenergic dysfunction. Biological Psychiatry 27, 813–833.Google Scholar
Cummings, J. L. (1986). Subcortical dementia. Neuropsychology, neuropsychiatry and pathophysiology. British Journal of Psychiatry 149, 682–697.CrossRefGoogle ScholarPubMed
Cummings, J. L. (1989). Dementia and depression: an evolving enigma. Journal of Neuropsychiatry 1, 236–242.Google ScholarPubMed
Cummings, J. L. & Benson, D. F. (1984). Subcortical dementia. Review of an emerging concept. Archives of Neurology 41, 874–879.Google Scholar
Dolan, R. J., Bench, C. J., Brown, R. G., Scott, L. C., Friston, K. J. & Frackowiak, R. S. J. (1992). Regional cerebral blood flow abnormalities in depressed patients with cognitive impairment. Journal of Neurology, Neurosurgery and Psychiatry 55, 768–773.CrossRefGoogle ScholarPubMed
Dunbar, G. C. & Lishman, W. A. (1984). Depression, recognition-memory and hedonic tone. A signal detection analysis. British Journal of Psychiatry 144, 376–382.CrossRefGoogle Scholar
Endicott, J. & Spitzer, R. L. (1978). A diagnostic interview. The Schedule for Affective Disorders and Schizophrenia. Archives of General Psychiatry 35, 837–844.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975). ‘Mini-mental state’: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189–198.Google Scholar
Frith, C. D., Stevens, M., Johnstone, E. V., Deakin, J. F. W., Lawler, P. & Crow, T. J. (1983). Effects of ECT and depression on various aspects of memory. British Journal of Psychiatry 142, 610–617.CrossRefGoogle ScholarPubMed
Golinkoff, M. & Sweeney, J. A. (1989). Cognitive impairments in depression. Journal of Affective Disorders 17, 105–112.CrossRefGoogle ScholarPubMed
Hachinski, V. C., Iliff, L. D., Zilkha, E., Du Boulay, G. H., McAllister, V. L., Marshall, J., Ross Rissell, R. W. & Symon, L. (1975). Cerebral blood flow in dementia. Archives of Neurology 32, 632–637.CrossRefGoogle ScholarPubMed
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 56–62.Google Scholar
Hart, R. P., Kwentus, J. A., Taylor, J. R. & Harkins, S. W. (1987 a). Rate of forgetting in dementia and depression. Journal of Consulting and Clinical Psychology 55, 101–105.CrossRefGoogle ScholarPubMed
Hart, R. P., Kwentus, J. A., Wade, J. B. & Hamer, R. M. (1987 b). Digit symbol performance in mild dementia and depression. Journal of Consulting and Clinical Psychology 55, 236–238.CrossRefGoogle ScholarPubMed
Hasher, L. & Zacks, R. T. (1979). Automatic and effortful processes in memory. Journal of Experimental Psychology 108, 356–388.Google Scholar
Jorm, A. F. (1986). Cognitive deficits in the depressed elderly: a review of some basic unresolved issues. Australian and New Zealand Journal of Psychiatry 20, 11–22.CrossRefGoogle ScholarPubMed
Kiloh, L. G. (1961). Pseudo-dementia. Acta Psychiatrica Scandinavica 37, 336–351.Google Scholar
Kopelman, M. D. (1986). Clinical tests of memory. British Journal of Psychiatry 148, 517–525.Google Scholar
McAllister, T. W. (1981). Cognitive functioning in the affective disorders. Comprehensive Psychiatry 22, 572–586.CrossRefGoogle ScholarPubMed
Miller, W. R. (1975). Psychological deficits in depression. Psychological Bulletin 82, 238–260.CrossRefGoogle ScholarPubMed
Miller, E. & Lewis, P. (1977). Recognition memory in elderly patients with depression and dementia: a signal detection analysis. Journal of Abnormal Psychology 86, 84–86.CrossRefGoogle ScholarPubMed
Nelson, H. E. & McKenna, P. (1975). The use of current reading ability in the assessment of dementia. British Journal of Social and Clinical Psychology 14, 259–267.CrossRefGoogle ScholarPubMed
Newman, P. J. & Sweet, J. J. (1992). Depressive Disorders. In Handbook of Neuropsychological Assessment: A Biopsychosocial Perspective (ed. Puente, A. E. and McCaffrey, R. J.), pp. 263–307. Plenum Press: New York.CrossRefGoogle Scholar
