Cognitive impairment as measured by the THINC-integrated tool (THINC-it): The association with self-reported anxiety in Major Depressive Disorder

Danielle S Cha; Nicole E Carmona; Nelson B Rodrigues; Rodrigo B Mansur; Yena Lee; Mehala Subramaniapillai; Lee Phan; Rebekah H Cha; Zihang Pan; Jae Hon Lee; JungGoo Lee; Fahad Almatham; Asem Alageel; Joshua D Rosenblat; Margarita Shekotikhina; Carola Rong; John Harrison; Roger S McIntyre

doi:10.1016/j.jad.2018.05.006

Cognitive impairment as measured by the THINC-integrated tool (THINC-it): The association with self-reported anxiety in Major Depressive Disorder

J Affect Disord. 2018 Oct 1:238:228-232. doi: 10.1016/j.jad.2018.05.006. Epub 2018 Jun 1.

Authors

Danielle S Cha¹, Nicole E Carmona¹, Nelson B Rodrigues¹, Rodrigo B Mansur¹, Yena Lee², Mehala Subramaniapillai¹, Lee Phan¹, Rebekah H Cha¹, Zihang Pan², Jae Hon Lee³, JungGoo Lee⁴, Fahad Almatham¹, Asem Alageel⁵, Joshua D Rosenblat¹, Margarita Shekotikhina¹, Carola Rong⁶, John Harrison⁷, Roger S McIntyre⁸

Affiliations

¹ Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
² Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
³ Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, Samsung Seoul Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea.
⁴ Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Paik Institute for Clinical Research, Inje University, Busan, Republic of Korea.
⁵ Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, College of Medicine, Imam University, Riyadh, Saudi Arabia.
⁶ Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; American University of Integrative Sciences School of Medicine, Sint Maarten, The Netherlands.
⁷ Alzheimer Center, VU Medical Center, Amsterdam, The Netherlands; Metis Cognition Ltd., Warminster, UK.
⁸ Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada. Electronic address: Roger.McIntyre@uhn.ca.

PMID: 29886204
DOI: 10.1016/j.jad.2018.05.006

Abstract

Background and objectives: This study evaluated the association between self-reported anxiety and objective/subjective measures of cognitive performance in adults with Major Depressive Disorder (MDD).

Methods: Acutely depressed subjects with recurrent MDD (n = 100) and age-, sex-, and education-matched healthy controls (HC; n = 100) between the ages of 18 and 65 completed the cross-sectional validation study of the THINC-integrated tool (THINC-it; ClinicalTrials.gov: NCT02508493). Objective cognitive performance was assessed using the THINC-it, and subjective cognitive impairment with the Perceived Deficits Questionnaire for Depression-5-item. Subjects also completed the Generalized Anxiety Disorder-7-item (GAD-7) questionnaire.

Results: Subjects with MDD reported significantly more anxiety symptoms, as assessed by the GAD-7, compared to HC (p < 0.001). Linear regression analysis determined that anxiety symptoms significantly accounted for 70.4% of the variability in subjective cognitive impairment, adjusting for depression severity. Moreover, subjects' ratings of the difficulties caused by their anxiety were reported as significantly more severe among subjects with MDD when compared to HC (p < 0.001). Likewise, greater self-reported difficulties with anxiety significantly predicted 57.8% of the variability in subjective cognitive impairment, adjusting for depression severity. Neither anxiety symptoms nor impairment due to anxiety symptoms predicted objective cognitive performance.

Limitations: Subjects were not prospectively verified to have a clinical diagnosis of GAD. Rather, this study examined the relationships between symptoms of generalized anxiety, assessed using a brief screening tool, and subjective and objective cognitive function.

Conclusions: Results from the current study indicate that adults with MDD and high levels of self-reported anxiety are significantly more likely to report experiencing subjective cognitive dysfunction.

Keywords: Anxiety; Cognition; Major Depressive Disorder; Measurement based care.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Anxiety / psychology
Cognition*
Cognitive Dysfunction / psychology*
Cross-Sectional Studies
Depressive Disorder, Major / psychology*
Female
Humans
Male
Mass Screening
Middle Aged
Recurrence
Regression Analysis
Self Report*
Surveys and Questionnaires
Young Adult

Associated data

ClinicalTrials.gov/NCT02508493