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

Psychol Med. 2009 Mar;39(3):393-402. doi: 10.1017/S0033291708003620. Epub 2008 Jun 4.


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 > or = 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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / physiopathology
  • Cognition Disorders / psychology
  • Depressive Disorder, Major / diagnosis*
  • Depressive Disorder, Major / physiopathology*
  • Depressive Disorder, Major / psychology
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neuropsychological Tests*
  • Outcome Assessment, Health Care
  • Patient Admission
  • Prognosis
  • Risk Factors
  • Severity of Illness Index