Peterson, L. R. & Peterson, M. J. (1959). Short-term retention of individual items. Journal of Experimental Psychology 58, 193–198.CrossRefGoogle Scholar
Robertson, G. & Taylor, P. J. (1985). Some cognitive correlates of affective disorders. Psychological Medicine 15, 297–309.Google Scholar
Roth, M., Tym, E., Mountjoy, C. Q., Huppert, F. A., Hendrie, H., Verma, S. & Goddard, R. (1986). CAMDEX: a standardized instrument for the diagnosis in the elderly with special reference to the early detection of dementia. British Journal of Psychiatry 149, 698–709.Google Scholar
Roth, M., Huppert, F. A., Tym, E. & Mountjoy, C. Q. (1988). CAMDEX: the Cambridge Examination for Mental Disorders of the Elderly. Cambridge University Press: Cambridge.Google Scholar
Roy-Byrne, P. P., Weingartner, H., Bierer, L. M., Thompson, K. & Post, R. M. (1986). Effortful and automatic cognitive processes in depression. Archives of General Psychiatry 43, 265–267.CrossRefGoogle ScholarPubMed
Savard, R. J., Rey, A. C. & Post, R. M. (1980). Halstead-Reitan Category Test in bipolar and unipolar affective disorders: relationship to age and phase of illness. Journal of Nervous and Mental Diseases 168, 297–304.CrossRefGoogle ScholarPubMed
Schonell, F. (1942). Backwardness in the Basic Subjects. Oliver & Boyd: London.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1977). Research Diagnostic Criteria for a Selected Group of Functional Disorders. Biometrics Research Division, New York State Psychiatric Institute: New York.Google Scholar
Spreen, O. & Benton, A. L. (1969). Neurosensory Centre Comprehensive Examination for Aphasia. Neuropsychology Laboratory, Department of Psychology, University of Victoria: Victoria, BC, Canada.Google Scholar
Sternberg, D. E. & Jarvik, M. E. (1976). Memory function in depression: improvement with antidepressant medication. Archives of General Psychiatry 33, 219–224.CrossRefGoogle Scholar
Taylor, E. M. (1959). Psychological Appraisal of Children with Cerebral Defects. Harvard University Press: Cambridge, Mass.CrossRefGoogle Scholar
Watts, F. N. & Cooper, Z. (1989). The effects of depression on structural aspects of the recall of prose. Journal of Abnormal Psychology 98, 150–153.CrossRefGoogle ScholarPubMed
Watts, F. N., Morris, L. & MacLeod, A. K. (1987). Recognition memory in depression. Journal of Abnormal Psychology 96, 273–275.Google Scholar
Watts, F. N., Dalgleish, T., Bourke, P. & Healy, D. (1990). Memory deficits in clinical depression: processing resources and the structure of materials. Psychological Medicine 20, 345–349.Google Scholar
Wechsler, D. (1945). A standardized memory scale for clinical use. Journal of Psychology 19, 87–95.CrossRefGoogle Scholar
Wechsler, D. (1986). The Wechsler Adult Intelligence Scale – Revised. Incorporating British Amendments to the Test Administration Section. The Psychological Corporation Ltd.: New York.Google Scholar
Weigl, E. (1941). On the psychology of so-called processes of abstraction. Journal of Abnormal and Social Psychology 36, 3–33.CrossRefGoogle Scholar
Weingartner, H. & Silberman, E. (1982). Models of cognitive impairment: cognitive changes in depression. Psychopharmacological Bulletin 18, 27–42.Google Scholar
Weingartner, H., Cohen, R. M., Murphy, D. L., Martello, J. & Gerdt, C. (1981). Cognitive processes in memory. Archives of General Psychiatry 38, 42–47.Google Scholar
Widlocher, D. & Hardy-Bayle, M-C. (1989). Cognition and control of action in psychopathology. European Bulletin of Cognitive Psychology 9, 1–33.Google Scholar
Willner, P. (1984). Cognitive functioning in depression: a review of theory and research. Psychological Medicine 14, 807–823.CrossRefGoogle ScholarPubMed
Wolfe, J., Granholm, E., Butters, N., Saunders, E. & Janowsky, D. (1987). Verbal memory deficits associated with major affective disorders: a comparison of unipolar and bipolar patients. Journal of Affective Disorders 13, 83–92.Google Scholar